Department of Early Psychosis Intervention, Institute of Mental Health, Singapore.
Ann Acad Med Singap. 2010 Dec;39(12):913-7.
Diabetes mellitus (DM) is a serious chronic illness that has a major impact on the quality of life of the individuals. Our aim was to examine the determinants of health-related quality of life (HRQOL) in patients with DM.
Adult outpatients attending a Diabetes Centre were recruited on consecutive basis between August 2006 and February 2007. Clinical data were collected from interviews with the subjects and from medical records. Assessment of depressive symptoms was done using the Center for Epidemiologic Studies Depression Scale (CES-D) and HRQOL using the Short Form 36 Health Survey (SF-36). A two-step regression analysis was conducted for identifying factors affecting patients' quality of life.
Five hundred and thirty-seven patients participated in the study. The mean (SD) age of the participants was 54.7 (13.3) years and 315 (58.7%) were males. The prevalence of depressive symptoms was 31.1% (n = 167). After adjusting for other variables, the effects of depressive symptoms persisted for all the 8 domains of SF-36 (P <0.001 for all). The medical factors that were negatively associated with HRQOL were a diagnosis of Type 1 DM, duration of the illness of more than 10 years, HbA1c levels of ≥7%, and comorbidity of stroke and retinopathy. Being male and a regular exerciser had a positive effect on HRQOL.
These findings highlight the importance of detecting and treating comorbid depression in DM.
糖尿病（DM）是一种严重的慢性疾病，对个体的生活质量有重大影响。我们的目的是研究影响糖尿病患者健康相关生活质量（HRQOL）的决定因素。
2006 年 8 月至 2007 年 2 月，连续招募在糖尿病中心就诊的成年门诊患者。从患者访谈和病历中收集临床数据。使用流行病学研究中心抑郁量表（CES-D）评估抑郁症状，使用健康调查简表 36 项（SF-36）评估 HRQOL。采用两步回归分析确定影响患者生活质量的因素。
537 名患者参加了研究。参与者的平均（SD）年龄为 54.7（13.3）岁，315 名（58.7%）为男性。抑郁症状的患病率为 31.1%（n=167）。调整其他变量后，抑郁症状对 SF-36 的所有 8 个领域的影响仍然存在（所有 P<0.001）。与 HRQOL 呈负相关的医学因素包括 1 型糖尿病的诊断、患病时间超过 10 年、HbA1c 水平≥7%，以及并发中风和视网膜病变。男性和定期锻炼者对 HRQOL 有积极影响。
这些发现强调了在糖尿病中检测和治疗共病性抑郁的重要性。
