[Association between cardiometabolic diseases and quality of life and the mediation effect of perceived stress].

Objective: To explore the association between cardiometabolic diseases (CMD) and quality of life, the association between CMD and perceived stress, and the mediation effect of perceived stress on the association between CMD and quality of life, and to provide evidence for the prevention and treatment of CMD and the improvement of quality of life in these patients. Methods: This is a cross-sectional study. Data were collected by the employees' physical examination of a company in Xi'an in 2021. Multiple linear regression models were used to analyze the association between the status of CMD (divided into three categories: no CMD, presence of one kind of CMD, and with≥2 kinds of CMD (≥2 kinds of CMD were defined as cardiometabolic multimorbidity (CMM)), quality of life, and perceived stress. Mediation analysis with a multi-categorical independent variable was conducted to determine the mediation effect of perceived stress on the association between CMD and quality of life. Results: Among all 4 272 participants, 1 457 (34.1%) participants had one kind of CMD and 677 (15.8%) participants had CMM. The average scores for quality of life and perceived stress were (57.5±15.7) and (16.9±7.9), respectively. Compared with participants without CMD, after adjusting for demographic and lifestyle factors, no statistically significant associations were observed between one kind of CMD and perceived stress or quality of life (both P>0.05). Perceived stress did not mediate the association between one kind of CMD and quality of life. However, participants with CMM had lower quality of life and higher perceived stress than participants without CMD. The relative total effect coefficient c (95%CI) and the relative direct effect coefficient c' (95%CI) between CMM and quality of life were -3.71 (-5.04--2.37) and -2.52 (-3.81--1.24) (both P<0.05), respectively. The relative indirect effect coefficient a2b (95%CI) of perceived stress on the association between CMM and quality of life was -1.18 (-1.62--0.77) (P<0.05). The mediation effect size was 31.8%. Conclusions: CMM is negatively associated with quality of life and positively associated with perceived stress. Perceived stress partially mediates the association between CMM and quality of life. Our results suggest that, in addition to preventing and treating CMM actively, efforts should be taken to relieve the perceived stress of people with CMM to improve their quality of life.目的： 探讨心血管代谢性疾病（CMD）与生活质量和知觉压力之间的关系以及知觉压力在CMD与生活质量关系中的中介作用，为防治CMD和改善患者生活质量提供依据。 方法： 本研究为横断面研究。基于2021年西安市某企业员工的体检数据，采用多因素线性回归模型分析CMD患病情况［分为未患病、患1种和患≥2种CMD 3类，将患≥2种CMD定义为患心血管代谢性共病（CMM）］与生活质量和知觉压力之间的关系，并采用多分类自变量中介效应模型分析知觉压力在CMD与生活质量关系中的中介作用。 结果： 共纳入4 272名研究对象，患1种CMD者和患CMM者分别为1 457（34.1%）人和677（15.8%）人。研究对象的生活质量评分为（57.5±15.7）分，知觉压力评分为（16.9±7.9）分。以未患CMD者为参照组，调整了社会人口学特征及生活方式因素后，患1种CMD与知觉压力和生活质量间的关联及知觉压力的中介效应均无统计学意义（P均>0.05）；患CMM者的生活质量比未患CMD者低，而知觉压力高；患CMM与生活质量间的相对总效应系数c（95%CI）和相对直接效应系数c′（95%CI）分别为-3.71（-5.04~-2.37）和-2.52（-3.81~-1.24）（P均<0.05），知觉压力在CMM与生活质量关系中的相对间接效应系数a2b（95%CI）为-1.18（-1.62~-0.77）（P<0.05），中介效应量为31.8%。 结论： CMM与生活质量呈负向关联，与知觉压力呈正向关联，知觉压力在CMM与生活质量的关系中起部分中介作用。提示在积极防治CMM的同时，应注意疏导CMM患者的知觉压力，改善患者的生活质量。.