Mediators of the Association Between Severity of Noncommunicable Diseases and Subjective Health‐Related Quality of Life

FIGURE 1. Flow diagram. Initially, 519 patients were enrolled in the study. As the number of orthostatic control disorders was only one and because of the age difference, the patient data from the NCCHD were excluded from the study. Next, patients from the NCC (n = 229) were excluded owing to different methods of mental health assessment in the NCC. Finally, data were excluded if the clinical assessment and blood sampling were not performed within 1 month (n = 115). NCC, National Cancer Center; NCCHD, National Center for Child Health and Development.

FIGURE 2. Proinflammatory and anti‐inflammatory cytokines and physical disease severity. Physical disease severity level 1: N = 60; 2: N = 45; 3: N = 25; 4: N = 43. Vertical lines attached to means represent 95% confidence intervals. Physical disease severity showed a significant correlation with the logarithmic transformed anti‐inflammatory cytokines (ADPN, IL‐10), but not with the proinflammatory cytokines (IL‐6, TNF‐α). ADPN, adiponectin; IL, interleukin; TNF‐α, tumor necrosis factor‐α.

FIGURE 3. Hypothetical structural equation model. Hypothetical structural equation model for physical disease severity, cytokines (log_ADPN, log_IL‐10, log_IL‐6, log_TNF‐α), mental health indicators (PA, STAI) and QOL (EQ_VAS). In the path diagram, covariances are specified between the residuals of the latent variables representing anti‐inflammatory and proinflammatory markers, as well as between the residuals of PA and STAI_1. These covariances account for potential shared variance owing to commonality in residuals or overlapping constructs. The model fit was excellent. †residuals. *p < 0.05, **p < 0.01, ***p < 0.001. χ 2 = 12.545, df = 13, p = 0.484; CFI = 1.000; RMSEA = 0.000. ADPN, adiponectin; EQ_VAS, EuroQol‐5 dimensions 5‐level visual analog scale; IL, interleukin; PA, positive affect; QOL, quality of life; STAI, state–trait anxiety inventory; TNF‐α, tumor necrosis factor‐α.