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Evaluation of health-related quality of life in adults with and without dyslipidaemia in rural areas of central China

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Abstract

Purpose

Dyslipidaemia is a common chronic disease in China but is among the list of diseases treated by basic public health services. In this study, we aimed to use the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) and visual analogue scale (VAS) to compare differences in health-related quality of life (HRQoL) between dyslipidaemic and non-dyslipidaemic individuals in rural China and to explore possible causes for the underlying differences.

Methods

This study examined 10,115 participants from 22 rural communities in Xinxiang County, Henan Province, China. The study participants were interviewed between March and June 2017. Generalised linear and Tobit regression models were used to analyse factors affecting participants’ HRQoL.

Results

Of 10,115 participants, 4355 had dyslipidaemia. The mean utility index was 0.953 (standard deviation = 0.119). Pain/discomfort (20.83%) and problems with mobility (15.91%) and self-care (3.75%) were frequently reported. Regression models revealed that patients with low utility index scores were older, ex-smokers, non-tea drinkers, and less active, consumed less fruit, lived in areas with a low socioeconomic status; and were less educated. Patients also had poorer sleep quality and mental health scores and suffered from chronic diseases. Cohen’s D effect size for age, sleep quality, non-communicable diseases, and depression was ≥ 0.4.

Conclusion

The prevalence rate of dyslipidaemia was 43.05%, and it was correlated with a lower HRQoL. Age, sleep quality, non-communicable diseases, and depression may be significant predictors of the utility index and VAS scores. Patients were unaware of the risks of dyslipidaemia caused by an unhealthy lifestyle.

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Data availability

The data used are under license for the current study. They are not publicly available.

References

  1. Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., et al. (2016). 2016 ESC/EAS guidelines for the management of dyslipidaemias. The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) developed with the special contribution of the European Association for cardiovascular prevention & rehabilitation (EACPR). Atherosclerosis,253, 281–344.

    CAS  PubMed  Google Scholar 

  2. Jellinger, P. S., Handelsman, Y., Rosenblit, P. D., Bloomgarden, Z. T., Fonseca, V. A., Garber, A. J., et al. (2017). American association of clinical endocrinologists and American College of endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease—Executive summary. Endocrine Practice,23(4), 479–497.

    PubMed  Google Scholar 

  3. Wang, Z., Wang, X., Hao, G., Chen, Z., Zhang, L., Shao, L., et al. (2019). A national study of the prevalence and risk factors associated with peripheral arterial disease from China: The China Hypertension Survey, 2012–2015. International Journal of Cardiology,275, 165–170.

    PubMed  Google Scholar 

  4. de la Sierra, A., Pinto, X., Guijarro, C., Miranda, J. L., Callejo, D., Cuervo, J., et al. (2015). Prevalence, treatment, and control of hypercholesterolemia in high cardiovascular risk patients: Evidences from a systematic literature review in Spain. Advances in Therapy,32(10), 944–961.

    PubMed  PubMed Central  Google Scholar 

  5. Moran, A., Gu, D., Zhao, D., Coxson, P., Wang, Y. C., Chen, C. S., et al. (2010). Future cardiovascular disease in china: Markov model and risk factor scenario projections from the coronary heart disease policy model-china. Circulation,3(3), 243–252.

    PubMed  Google Scholar 

  6. Pan, L., Yang, Z. H., Wu, Y., Yin, R. X., Liao, Y. H., Wang, J. W., et al. (2016). The prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis,248, 2–9.

    CAS  PubMed  Google Scholar 

  7. Zhou, J. M., Ren, Y. C., Wang, C. J., Li, L. L., Zhang, L., Wang, B. Y., et al. (2018). Association of change in waist circumference and dyslipidaemia risk: The rural Chinese cohort study. Diabetes/Metabolism Research and Reviews,34(1), e2949.

    Google Scholar 

  8. Karimi, M., & Brazier, J. (2016). Health, health-related quality of life, and quality of life: What is the difference? Pharmacoeconomics,34(7), 645–649.

    PubMed  Google Scholar 

  9. Alonso, J., Ferrer, M., Gandek, B., Ware, J. E., Jr., Aaronson, N. K., Mosconi, P., et al. (2004). Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Quality of Life Research,13(2), 283–298.

    PubMed  Google Scholar 

  10. Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., et al. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research,22(7), 1717–1727.

    CAS  PubMed  Google Scholar 

  11. Yao, Q., Liu, C., Zhang, Y., & Xu, L. (2019). Changes in health-related quality of life of Chinese populations measured by the EQ-5D-3 L: a comparison of the 2008 and 2013 National Health Services Surveys. Health and Quality of Life Outcomes,17(1), 43.

