Obesity and health-related quality of life in adolescents from ethnic groups of rural areas of Buryatia, Russia

Objectives. To assess the impact of obesity on health-related quality of life (HRQoL) in Mongolian and Caucasian adolescents living in rural areas of Buryatia, Russia.

Materials and methods. The study included 77 overweight and obese adolescents aged 11–17 years from rural areas of Buryatia, Russia. Forty-six of them were Mongolians (13 were Soyots (minor ethnic group), 33 were Buryats) and 31 were Caucasians. To compare, we recruited seventy-three adolescents from the same community-based sample with normal weight, comparable with the overweight group in gender, age and race/ ethnos.

Height, weight and waist circumference were objectively measured using standardized methods. BMI and waist circumference Z-scores were calculated using the age and sex specific reference. HRQoL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.

Results. Being overweight was associated with poorer adolescent-reported HRQoL totals and in each domain in comparison with the control group of Caucasian adolescents (all р < 0.01), but not Mongolians.

Subgroup analysis for overweight adolescents indicated that after controlling for gender, age, Tanner stage of adolescents, education and social status of their mothers, HRQoL scores were significantly lower in the Caucasians compared with the Mongolians regardless of BMI z-score in all domains. Moreover, abdominal obesity was independently associated with poorer scores in the domains of emotional (β = –0.26; р = 0.018), school (β = –0.23; р = 0.03) and psychosocial (β = –0.24; р = 0.028) functioning and total HRQoL scores  (β = –0.22; р = 0.04).

Conclusion. In the rural community-based sample, overweight Caucasian adolescents have significantly poorer HRQoL than their non-overweight peers of the same race, and they have worse HRQoL than obese Mongolian adolescents with comparable anthropometric characteristics.

When developing health improvement programs for adolescents from rural Buryatia, it should be considered that the improvement of quality of life may become a good motivation to lose weight for Caucasian adolescents but not for Mongolian adolescents.

obesity, overweight, adolescents, children, health-related quality of life, ethnos, race

1. Ng M., Fleming T., Robinson M. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384 (9945): 766–781. DOI: 10.1016/S01406736(14)60460-8.

2. Tutel’yan V.L., Baturin A.K., Kon’ I.Ya., Martinchik A.N., Uglitskikh A.K., Korosteleva M.M., Toboleva M.A., Aleshina I.V. Prevalence of overweight and obesity in child population of Russia: multicenter study. Pediatriya im. A.N. Speranskogo – Pediatriya named after G.N. Speransky. 2014; 93 (5): 28–31 (in Russ.).

3. Daniels S.R. Complications of obesity in children and adolescents. Int. J. Obes (Lond). 2009; 33(Suppl. 1): S60– 65. DOI: 10.1038/ijo.2009.20.

4. Arroyo-Johnson C., Mincey K.D. Obesity Epidemiology Worldwide. Gastroenterol Clin. North. Am. 2016; 45 (4): 571–579. DOI: 10.1016/j.gtc.2016.07.012.

5. Sjöberg R.L., Nilsson K.W., Leppert J. Obesity, shame, and depression in school-aged children: a populationbased study. Pediatrics. 2005; 116 (3): e389–392. DOI: 10.1542/peds.2005-0170.

6. De Beer M., Hofsteenge G.H., Koot H. et al. Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr. 2007; 96: 710–714.

7. Aver’yanov A.P., Bolotova N.V., Andriyanova G.A., Zotova Yu.A. An еvaluation of the life quality of obese children. Voprosy detskoy dietologii – Pediatric Nutrition. 2006; 4 (6): 14–16 (in Russ.).

8. Akhmedova R.M., Sofronova L.V. Children obesity: life quality assessment. Meditsinskiy al’manakh – Medical Almanac. 2012; 5 (24): 122–124 (in Russ.).

9. Bespalova I.D., Bychkov V.A., Kalyuzhin V.V., Ryazantseva N.V., Medyantsev Yu.A., Osikhov I.A., Murashev B.Yu. Quality of life of hypertensive patients with metabolic syndrome: interrelation with markers of systemic inflammation. Byulleten’ sibirskoy meditsiny – Bulletin of Siberian Medicine. 2013; 12 (6): 5–15(in Russ.).

10. Guseva A.A., Gurova M.M. The state of the hepatobiliary system, metabolic characteristics and the quality of life in overweight and obese children. Voprosy detskoy dietologii – Pediatric Nutrition. 2013; 11 (2): 24–28 (in Russ.).

11. Kartseva T.V., Kazanina O.N. Health and life quality of children and adolescents with obesity. Palliativnaya meditsina i reabilitatsiya – Palliative Care and Rehabilitation. 2008; 1: 5–10 (in Russ.).

12. Ushakova S.A. The influence of risk factors of noncommunicable diseases on life quality of high schoolage girls. Meditsinskaya nauka i obrazovanie Urala – Medical Science and Eeducation of Urals. 2016; 17 (3): 31–35 (in Russ.).

13. Herranz Barbero A., Lуpez de Mesa M.R., Azcona San Julián C. Influence of excess weight on the health-related quality of life in adolescents. An Pediatr (Barc). 2015; 82 (3): 131–138. DOI: 10.1016/j.anpedi.2014.06.019.

14. Keating C.L., Moodie M.L., Swinburn B.A. The health-related quality of life of overweight and obese adolescents – a study measuring body mass index and adolescent-reported perceptions. Int. J. Pediatr. Obes. 2011; 6 (5–6): 434–441. DOI: 10.3109/17477166.2011.590197.

