Impact of biased constitutions on health-related quality of life and mediating effects of sleep quality
Objective To explore the effects of biased constitutions on health-related quality of life (HRQOL) and mechanisms of the role of sleep quality in the relationship between biased constitutions and HRQOL.Methods Data collected from the propulation of Beijing and Shijiazhuang,Hebei province for health check-up from March 2015 to December 2016. The biased constitutions were evaluated using the Constitution in Chinese Medicine Questionnaire (CCMQ) score;CCMQ consists of gentleness type (A type),qi-deficiency type (B type),yang-deficiency type (C type),yin-deficiency type (D type),phlegm-wetness type (E type),wet-heat type (F type),blood-stasis type (G type),qi-depression type (H type),and special diathesis type (I type),the eight constitutions except A type are classified as biased constitution (BC),Sleep quality (SQ) was evaluated using the Pittsburgh Sleep Quality Index (PSQI). HRQOL was evaluated using the 36-item Short Form Health Survey (SF-36). Pearson's correlation analysis was used to explore the correlation among the eight BCs,SQ,and HRQOL,and the structural equation model was further constructed to explore the effects of the eight BCs on HRQOL and the mediating effect of SQ.Results A total of 2,170 samples were included in the database. Finally,1,982 samples were included as study subjects after excluding 188 unqualified samples. The SF-36 and PSQI scores of the samples were 79.73±12.89 and 4.29±2.66,respectively,and the scores for the eight BCs were 27.46±14.84,25.12±19.17,23.55±14.99,21.57±15.20,23.67±15.49,21.68±14.49,22.00±16.14,and 16.13±14.19 for B,C,D,E,F,G,H,and I types,respectively. The result of Pearson's correlation analysis showed that all biased constitution scores were negatively correlated with the SF-36 score (r=-0.562 to-0.327,P<0.01),and were positively correlated with the PSQI score (r=0.272 to 0.431,P<0.01),and PSQI score was negatively correlated with the SF-36 score (r=-0.471,P<0.01). The result of the structural equation model showed that all biased constitutions had a negative effect on HRQOL and that the mediating role of SQ in the relationship between eight BCs and HRQOL was all statistically significant. The total effects of the eight BCs on HRQOL were-0.776,-0.528,-0.603,-0.684,-0.596,-0.678,-0.751,and-0.452 for the B,C,D,E,F,G,H,and I types,respectively. Moreover,the absolute effects of the B and H types were significantly higher than in other BCs;the mediation effect of SQ was-0.242,-0.272,-0.291,-0.261,-0.265,-0.395,-0.203,and-0.287 for the B,C,D,E,F,G,H,and I types,respectively,the absolute value of the mediation effect between G type and HRQOL was significantly higher than that of other BCs. Conclusion The eight BCs had negative effects on HRQOL,and SQ played a mediator role in the relationship between the eight BCs and HRQOL.
TCM constitutionbiased constitutionhealth-related quality of lifesleep qualitymediating effect