    PubMed  PubMed Central  Google Scholar 

  12. Rencz, F., Gulacsi, L., Drummond, M., Golicki, D., Prevolnik Rupel, V., Simon, J., et al. (2016). EQ-5D in Central and Eastern Europe: 2000–2015. Quality of Life Research,25(11), 2693–2710.

    PubMed  Google Scholar 

  13. Liu, X., Yu, S., Mao, Z., Li, Y., Zhang, H., Yang, K., et al. (2018). Dyslipidemia prevalence, awareness, treatment, control, and risk factors in Chinese rural population: The Henan rural cohort study. Lipids in Health and Disease,17(1), 119.

    PubMed  PubMed Central  Google Scholar 

  14. Liu, X., Mao, Z., Li, Y., Wu, W., Zhang, X., Huo, W., et al. (2019). The Henan Rural Cohort: A prospective study of chronic non-communicable diseases. International Journal of Epidemiology. https://doi.org/10.1093/ije/dyz039.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hiscock, R., Judge, K., & Bauld, L. (2011). Social inequalities in quitting smoking: What factors mediate the relationship between socioeconomic position and smoking cessation? Journal of Public Health,33(1), 39–47.

    PubMed  Google Scholar 

  16. Tsang, H. H. L., Cheung, J. P. Y., Wong, C. K. H., Cheung, P. W. H., Lau, C. S., & Chung, H. Y. (2019). Psychometric validation of the EuroQoL 5-dimension (EQ-5D) questionnaire in patients with spondyloarthritis. Arthritis Research and Therapy,21(1), 41.

    PubMed  Google Scholar 

  17. Liu, G. G., Wu, H., Li, M., Gao, C., & Luo, N. (2014). Chinese time trade-off values for EQ-5D health states. Value Health,17(5), 597–604.

    PubMed  Google Scholar 

  18. Luo, N., Liu, G., Li, M., Guan, H., Jin, X., & Rand-Hendriksen, K. (2017). Estimating an EQ-5D-5L value set for China. Value Health,20(4), 662–669.

    PubMed  Google Scholar 

  19. Zhuo, L., Xu, L., Ye, J., Sun, S., Zhang, Y., Burstrom, K., et al. (2018). Time trade-off value set for EQ-5D-3L based on a Nationally Representative Chinese Population Survey. Value Health,21(11), 1330–1337.

    PubMed  Google Scholar 

  20. Janssen, M. F., Bonsel, G. J., & Luo, N. (2018). Is EQ-5D-5L better than EQ-5D-3L? A head-to-head comparison of descriptive systems and value sets from seven Countries. Pharmacoeconomics,36(6), 675–697.

    PubMed  PubMed Central  Google Scholar 

  21. Nolan, C. M., Longworth, L., Lord, J., Canavan, J. L., Jones, S. E., Kon, S. S., et al. (2016). The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference. Thorax,71(6), 493–500.

    PubMed  PubMed Central  Google Scholar 

  22. Sun, S., Chen, J., Johannesson, M., Kind, P., Xu, L., Zhang, Y., et al. (2011). Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Quality of Life Research,20(3), 309–320.

    PubMed  Google Scholar 

  23. Tierney, M., Fraser, A., & Kennedy, N. (2015). Criterion validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) for use in patients with rheumatoid arthritis: comparison with the sense wear armband. Physiotherapy,101(2), 193–197.

    CAS  PubMed  Google Scholar 

  24. Farrahi Moghaddam, J., Nakhaee, N., Sheibani, V., Garrusi, B., & Amirkafi, A. (2012). Reliability and validity of the persian version of the pittsburgh sleep quality index (PSQI-P). Sleep Breath,16(1), 79–82.

    PubMed  Google Scholar 

  25. Ye, Q., Hong, X., Wang, Z., Yang, H., Chen, X., Zhou, H., et al. (2016). Reproducibility and validity of an FFQ developed for adults in Nanjing, China. British Journal of Nutrition,115(5), 887–894.

    CAS  PubMed  Google Scholar 

  26. Blakely, T. (2012). What socioeconomic factors shall I measure and include in my analyses? Journal of Primary Health Care,4(4), 268–270.

    PubMed  Google Scholar 

  27. Jia, W. P. (2015). Obesity in China: Its characteristics, diagnostic criteria, and implications. Frontiers of Medicine,9(2), 129–133.

    PubMed  Google Scholar 

  28. Dobbelsteyn, C. J., Joffres, MacLean, & Flowerdew, G. A. (2001). A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. International Journal of Obesity,25(5), 652–661.

