韩国健康相关生活质量与非传染性疾病之间的关联：一项全国代表性研究

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中文摘要

健康相关生活质量（HRQoL）是人群健康的关键指标，但其与非传染性疾病（NCDs）的关联尚未完全阐明。本研究旨在阐明韩国NCDs与HRQoL之间的关联，重点关注性别、年龄和家庭收入方面的差异。在《加强观察性流行病学研究报告》指南下，本研究使用2010年至2023年韩国国民健康与营养调查中年龄≥19岁韩国成人的数据，检验了HRQoL与NCDs之间的关联。HRQoL采用欧洲五维健康量表三水平版本（包括行动能力、自我照顾、日常活动、疼痛/不适和焦虑/抑郁）进行评估，10种主要NCDs（包括高血压、心肌梗死、卒中、血脂异常、肾脏疾病、糖尿病、骨关节炎、过敏性鼻炎、哮喘和特应性皮炎）的存在由自我报告的医生诊断确定。采用加权多因素logistic回归模型估计HRQoL与NCDs关联的加权比值比及95%置信区间。在2010年至2023年韩国国民健康与营养调查的40,985名成人（56.57%为女性）中，较低的HRQoL始终与较高的NCDs比值比相关，其中关联最强的是卒中（加权比值比1.32[95%置信区间1.27-1.38]）和骨关节炎（1.37[1.33-1.42]）。除卒中外，各NCDs均未观察到显著性别差异；卒中所致的HRQoL降低关联在男性（1.74[1.63-1.86]）中强于女性。分层结果显示，年轻成人中关联更强，尤其是30至39岁人群，其中高血压（1.37[1.09-1.72]）、心肌梗死（2.05[1.48-2.83]）、糖尿病（1.77[1.35-2.32]）、过敏性鼻炎（1.31[1.18-1.46]）和哮喘（1.31[1.18-1.46]）的比值比最高。骨关节炎（2.24[2.04-2.45]）和心肌梗死（1.59[1.42-1.77]）观察到反向社会经济梯度，其中第二高收入四分位组的关联最强。在韩国成人中，HRQoL降低与十种疾病中较高的NCDs比值比相关，且在年轻和较高收入人群中关联最强。这些发现强调HRQoL是NCD管理的有价值指标，并提示需要制定应对新出现健康差异的政策。

英文摘要

Health-related quality of life (HRQoL) is a key indicator of population health, but its association with noncommunicable diseases (NCDs) has not been fully clarified. This study aimed to clarify the association between NCDs and HRQoL in South Korea, focusing on differences by sex, age, and household income. Under Strengthening the Reporting of Observational Studies in Epidemiology guidelines, this study examined the association between HRQoL and NCDs using data from Korean adults aged ≥19 years in the Korea National Health and Nutrition Examination Survey between 2010 and 2023. HRQoL was assessed using the European Quality of Life 5 Dimensions 3 Level (for mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and the presence of 10 major NCDs, including hypertension, myocardial infarction, stroke, dyslipidemia, kidney disease, diabetes mellitus, osteoarthritis, allergic rhinitis, asthma, and atopic dermatitis, was determined by self-reported physician diagnoses. Weighted multivariate logistic regression models were used to estimate weighted odds ratios with 95% confidence intervals for the association between HRQoL and NCDs. Among 40,985 adults (56.57% females) in the Korea National Health and Nutrition Examination Survey from 2010 to 2023, lower HRQoL was consistently associated with higher odds of NCDs, with the strongest associations observed for stroke (weighted odds ratio, 1.32 [95% confidence interval, 1.27-1.38]) and osteoarthritis (1.37 [1.33-1.42]). No significant sex differences were observed across NCDs except for stroke, for which the association with reduced HRQoL was stronger in males (1.74 [1.63-1.86]) than in females. Stratified results indicated stronger associations among younger adults, particularly those aged 30 to 39 years, with the highest odds observed for hypertension (1.37 [1.09-1.72]), myocardial infarction (2.05 [1.48-2.83]), diabetes mellitus (1.77 [1.35-2.32]), allergic rhinitis (1.31 [1.18-1.46]), and asthma (1.31 [1.18-1.46]). Inverse socioeconomic gradients were observed for osteoarthritis (2.24 [2.04-2.45]) and myocardial infarction (1.59 [1.42-1.77]), with the strongest associations found in the second-highest income quartile. Decreased HRQoL was associated with higher odds of NCDs across ten conditions in Korean adults, with the strongest associations in younger and higher-income groups. These findings underscore HRQoL as a valuable indicator for NCD management and the need for policies addressing emerging health disparities.