Department of Medicine, Monash Medical Centre Southern Clinical School, Monash University, Victoria, Australia.
Diabetes Care. 2010 Apr;33(4):757-62. doi: 10.2337/dc09-1107. Epub 2009 Dec 10.
To determine the longitudinal association of components of health-related functioning (HRF) with incident impaired glucose metabolism and type 2 diabetes.
The Australian Diabetes Obesity and Lifestyle (AusDiab) study is a national, longitudinal study of adults aged > or =25 years from 42 randomly selected areas of Australia. Diabetes status was defined using the World Health Organization criteria, and HRF was assessed using the SF-36 questionnaire in 1999-2000 and 2004-2005.
Incident impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and newly diagnosed type 2 diabetes were associated with increased bodily pain at baseline compared with those with normal glucose tolerance (NGT) (IFG P = 0.005, IGT P < 0.004, and newly diagnosed type 2 diabetes P = 0.005), after adjustment. In addition, those with incident IGT and newly diagnosed type 2 diabetes had significantly reduced physical functioning, general health, mental health, and vitality at baseline compared with those with NGT. After we controlled for factors associated with incident diabetes, those in the lowest quartile of the physical component summary scale at baseline had at least a 50% higher risk of progression to impaired glucose metabolism and diabetes 5 years later.
These findings show that incident IFG, IGT, and newly diagnosed type 2 diabetes are associated with reduced HRF independent of cardiovascular disease and that this is evident before the onset of these conditions. If future health promotion campaigns are to effectively target those at high risk of developing diabetes, an understanding of the process of declining health before onset of the disease is essential.
确定健康相关功能（HRF）各组成部分与葡萄糖代谢受损和 2 型糖尿病发生之间的纵向关联。
澳大利亚糖尿病肥胖与生活方式（AusDiab）研究是一项全国性、纵向研究，对象为来自澳大利亚 42 个随机选定地区的年龄≥25 岁的成年人。糖尿病状态采用世界卫生组织标准进行定义，HRF 使用 SF-36 问卷在 1999-2000 年和 2004-2005 年进行评估。
与糖耐量正常（NGT）相比，新诊断的空腹血糖受损（IFG）、葡萄糖耐量受损（IGT）和 2 型糖尿病患者的基线时躯体疼痛更明显（IFG P=0.005，IGT P＜0.004，新诊断的 2 型糖尿病 P=0.005），校正后差异仍有统计学意义。此外，与 NGT 相比，新诊断的 IGT 和 2 型糖尿病患者的生理功能、总体健康、心理健康和活力明显降低。在控制与糖尿病发生相关的因素后，基线时生理成分综合评分最低四分位数的患者在 5 年内进展为葡萄糖代谢受损和糖尿病的风险至少增加了 50%。
这些发现表明，IFG、IGT 和新诊断的 2 型糖尿病的发生与 HRF 降低有关，且独立于心血管疾病，而这种情况在这些疾病发生之前就已经显现。如果未来的健康促进运动要有效地针对那些发生糖尿病风险高的人群，那么了解疾病发生前健康状况下降的过程是至关重要的。