15. Lin C.Y., Su C.T., Wang J.D., Ma H.I. Self-rated and parent-rated quality of life (QoL) for community-based obese and overweight children. Acta Paediatr. 2013; 102 (3): e114–119. DOI: 10.1111/apa.12108.

16. Ottova V., Erhart M., Rajmil L. et al. Overweight and its impact on the health-related quality of life in children and adolescents: results from the European KIDSCREEN survey. Qual. Life Res. 2012; 21 (1): 59–69. DOI: 10.1007/s11136-011-9922-7.

17. Wille N., Bullinger M., Holl R. et al. Health-related quality of life in overweight and obese youths: results of a multicenter study. Health Qual. Life Outcomes. 2010; 8: 36. DOI: 10.1186/1477-7525-8-36.

18. Williams J., Wake M., Hesketh K. et al. Health-related quality of life of overweight and obese children. JAMA. 2005; 293 (1): 70–76. DOI: 10.1001/jama.293.1.70.

19. Faus A.L., Turchi R.M., Polansky M., Berez A., Leibowitz K.L. Health-related quality of life in overweight/ obese children compared with children with inflammatory bowel disease. Clin. Pediatr (Phila). 2015; 54 (8): 775–782. DOI: 10.1177/0009922814562555.

20. Schwimmer J.B., Burwinkle T.M., Varni J.W. Healthrelated quality of life of severely obese children and adolescents. JAMA. 2003; 289 (14): 1813–1819. DOI: 10.1001/jama.289.14.1813.

21. Trevino R., Pham T., Edelstein S. Obesity and preference-weighted quality of life of ethnically diverse middle school children: the HEALTHY study. J Obes. 2013; 206074. DOI: 10.1155/2013/206074.

22. Fallon E.M., Tanofsky-Kraff M., Norman A.C., McDuffie J.R., Taylor E.D., Cohen M.L., Young-Hyman D., Keil M., Kolotkin R.L., Yanovski J.A. Health-related quality of life in overweight and nonoverweight black and white adolescents. J. Pediatr. 2005; 147 (4): 443–450. DOI: 0.1016/j.jpeds.2005.05.039.

23. Radhakishun N.N., de Wit M., van Vliet M., von Rosenstiel I.A., Beijnen J.H., Brandjes D.P., Diamant M. Impaired quality of life in treatment-seeking obese children of Dutch, Moroccan, Turkish and Surinamese descent. Public Health Nutr. 2016; 19 (5): 796–803. DOI: 10.1017/S1368980015002074.

24. Denisova R.V., Alekseeva E.I., Al’bitskiy V.Yu., Vinyarskaya I.V., Valieva S.I., Bzarova T.M., Lisitsyn A.O., Gudkova E.Yu. Reliability, validity and sensitivity of Russian versions of PedsQL generic core scale and PedsQL Rheumatology Module Questionnaires. Voprosy sovremennoy pediatrii – Current Pediatrics. 2009; 8 (1): 30–40 (in Russ.).

25. Wallander J.L., Kerbawy S., Toomey S., Lowry R., Elliott M.N., Escobar-Chaves S.L., Franzini L., Schuster M.A. Is obesity associated with reduced health-related quality of life in Latino, black and white children in the community? Int. J. Obes (Lond). 2013; 37 (7): 920–925. DOI: 10.1038/ijo.2013.31.

26. Petersen S., Moodie M., Mavoa H., Waqa G., Goundar R., Swinburn B. Relationship between overweight and health-related quality of life in secondary school children in Fiji: results from a cross-sectional population-based study. Int. J. Obes (Lond). 2014; 38 (4): 539–546. DOI: 10.1038/ijo.2013.212.

27. Boodai S.A., Reilly J.J. Health related quality of life of obese adolescents in Kuwait. BMC Pediatr. 2013; 13 (1): 105. DOI: 10.1186/1471-2431-13-105.

28. Cui-ling W., Yu-ming C., Zhong-lin Z., Wei-qing C., Jian-ping W., Wen-heng Z., Jiang-nan W., Yu-ming C., Zhonglin Z., Wei-qing C. et al. Impact of obesity on health-related quality of life in elementary school children. Maternal and Child Health Care China. 2007; 36: 5148–5150.

29. Liu W., Lin R., Liu W., Guo Zh., Xiong L., Li B., Cheng K.K., Adab P., Pallan M. Relationship between weight status and health-related quality of life in Chinese primary school children in Guangzhou: a cross-sectional study. Health Qual. Life Outcomes. 2016; 14: 166. DOI: 10.1186/s12955-016-0567-7.

30. Kesztyüs D., Schreiber A., Kobel S., Wartha O., Kesztyüs T., Kilian R., Steinacker J.M. Illness and determinants of health-related quality of life in a cross-sectional sample of schoolchildren in different weight categories. Ger. Med. Sci. 2014; 12: 04. DOI: 10.3205/000189.

31. Morrison K.M., Shin S., Tarnopolsky M., Taylor V.H. Association of depression & health related quality of life with body composition in children and youth with obesity. J. Affect Disord. 2015; 172: 18–23. DOI: 10.1016/j.jad.2014.09.014.

32. Aparicio E., Canals J., Voltas N., Hernández-Martínez C., Arija V. Emotional psychopathology and increased adiposity: Follow-up study in adolescents. J. Adolesc. 2013; 36 (2): 319–330. DOI: 10.1016/j.adolescence.2012.12.003.

33. Taylor V.H., Macqueen G.M. The role of adipokines in understanding the associations between obesity and depression. J. Obes. 2010; pii: 748048. DOI: 10.1155/2010/748048.