Table 2.
Associations between cancer-related symptoms, health-related quality of life (HRQOL) and body mass index (BMI) at the 30 months post-diagnosis assessment
| Overall | BMI < 25 | 25 ≤ BMI < 30 | BMI ≥ 30 | ||
|---|---|---|---|---|---|
| N=661 | N=253 | N=209 | N=199 | ||
| Cancer-related symptoms | Mean Scores (SD) | P trend | |||
| Chest wall symptom (Scored 0–4) | |||||
| Unadjusted mean (SD) | 0.97 (0.82) | 0.91 (0.77) | 0.99 (0.86) | 1.03 (0.85) | |
| Adjusted mean (Model 1) | 0.94 | 1.00 | 1.04 | 0.21 | |
| Adjusted mean (Model 1+CRP) | 0.98 | 0.99 | 1.00 | 0.83 | |
| Arm symptom (Scored 0–4) | |||||
| Unadjusted mean (SD) | 0.82 (0.87) | 0.68 (0.79) | 0.84 (0.89) | 0.97 (0.93) | |
| Adjusted mean (Model 1) | 0.72 | 0.83 | 0.90 a | 0.04 | |
| Adjusted mean (Model 1+CRP) | 0.73 | 0.83 | 0.89 | 0.10 | |
| Urinary incontinence (Scored 0–4) | |||||
| Unadjusted mean (SD) | 0.90 (1.03) | 0.73 (0.90) | 1.01 (1.03) | 1.01 (1.16) | |
| Adjusted mean (Model 1) | 0.80 | 1.09 b | 1.12 b | 0.001 | |
| Adjusted mean (Model 1+CRP) | 0.82 | 1.09 b | 1.11 a | 0.01 | |
| Vasomotor symptoms (Scored 0–4) | |||||
| Unadjusted mean (SD) | 1.63 (1.11) | 1.61 (1.10) | 1.63 (1.12) | 1.64 (1.13) | |
| Adjusted mean (Model 2) | 1.66 | 1.66 | 1.56 | 0.35 | |
| Adjusted mean (Model 2+CRP) | 1.68 | 1.66 | 1.54 | 0.28 | |
| Vaginal symptoms (Scored 0–4) | |||||
| Unadjusted mean (SD) | 0.55 (0.74) | 0.55 (0.73) | 0.55 (0.74) | 0.56 (0.76) | |
| Adjusted mean (Model 2) | 0.67 | 0.67 | 0.62 | 0.52 | |
| Adjusted mean (Mode l 2+CRP) | 0.71 | 0.66 | 0.58 | 0.13 | |
| Cognitive/mood problems (Scored 0–4) | |||||
| Unadjusted mean (SD) | 1.07 (0.80) | 1.05 (0.81) | 1.05 (0.78) | 1.11 (0.82) | |
| Adjusted mean (Model 2) | 1.29 | 1.27 | 1.27 | 0.72 | |
| Adjusted mean (Model 2+CRP) | 1.29 | 1.27 | 1.27 | 0.86 | |
| Sexual interest/function (Scored 0–3)* | |||||
| Unadjusted mean (SD) | 0.88 (0.79) | 0.96 (0.83) | 0.86 (0.75) | 0.79 (0.75) | |
| Adjusted mean (Model 2) | 0.91 | 0.81 | 0.79 | 0.23 | |
| Adjusted mean (Model 2+CRP) | 0.89 | 0.82 | 0.82 | 0.54 | |
| Sleep (hrs/d)† | |||||
| Unadjusted mean (SD) | 6.94 (1.21) | 6.99 (1.17) | 6.88 (1.24) | 6.95 (1.22) | |
| Adjusted mean (Model 2) | 6.95 | 6.91 | 7.12 | 0.20 | |
| Adjusted mean (Model 2+CRP) | 6.90 | 6.92 | 7.17 | 0.057 | |
| Interrupted sleep (Scored 0–4) | |||||
| Unadjusted mean (SD) | 1.67 (1.27) | 1.72 (1.22) | 1.67 (1.28) | 1.60 (1.32) | |
| Adjusted mean (Model 2) | 1.83 | 1.74 | 1.60 | 0.07 | |
| Adjusted mean (Model 2+CRP) | 1.85 | 1.74 | 1.58 | 0.057 | |
| Tendency to nap (Scored 0–4) | |||||
| Unadjusted mean (SD) | 0.88 (1.05) | 0.74 (0.90) | 0.88 (1.05) | 1.06 (1.19) | |
| Adjusted mean (Model 2) | 1.11 | 1.23 | 1.32 a | 0.04 | |
| Adjusted mean (Model 2+CRP) | 1.13 | 1.23 | 1.29 | 0.18 | |
| Trouble getting to sleep (Scored 0–4) | |||||
| Unadjusted mean (SD) | 2.35 (1.03) | 2.49 (0.96) | 2.33 (1.06) | 2.20 (1.07) | |
| Adjusted mean (Model 2) | 2.43 | 2.29 | 2.19 a | 0.02 | |
| Adjusted mean (Model 2+CRP) | 2.48 | 2.28 | 2.15 b | 0.055 | |
| Feeling awake (Scored 0–10) † | |||||
| Unadjusted mean (SD) | 3.73 (2.66) | 3.54 (2.69) | 3.73 (2.60) | 3.97 (2.69) | |
| Adjusted mean (Model 2) | 4.07 | 4.11 | 4.11 | 0.85 | |