    CAS  PubMed  Google Scholar 

  29. Liu, L. S. (2019). 2018 Chinese guidelines for prevention and treatment of hypertension-A report of the revision Committee of Chinese guidelines for prevention and treatment of hypertension. Journal of Geriatric Cardiology,16(3), 182–241.

    Google Scholar 

  30. Richardson, L. P., Rockhill, C., Russo, J. E., Grossman, D. C., Richards, J., McCarty, C., et al. (2010). Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics,125(5), E1097–E1103.

    PubMed  PubMed Central  Google Scholar 

  31. Yu, X. N., Stewart, S. M., Wong, P. T. K., & Lam, T. H. (2011). Screening for depression with the Patient Health Questionnaire-2 (PHQ-2) among the general population in Hong Kong. Journal of Affective Disorders,134(1–3), 444–447.

    PubMed  Google Scholar 

  32. Fritz, M. S., Taylor, A. B., & Mackinnon, D. P. (2012). Explanation of two anomalous results in statistical mediation analysis. Multivariate Behavorial Research,47(1), 61–87.

    Google Scholar 

  33. Zhao, W. H., Zhang, J., Zhai, Y., You, Y., Man, Q. Q., Wang, C. R., et al. (2007). Blood lipid profile and prevalence of dyslipidemia in Chinese adults. Biomedical and Environmental Sciences,20(4), 329–335.

    CAS  PubMed  Google Scholar 

  34. Ge, P., Dong, C., Ren, X., Weiderpass, E., Zhang, C., Fan, H., et al. (2015). The high prevalence of low HDL-cholesterol levels and dyslipidemia in rural populations in Northwestern China. PLoS ONE,10(12), e0144104.

    PubMed  PubMed Central  Google Scholar 

  35. DALYs, G. B. D., & Collaborators, H. (2017). Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet,390(10100), 1260–1344.

    Google Scholar 

  36. Wang, H., Yip, W., Zhang, L., & Hsiao, W. C. (2009). The impact of rural mutual health care on health status: Evaluation of a social experiment in rural China. Health Economics,18(Suppl 2), S65–S82.

    PubMed  Google Scholar 

  37. Knight, J., Song, L., & Gunatilaka, R. (2009). Subjective well-being and its determinants in rural China. China Economic Review,20(4), 635–649.

    Google Scholar 

  38. Han, C. (2015). Explaining the subjective well-being of urban and rural Chinese: Income, personal concerns, and societal evaluations. Social Science Research,49, 179–190.

    PubMed  Google Scholar 

  39. Cai, F. (2012). The elderly and old age support in rural China. Washington, D.C.: World Bank.

    Google Scholar 

  40. Liu, H., Han, X., Xiao, Q., Li, S., & Feldman, M. W. (2015). Family structure and quality of life of elders in rural China: The role of the new rural social pension. Journal of Aging & Social Policy,27(2), 123–138.

    Google Scholar 

  41. Tian, M., Wang, H., Tong, X., Zhu, K., Zhang, X., & Chen, X. (2015). Essential public health services’ accessibility and its determinants among adults with Chronic Diseases in China. PLoS ONE,10(4), e0125262.

    PubMed  PubMed Central  Google Scholar 

  42. Crowe-White, K., Parrott, J. S., Stote, K. S., Gutschall, M., Benson-Davies, S., Droke, E., et al. (2017). Metabolic impact of 100% fruit juice consumption on antioxidant/oxidant status and lipid profiles of adults: An evidence-based review. Critical Reviews in Food Science and Nutrition,57(1), 152–162.

    CAS  PubMed  Google Scholar 

  43. Yuan, C., Lee, H. J., Shin, H. J., Stampfer, M. J., & Cho, E. (2015). Fruit and vegetable consumption and hypertriglyceridemia: Korean National Health and Nutrition Examination Surveys (KNHANES) 2007–2009. European Journal of Clinical Nutrition,69(11), 1193–1199.

    CAS  PubMed  Google Scholar 

  44. Bornhoeft, J., Castaneda, D., Nemoseck, T., Wang, P. W., Henning, S. M., & Hong, M. Y. (2012). The protective effects of green Tea polyphenols: Lipid profile, inflammation, and antioxidant capacity in rats fed an atherogenic diet and dextran sodium sulfate. Journal of Medicinal Food,15(8), 726–732.

    CAS  PubMed  Google Scholar 

  45. Yi, D., Tan, X., Zhao, Z., Cai, Y., Li, Y., Lin, X., et al. (2014). Reduced risk of dyslipidaemia with oolong tea consumption: A population-based study in southern China. British Journal of Nutrition,111(8), 1421–1429.

