Impairment of gastrointestinal quality of life in severely obese patients

Table 1 Demographics of patients and normal controls n (%)

Demographics	Severe obesity	Normal control	P value
	(n = 340)	(n = 340)
Age (mean ± SD)	30.5 ± 7.8	31.6 ± 8.6	NS
Sex ratio (F/M)	270:70	270:70	NS
BMI (kg/m2)	42.9 ± 6.1	23.1 ± 3.8	< 0.001
Marriage (Y/N)	159:181	163:177	NS
Education (College)	238 (70)	252 (74)	NS

BMI: Body mass index; NS: Not significant; BP: Blood pressure; F: Female; M: Male.

Table 2 Distribution of co-morbidities in severely obese patients n (%)

Distribution	Severe obesity (n = 340)
Hypertension
SBP > 130 mmHg	221 (65.1)
DBP > 85 mmHg	170 (50.0)
Hyperglycemia (FPG > 100 mg/dL)	148 (43.5)
Hyper TG ( TG > 150 mg/dL)	162 (47.0)
HDL-C (male) < 40 mg/dL	28 (40.5)
HDL-C (female) < 50 mg/dL	175 (64.8)
Diabetes (HbA1c > 6.5)	64 (18.8)

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; TG: Triglycerides; HDL-C: High-density lipoprotein cholesterol.

Table 3 Total gastrointestinal quality of life and domain scores n (%)

GIQLI	Severe obesity	Normal control	Difference	P value
Overall	108.5 ± 17.1	123.2 ± 14.8	14.7 (11.9)	< 0.01
Symptoms	63.9 ± 6.7	66.3 ± 7.2	2.4 (3.6)	< 0.05
Physical	17.3 ± 6.0	22.4 ± 3.1	5.1 (22.8)	< 0.01
Emotional	12.6 ± 4.3	16.6 ± 3.1	4.0 (24.1)	< 0.01
Social	14.7 ± 3.9	17.9 ± 2.5	5.2 (29.0)	< 0.01

GIQLI: Gastrointestinal quality of life.

Table 4 Items in the questionnaire of gastrointestinal quality-of-life index and scores in each item

Item	Morbid obesity	Normal control	P value
Symptoms
Abdominal pain	3.4 ± 0.7	3.4 ± 0.7	NS
Feeling of abdominal fullnessb	2.7 ± 1.0	3.1 ± 0.9
Abdominal bloating (too much gas)	3.2 ± 0.9	3.1 ± 1.0	NS
Trouble with flatulence	3.1 ± 1.0	3.1 ± 0.9	NS
Trouble with burping or belching	3.4 ± 0.8	3.5 ± 0.8	NS
Trouble with gurgling abdominal noisesb	3.6 ± 0.6	3.4 ± 0.8
Trouble with bowel frequency	3.4 ± 0.8	3.5 ± 0.8	NS
Enjoyed eatingb	2.0 ± 1.1	2.5 ± 1.1
Need for restricted eatingb	2.9 ± 1.1	3.4 ± 0.9
Regurgitationa	3.5 ± 0.8	3.7 ± 0.7
Trouble with slow speed of eatingb	3.6 ± 0.7	3.8 ± 0.5
Trouble with dysphagia	3.8 ± 0.5	3.9 ± 0.1	NS
Trouble with bowel urgencya	3.7 ± 0.6	3.8 ± 0.5
Trouble with diarrheab	3.3 ± 0.8	3.5 ± 0.8
Trouble with constipation	3.4 ± 0.9	3.5 ± 0.8	NS
Trouble with nausea	3.5 ± 0.7	3.6 ± 0.7	NS
Trouble with blood in stool	3.8 ± 0.5	3.8 ± 0.5	NS
Trouble with heartburna	3.6 ± 0.8	3.7 ± 0.8
Trouble with incontinencea	3.9 ± 0.2	4.0 ± 0.2
Emotional items
Coping with every day stress	2.5 ± 0.8	2.6 ± 0.8	NS
Sadness about illnessb	2.5 ± 1.2	3.4 ± 1.1
Nervousness or anxious about illnessb	2.8 ± 1.1	3.3 ± 0.8
Happiness with life in generalb	2.3 ± 1.1	2.8 ± 1.0
Frustration about illnessb	2.5 ± 1.2	3.5 ± 0.8
Physical items
Trouble with fatigue	2.7 ± 1.1	2.8 ± 1.0	NS
Feeling unwell	2.8 ± 0.9	2.9 ± 0.9	NS
Wake-up at nightb	3.1 ± 1.1	3.4 ± 0.9
Trouble with changes in appearanceb	2.1 ± 1.4	3.6 ± 0.7
Loss of physical strengthb	2.1 ± 1.2	3.4 ± 0.8
Loss of endurance through illnessb	2.1 ± 1.2	3.1 ± 1.0
Feeling unfitb	2.2 ± 1.2	3.2 ± 1.0
Social items
Coping with daily activitiesb	2.8 ± 1.1	3.5 ± 0.8
Taking part in leisure activitiesb	2.8 ± 1.1	3.3 ± 1.0
Bothered by medical treatmentb	2.8 ± 1.0	3.7 ± 0.6
Trouble of personal relationshipb	3.3 ± 1.0	3.6 ± 0.7
Sexual life impairmentb	3.0 ± 1.2	3.8 ± 0.6

