Maddigan Sheri L, Feeny David H, Majumdar Sumit R, Farris Karen B, Johnson Jeffrey A
Institute of Health Economics, Edmonton, Alberta, Canada.
Am J Public Health. 2006 Sep;96(9):1649-55. doi: 10.2105/AJPH.2005.067728. Epub 2006 Jul 27.
We assessed which of a broad range of determinants of health are most strongly associated with health-related quality of life (HRQL) among people with type 2 diabetes.
Our analysis included respondents from the Canadian Community Health Survey Cycle 1.1 (2000-2001) who were aged 18 years and older and who were identified as having type 2 diabetes. We used regression analyses to assess the associations between the Health Utilities Index Mark 3 and determinants of health.
Comorbidities had the largest impact on HRQL, with stroke (-0.11; 95% confidence interval [CI] = -0.17, -0.06) and depression (-0.11; 95% CI = -0.15, -0.06) being associated with the largest deficits. Large differences in HRQL were observed for 2 markers of socioeconomic status: social assistance (-0.07; 95% CI=-0.12, -0.03) and food insecurity (-0.07; 95% CI=-0.10, -0.04). Stress, physical activity, and sense of belonging also were important determinants. Overall, 36% of the variance in the Health Utilities Index Mark 3 was explained.
Social and environmental factors are important, but comorbidities have the largest impact on HRQL among people with type 2 diabetes.
我们评估了在2型糖尿病患者中,众多健康决定因素中哪些与健康相关生活质量(HRQL)的关联最为紧密。
我们的分析纳入了加拿大社区健康调查第1.1轮(2000 - 2001年)中年龄在18岁及以上且被确定患有2型糖尿病的受访者。我们使用回归分析来评估健康效用指数Mark 3与健康决定因素之间的关联。
合并症对HRQL的影响最大,中风(-0.11;95%置信区间[CI]= -0.17,-0.06)和抑郁症(-0.11;95% CI = -0.15,-0.06)与最大的健康质量下降相关。在社会经济地位的两个指标上观察到HRQL存在较大差异:社会援助(-0.07;95% CI = -0.12,-0.03)和粮食不安全(-0.07;95% CI = -0.10,-0.04)。压力、身体活动和归属感也是重要的决定因素。总体而言,健康效用指数Mark 3中36%的变异得到了解释。
社会和环境因素很重要,但合并症对2型糖尿病患者的HRQL影响最大。