| Adjusted mean (Model 2+CRP) | 4.19 | 4.08 | 3.98 | 0.48 | |
|
HRQOL (Scored 0–100) | |||||
| Physical functioning | |||||
| Unadjusted mean (SD) | 74.7 (25.2) | 82.3 (21.0) | 75.3 (24.3) | 64.3 (27.4) | |
| Adjusted mean (Model 3) | 71.0 | 66.9 a | 59.9 b | <0.0001 | |
| Adjusted mean (Model 3 + CRP) | 69.2 | 67.2 | 61.7 b | 0.003 | |
| Role-physical | |||||
| Unadjusted mean (SD) | 65.8 (39.8) | 70.4 (37.6) | 65.2 (40.1) | 60.6 (41.6) | |
| Adjusted mean (Model 3) | 60.2 | 57.5 | 54.9 | 0.17 | |
| Adjusted mean (Model 3 + CRP) | 57.3 | 58.0 | 57.8 | 0.91 | |
| Bodily pain | |||||
| Unadjusted mean (SD) | 71.1 (24.8) | 75.8 (23.5) | 69.8 (24.7) | 66.5 (25.6) | |
| Adjusted mean (Model 3) | 65.6 | 61.7 | 61.8 | 0.10 | |
| Adjusted mean (Model 3 + CRP) | 64.7 | 61.9 | 62.7 | 0.44 | |
| Vitality | |||||
| Unadjusted mean (SD) | 56.2 (22.0) | 58.4 (22.1) | 55.1 (21.6) | 54.7 (22.1) | |
| Adjusted mean (Model 3) | 42.1 | 39.3 | 40.5 | 0.42 | |
| Adjusted mean (Model 3 + CRP) | 40.8 | 39.5 | 41.7 | 0.73 | |
| General health | |||||
| Unadjusted mean (SD) | 45.4 (9.7) | 46.5 (9.9) | 45.6 (9.6) | 43.7 (9.4) | |
| Adjusted mean (Model 3) | 42.8 | 42.5 | 42.0 | 0.45 | |
| Adjusted mean (Model 3 + CRP) | 42.7 | 42.5 | 42.1 | 0.58 | |
| Social functioning | |||||
| Unadjusted mean (SD) | 81.1 (23.2) | 82.6 (22.9) | 82.9 (22.2) | 77.5 (24.4) | |
| Adjusted mean (Model 3) | 69.0 | 70.7 | 69.1 | 0.90 | |
| Adjusted mean (Model 3 + CRP) | 67.5 | 71.0 | 70.5 | 0.23 | |
| Role-emotional | |||||
| Unadjusted mean (SD) | 71.8 (36.8) | 72.5 (36.0) | 70.6 (37.1) | 72.2 (37.7) | |
| Adjusted mean (Model 3) | 62.9 | 61.9 | 64.0 | 0.80 | |
| Adjusted mean (Model 3 + CRP) | 62.5 | 62.0 | 64.3 | 0.68 | |
| Mental health | |||||
| Unadjusted mean (SD) | 75.6 (16.9) | 74.9 (17.1) | 76.0 (16.3) | 75.9 (17.2) | |
| Adjusted mean (Model 3) | 68.6 | 69.8 | 69.9 | 0.40 | |
| Adjusted mean (Model 3 + CRP) | 68.8 | 69.8 | 69.8 | 0.58 | |
| Physical component summary score | |||||
| Unadjusted mean (SD) | 43.1 (9.7) | 45.8 (8.5) | 43.0 (9.3) | 39.7 (10.5) | |
| Adjusted mean (Model 3) | 42.0 | 40.2 a | 38.5 b | <0.0001 | |
| Adjusted mean (Model 3 + CRP) | 41.2 | 40.4 | 39.3 | 0.054 | |
| Mental component summary score | |||||
| Unadjusted mean (SD) | 50.5 (9.0) | 49.5 (8.9) | 50.7 (8.6) | 51.7 (9.3) | |
| Adjusted mean (Model 3) | 46.7 | 47.7 | 48.7 a | 0.02 | |
| Adjusted mean (Model 3 + CRP) | 46.8 | 47.7 | 48.5 | 0.09 | |
*
N=351 (BMI<25 N=151, 25≤BMI<30 N=110, BMI>30 N=90).
†
N=660
Higher symptoms scores indicate scores indicate more frequent symptoms. Higher HRQOL scores indicate better HRQOL.
Model 1 was adjusted for age, race/study site, cancer treatment, and number of comorbid condition.
Model 2 was adjusted for age, race/study site, cancer treatment, number of comorbid condition, menopausal status, and tamoxifen and antidepressants/anxiolytics use.
Model 3 was adjusted for age, race/study site, education, marital status, cancer treatment, number of comorbid condition, menopausal status, and tamoxifen and antidepressants/anxiolytics use.
P trend tested a trend across the subgroups defined by BMI.
a
P values for direct comparisons between subgroups are indicated with symbols: p<0.05 vs. ‘BMI < 25’,
b
p<0.01 vs. ‘BMI<25’.