^aP < 0.05,

^bP < 0.01 vs preoperative data. NS: Not significant.

Table 5 Pearson correlation coefficients analysis between clinical and laboratory data and scores of different domains in the gastrointestinal quality-of-life index

Clinical and laboratory items	Total Score	Physical domain	Emotional domain	Social domain	Symptoms
	(36 items)	(7 items)	(5 items)	(5 items)	(19 items)
Age (yr)	-0.1353	-0.1262	-0.1543	-0.1773	NS
Sex	0.1472	0.1523	0.1983	0.1893	NS
BMI (BMI > 35 kg/m2)	0.1151	NS	0.1442	0.1221	NS
Weight (kg)	NS	NS	NS	NS	NS
Waist circumference (cm)	NS	NS	NS	NS	NS
Waist:hip ratio	NS	NS	NS	NS	NS
Systolic blood pressure	NS	NS	NS	NS	NS
Diastolic blood pressure	NS	NS	NS	NS	NS
Fasting glucose (mmol/L)	NS	NS	NS	NS	NS
HbA1c	NS	NS	NS	NS	-0.1762
Fasting insulin (mU/L)	NS	NS	NS	NS	NS
C-Peptide (pmol/mL)	NS	NS	NS	NS	NS
Total cholesterol (mmol/L)	NS	NS	NS	NS	NS
HDL cholesterol (mmol/L)	NS	NS	NS	NS	NS
Fasting triglyceride (mmol/L)	NS	NS	NS	NS	NS
Total protein (g/L)	NS	NS	NS	NS	NS
Albumin (g/L)	NS	NS	NS	NS	0.0941
ALT	NS	NS	NS	NS	NS
AST	NS	NS	NS	NS	NS
Alkaline phosphatase	NS	NS	NS	NS	NS
HSCRP	NS	NS	NS	NS	NS
WBC	NS	NS	NS	NS	NS
Hemoglobin	NS	NS	NS	NS	NS
MCV	NS	NS	NS	NS	NS

¹Correlation is significant at 0.05 level (2-tail);

²Correlation is significant at 0.01 level (2-tail);

³Correlation is significant at 0.001 level (2-tail). HSCRP: High sensitive C-reactive protein; MCV: Mean cellular volume; HDL: High-density lipoprotein; WBC: White blood cells; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; BMI: Body mass index; HbA1c: Hemoglobin A1c; NS: Not significant.