Prospective Study
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World J Gastroenterol. Jun 14, 2014; 20(22): 7027-7033
Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.7027
Impairment of gastrointestinal quality of life in severely obese patients
Po-Jui Yu, Ju-Juin Tsou, Wei-Jei Lee, Kuo-Ting Lee, Yi-Chih Lee
Po-Jui Yu, Department of Nursing, National Taiwan University, Taipei 10617, Taiwan
Ju-Juin Tsou, Wei-Jei Lee, Department of Surgery, Min-Sheng General Hospital, Taoyuan 330, Taiwan
Kuo-Ting Lee, Department of Surgery, National Cheng-Kung University Hospiyal, Tainan 704, Taiwan
Yi-Chih Lee, Department of International Business, Chien Hsin University of Science and Technology, Taoyuan 32097, Taiwan
Author contributions: Yu PJ and Lee WJ designed the research; Tsou JJ, Lee KT, Lee YC performed the research; Yu PJ and Lee YC analyzed the data; Yu PY and Lee WJ wrote the paper.
Correspondence to: Wei-Jei Lee, Professor, Department of Surgery, Min-Sheng General Hospital, No 168, Chin-Kuo Road, Taoyuan 330, Taiwan. wjlee_obesssurg_tw@yahoo.com.tw
Telephone: +886-3-3179599-1598 Fax: +886-3-3469291
Received: November 12, 2013
Revised: January 2, 2014
Accepted: March 6, 2014
Published online: June 14, 2014
Abstract

AIM: To investigate the common gastro-intestinal symptoms and quality of life in severely obese subjects.

METHODS: We prospectively recruited 340 severely obese patients [mean age 30.5 ± 7.8 years; mean body mass index (BMI) 42.9 ± 6.1 kg/m2] and 340 healthy persons (mean BMI 23.1 ± 3.8 kg/m2) matched in sex, age, marriage and education. The quality of life was studied using a specific gastrointestinal quality of life index (GIQLI) questionnaire. The 36 items and four functional domains of the GIQLI were compared and analyzed between the groups. The possible correlation of GIQLI scores with specific clinical variables in severely obese patients was assessed by measuring Pearson’s coefficient of correlation.

RESULTS: The mean GIQLI score of severely obese patients was lower than the normal control group (108.5 ± 17.1 vs 123.2 ± 14.8, P < 0.01). Severely obese patients had decreased scores in the domains of general health, including physical (17.3 ± 6.0 vs 22.4 ± 3.1, P < 0.01), emotional (12.6 ± 4.3 vs 16.6 ± 3.1, P < 0.01) and social function (14.7 ± 3.9 vs 17.9 ± 2.5, P < 0.01), and in the domain of gastrointestinal symptoms (63.9 ± 6.7 vs 66.3 ± 7.2, P < 0.05). A significantly decreased score was found in nine items, and there was an increased score in one out of the 19 items in the domain of symptoms of the GIQLI questionnaire. The decreased score in the domain of symptoms was correlated with increasing glycosylated hemoglobin (HbA1c) levels.

CONCLUSION: Severe obesity resulted in a significant impairment of the quality of life and caused specific gastrointestinal symptoms compared with normal controls. The development of gastrointestinal symptoms is correlated increasing HbA1c, suggesting that a poor control of hyperglycemia might be the etiology.

Keywords: Severe obesity, Quality of life, Gastro-intestinal symptoms, Glycosylated hemoglobin

Core tip: This study found that the severely obese patients had a significant impaired general quality of life, including social, emotional and physical domain. This finding is similar to previous studies and supports the role of bariatric surgery in treating this group of patients. Although the impairment of the specific gastrointestinal quality of life is not as high as the general quality of life, this study did detect a significant impairment in 9 (47%) out of 19 specific gastrointestinal symptoms. The arousing of these annoying gastrointestinal symptoms is interesting and deserves further investigation.