Changes in health state utilities with changes in body mass in the diabetes prevention program

Ronald T. Ackermann, Sharon L. Edelstein, K. M. Venkat Narayan, Ping Zhang, Michael M. Engelgau, William H. Herman, David Marrero

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Health utilities are measures of health-related quality of life (HRQL) used in cost-effectiveness research. We evaluated whether changes in body weight were associated with changes in health utilities in the Diabetes Prevention Program (DPP) and whether associations differed by treatment assignment (lifestyle intervention, metformin, placebo) or baseline obesity severity. We constructed physical (PCS-36) and mental component summary (MCS-36) subscales and short-form-6D (SF-6D) health utility index for all DPP participants completing a baseline 36-item short form (SF-36) HRQL assessment (N = 3,064). We used linear regression to test associations between changes in body weight and changes in HRQL indicators, while adjusting for other demographic and behavioral variables. Overall differences in HRQL between treatment groups were highly statistically significant but clinically small after 1 year. In multivariable models, weight change was independently associated with change in SF-6D score (increase of 0.007 for every 5 kg weight loss; P 0.001), but treatment effects independent of weight loss were not. We found no significant interaction between baseline obesity severity and changes in SF-6D with changes in body weight. However, increases in physical function (PCS-36) with weight loss were greater in persons with higher baseline obesity severity. In summary, improvements in HRQL are associated with weight loss but not with other effects of obesity treatments that are unrelated to weight loss. Although improvements in the SF-6D did not exceed commonly reported thresholds for a minimally important difference (0.04), these changes, if causal, could still have a significant impact on clinical cost-effectiveness estimates if sustained over multiple years.

Original languageEnglish
Pages (from-to)2176-2181
Number of pages6
JournalObesity
Volume17
Issue number12
DOIs
StatePublished - Dec 2009

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Weight Loss
Quality of Life
Body Weight Changes
Obesity
Health
Cost-Benefit Analysis
Metformin
Therapeutics
Life Style
Linear Models
Placebos
Demography
Weights and Measures
Research

ASJC Scopus subject areas

  • Endocrinology
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Ackermann, R. T., Edelstein, S. L., Venkat Narayan, K. M., Zhang, P., Engelgau, M. M., Herman, W. H., & Marrero, D. (2009). Changes in health state utilities with changes in body mass in the diabetes prevention program. Obesity, 17(12), 2176-2181. https://doi.org/10.1038/oby.2009.114

Changes in health state utilities with changes in body mass in the diabetes prevention program. / Ackermann, Ronald T.; Edelstein, Sharon L.; Venkat Narayan, K. M.; Zhang, Ping; Engelgau, Michael M.; Herman, William H.; Marrero, David.

In: Obesity, Vol. 17, No. 12, 12.2009, p. 2176-2181.

Research output: Contribution to journalArticle

Ackermann, RT, Edelstein, SL, Venkat Narayan, KM, Zhang, P, Engelgau, MM, Herman, WH & Marrero, D 2009, 'Changes in health state utilities with changes in body mass in the diabetes prevention program', Obesity, vol. 17, no. 12, pp. 2176-2181. https://doi.org/10.1038/oby.2009.114
Ackermann RT, Edelstein SL, Venkat Narayan KM, Zhang P, Engelgau MM, Herman WH et al. Changes in health state utilities with changes in body mass in the diabetes prevention program. Obesity. 2009 Dec;17(12):2176-2181. https://doi.org/10.1038/oby.2009.114
Ackermann, Ronald T. ; Edelstein, Sharon L. ; Venkat Narayan, K. M. ; Zhang, Ping ; Engelgau, Michael M. ; Herman, William H. ; Marrero, David. / Changes in health state utilities with changes in body mass in the diabetes prevention program. In: Obesity. 2009 ; Vol. 17, No. 12. pp. 2176-2181.
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