    CAS  PubMed  Google Scholar 

  46. Igarashi, Y., Obara, T., Ishikuro, M., Matsubara, H., Shigihara, M., Metoki, H., et al. (2017). Randomized controlled trial of the effects of consumption of ‘Yabukita’ or ‘Benifuuki’ encapsulated tea-powder on low-density lipoprotein cholesterol level and body weight. Food & Nutrition Research,61(1), 1334484.

    Google Scholar 

  47. Kraus, W. E., Houmard, J. A., Duscha, B. D., Knetzger, K. J., Wharton, M. B., McCartney, J. S., et al. (2002). Effects of the amount and intensity of exercise on plasma lipoproteins. New England Journal of Medicine,347(19), 1483–1492.

    CAS  PubMed  Google Scholar 

  48. Kessler, H. S., Sisson, S. B., & Short, K. R. (2012). The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Medicine,42(6), 489–509.

    PubMed  Google Scholar 

  49. Liang, Z. R., Zhang, T. T., Lin, T. F., Liu, L. S., Wang, B. Y., Fu, A. Z., et al. (2019). Health-related quality of life among rural men and women with hypertension: Assessment by the EQ-5D-5L in Jiangsu, China. Quality of Life Research,28(8), 2069–2080.

    PubMed  Google Scholar 

  50. Taype-Rondan, A., Abbs, E. S., Lazo-Porras, M., Checkley, W., Gilman, R. H., Smeeth, L., et al. (2017). Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru. Quality of Life Research,26(12), 3439–3447.

    PubMed  PubMed Central  Google Scholar 

  51. Kohansieh, M., Makaryus, A. N. (2015) Sleep deficiency and deprivation leading to cardiovascular disease. International Journal of Hypertension

  52. van Reedt Dortland, A. K., Giltay, E. J., van Veen, T., Zitman, F. G., & Penninx, B. W. (2013). Longitudinal relationship of depressive and anxiety symptoms with dyslipidemia and abdominal obesity. Psychosomatic Medicine,75(1), 83–89.

    PubMed  Google Scholar 

  53. Mouhamed, D. H., Ezzaher, A., Neffati, F., Gaha, L., Douki, W., & Najjar, M. F. (2013). Association between cigarette smoking and dyslipidemia. Immuno-Analyse & Biologie Specialisee,28(4), 195–200.

    Google Scholar 

  54. Kuwabara, M., Kuwabara, R., Niwa, K., Hisatome, I., Smits, G., Roncal-Jimenez, C. A., et al. (2018). Different risk for hypertension, diabetes, dyslipidemia, and hyperuricemia according to level of body mass index in Japanese and American Subjects. Nutrients,10(8), 1011.

    PubMed Central  Google Scholar 

  55. Sun, G. Z., Li, Z., Guo, L., Zhou, Y., Yang, H. M., & Sun, Y. X. (2015). High prevalence of dyslipidemia and associated risk factors among rural Chinese adults. Journal of the American College of Cardiology,66(16), C124–C124.

    Google Scholar 

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Funding

National Key Research and Development Program of China (2016YFC0900803; 2017YFD0400301).

Author information

Authors and Affiliations

  1. School of Public Health, Tianjin Medical University, Tianjin, China

    Hui Wu & Naijun Tang

  2. School of Public Health, Xinxiang Medical University, Xinxiang, China

    Hui Wu, Huijun Li, Haibin Li, Yu Ding & Guicheng Zhang

  3. Henan Province General Medical Educations and Research Center, Xinxiang, China

    Hui Wu, Yu Ding & Weidong Wu

  4. School of Public Health, Zhengzhou University, Zhengzhou, China

    Chongjian Wang

  5. School of Public Health, Curtin University, Perth, Australia

    Guicheng Zhang

  6. Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China

    Naijun Tang

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  1. Hui Wu
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  4. Yu Ding
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Contributions

HW analysed the data and wrote the paper. WW designed the study. NT corrected the manuscript. All authors participated in data analysis and read and approved the final version of this manuscript for submission for publication.

Corresponding authors

Correspondence to Naijun Tang or Weidong Wu.

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The authors declare no conflicts of interest.

Ethical approval

Ethical approval was obtained from the “Xinxiang Medical University Life Science Ethics Committee.” Ethics approval code: [2016] MEC (S128).

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Informed consent was obtained from all individual participants included in the study.

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Wu, H., Li, H., Li, H. et al. Evaluation of health-related quality of life in adults with and without dyslipidaemia in rural areas of central China. Qual Life Res 29, 925–939 (2020). https://doi.org/10.1007/s11136-019-02336-0

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