Jeong-Won Lee1, Ji-Hyoun Kang1, Kyung-Eun Lee1, Dong-Jin Park1, Seong Wook Kang2, Seung-Ki Kwok3, Seong-Kyu Kim4, Jung-Yoon Choe4, Hyoun-Ah Kim5, Yoon-Kyoung Sung6, Kichul Shin7, Sang-Il Lee8, Chang Hoon Lee9, Sung Jae Choi10, Shin-Seok Lee11. 1. Department of Rheumatology, Chonnam National University Medical School & Hospital, 42 Jebong-ro, Dong-gu, Kwangju, 61469, Republic of Korea. 2. Department of Internal Medicine, Chungnam National University School of Medicine, Taejon, Republic of Korea. 3. Division of Rheumatology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 4. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Taegu, Republic of Korea. 5. Department of Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea. 6. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea. 7. Department of Internal Medicine, Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 8. Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Gyeongnam, Republic of Korea. 9. Division of Rheumatology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Republic of Korea. 10. Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea. 11. Department of Rheumatology, Chonnam National University Medical School & Hospital, 42 Jebong-ro, Dong-gu, Kwangju, 61469, Republic of Korea. shinseok@chonnam.ac.kr.
Abstract
PURPOSE: This study assessed the relationships among the risk factors for and components of metabolic syndrome (MetS) and health-related quality of life (HRQOL) in a hypothesized causal model using structural equation modeling (SEM) in patients with systemic lupus erythematosus (SLE). METHODS: Of the 505 SLE patients enrolled in the Korean Lupus Network (KORNET registry), 244 had sufficient data to assess the components of MetS at enrollment. Education level, monthly income, corticosteroid dose, Systemic Lupus Erythematosus Disease Activity Index, Physicians' Global Assessment, Beck Depression Inventory, MetS components, and the Short Form-36 at the time of cohort entry were determined. SEM was used to test the causal relationship based on the Analysis of Moment Structure. RESULTS: The average age of the 244 patients was 40.7 ± 11.8 years. The SEM results supported the good fit of the model (χ 2 = 71.629, p = 0.078, RMSEA 0.034, CFI 0.972). The final model showed a direct negative effect of higher socioeconomic status and a positive indirect effect of higher disease activity on MetS, the latter through corticosteroid dose. MetS did not directly impact HRQOL but had an indirect negative impact on it, through depression. CONCLUSIONS: In our causal model, MetS risk factors were related to MetS components. The latter had a negative indirect impact on HRQOL, through depression. Clinicians should consider socioeconomic status and medication and seek to modify disease activity, MetS, and depression to improve the HRQOL of SLE patients.
PURPOSE: This study assessed the relationships among the risk factors for and components of metabolic syndrome (MetS) and health-related quality of life (HRQOL) in a hypothesized causal model using structural equation modeling (SEM) in patients with systemic lupus erythematosus (SLE). METHODS: Of the 505 SLEpatients enrolled in the Korean Lupus Network (KORNET registry), 244 had sufficient data to assess the components of MetS at enrollment. Education level, monthly income, corticosteroid dose, Systemic Lupus Erythematosus Disease Activity Index, Physicians' Global Assessment, Beck Depression Inventory, MetS components, and the Short Form-36 at the time of cohort entry were determined. SEM was used to test the causal relationship based on the Analysis of Moment Structure. RESULTS: The average age of the 244 patients was 40.7 ± 11.8 years. The SEM results supported the good fit of the model (χ 2 = 71.629, p = 0.078, RMSEA 0.034, CFI 0.972). The final model showed a direct negative effect of higher socioeconomic status and a positive indirect effect of higher disease activity on MetS, the latter through corticosteroid dose. MetS did not directly impact HRQOL but had an indirect negative impact on it, through depression. CONCLUSIONS: In our causal model, MetS risk factors were related to MetS components. The latter had a negative indirect impact on HRQOL, through depression. Clinicians should consider socioeconomic status and medication and seek to modify disease activity, MetS, and depression to improve the HRQOL of SLEpatients.
Entities:
Keywords:
Depression; Metabolic syndrome; Quality of life; Systemic lupus erythematosus
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