Huang Guan-Hua, Palta Mari, Allen Catherine, LeCaire Tamara, D'Alessio Donn
Department of Population Health Sciences, University of Wisconsin Medical School, Madison, WI, USA.
Am J Epidemiol. 2004 Feb 15;159(4):364-72. doi: 10.1093/aje/kwh055.
Care for type 1 diabetes mellitus should both alleviate the physical complications of the disease and improve overall quality of life. The Wisconsin Diabetes Registry, comprising a population-based cohort that is followed longitudinally from diagnosis of type 1 diabetes, provided the authors with a unique opportunity to examine quality of life in children, adolescents, and young adults with type 1 diabetes and its relation to both sociodemographic and clinical risk factors. The authors analyzed data from 1987-2002 with a mean of 10.2 years' duration of diabetes (n = 569). They used ordinal-scaled self-rated global health as a measure of quality of life. In this paper, they propose a random-effects model for drawing inferences on individuals regarding the relation of longitudinally measured quality of life to multiple risk factors. Results showed that male gender, higher parental socioeconomic level, younger age at diabetes diagnosis, shorter diabetes duration, no hospitalization in the preceding 6 months, lower glycosylated hemoglobin level, and questionnaire responses by a person other than the subject were independently associated with better reported health. The authors found that individuals varied in their reported health even after adjustment for all identified risk factors. This could imply either that there is variability in perception even with the same health status or that there are independent unmeasured risk factors for poor health in persons with type 1 diabetes.
1型糖尿病的护理应既能缓解该疾病的身体并发症,又能提高整体生活质量。威斯康星糖尿病登记处包含一个基于人群的队列,从1型糖尿病诊断开始进行纵向跟踪,为作者提供了一个独特的机会,来研究1型糖尿病儿童、青少年和年轻成年人的生活质量及其与社会人口统计学和临床风险因素的关系。作者分析了1987年至2002年的数据,糖尿病病程平均为10.2年(n = 569)。他们使用序数尺度的自我评定总体健康状况作为生活质量的衡量指标。在本文中,他们提出了一个随机效应模型,用于推断个体纵向测量的生活质量与多种风险因素之间的关系。结果显示,男性、父母社会经济水平较高、糖尿病诊断时年龄较小、糖尿病病程较短、前6个月未住院、糖化血红蛋白水平较低以及由受试者以外的其他人填写问卷,均与更好的健康报告独立相关。作者发现,即使在对所有已确定的风险因素进行调整后,个体报告的健康状况仍存在差异。这可能意味着,即使健康状况相同,认知也存在差异,或者1型糖尿病患者存在未测量的独立健康风险因素。