不同血管风险糖尿病患者的健康相关生活质量。
Health-related quality of life in diabetic people with different vascular risk.
机构信息
Economic Analysis Department, University of Castilla-La Mancha (Spain), Facultad de CC, Jurídicas y Sociales de Toledo, Cobertizo de San Pedro Mártir, s/n, 45071, Toledo, Spain.
出版信息
BMC Public Health. 2012 Sep 20;12:812. doi: 10.1186/1471-2458-12-812.
BACKGROUND
The number of papers on the health related quality of life of patients with DM has grown in recent years but fewer studies have drawn comparisons between diabetic persons and the general population considering different risk groups. The aim of this study is to examine health related quality of life (HRQOL) in people with diabetes mellitus (DM) and to analyze the differences in HRQOL adjusting by vascular risk.
METHODS
The data used in this analysis was obtained from the responses of 15,926 individuals who participated in the 2006 Catalonia Health Survey. Our analysis provides a number of multivariate statistical models designed for studying HRQOL, based on the EQ-5D questionnaire, controlling for demographic factors of survey participants and variables that identify diagnosed illnesses and health problems.
RESULTS
Our findings suggest there is a significant, moderate negative relationship between DM and HRQOL in comparison with non diabetic people (absolute value of the coefficient ranges between -0.04 and -0.054 points on a scale of 1). A further analysis of subgroups reveals that diabetics who have not had vascular risk factors neither vascular diseases do not have a diminished HRQOL when compared to the non-diabetic population in general, when other factors are controlled for. In contrast, a comparison of diabetics and non-diabetics who exhibit vascular disease or risk factors for vascular disease reveals HRQOL is significantly diminished to a greater extent for those with diabetes (between 0.152 and 0.175 points loss when comparing a non-diabetic person with a diabetic with vascular disease). Also, HRQOL in diabetic patients who have additional risk factors or a vascular disease are lower than people non-diabetic who have additional risk factors or a vascular disease. When we focus our analysis to the EQ-5D dimensions, we observe that diabetic persons who are neither at risk for nor have a diagnosed vascular disease are no more likely than non-diabetics to report problems. However, diabetic patients who have additional risk factors for vascular disease or a diagnosed vascular disease are significantly more likely to report moderated or severe problems in 4 of the 5 dimensions of EQ-5D.
CONCLUSIONS
The HRQOL of a person who has diabetes is not necessarily lower than for a non-diabetic. Control of risk factors associated to vascular diseases is a key factor for an enhanced quality of life. Vascular disease or risk factors for vascular disease, on the other hand, are associated with a significantly diminished quality of life for diabetic persons.
背景
近年来，关于糖尿病患者健康相关生活质量的文献数量有所增加，但较少有研究比较糖尿病患者与普通人群在不同风险群体下的生活质量差异。本研究旨在探讨糖尿病患者的健康相关生活质量（HRQOL），并分析调整血管风险后 HRQOL 的差异。
方法
本分析使用的数据来自于 2006 年加泰罗尼亚健康调查中 15926 名参与者的回答。我们的分析提供了一些基于 EQ-5D 问卷的多变量统计模型，用于研究 HRQOL，这些模型控制了调查参与者的人口统计学因素以及识别诊断疾病和健康问题的变量。
结果
我们的研究结果表明，与非糖尿病患者相比，DM 与 HRQOL 之间存在显著的、中度的负相关关系（系数的绝对值在 1 分制的 0.04 到 0.054 分之间）。进一步对亚组进行分析表明，在控制其他因素的情况下，没有血管危险因素或血管疾病的糖尿病患者的 HRQOL 与一般非糖尿病人群相比并没有降低。相比之下，比较患有血管疾病或血管疾病危险因素的糖尿病患者和非糖尿病患者，发现糖尿病患者的 HRQOL 显著降低，幅度在 0.152 到 0.175 分之间（与患有血管疾病的非糖尿病患者相比，患有血管疾病的糖尿病患者损失 0.152 到 0.175 分）。此外，患有其他血管危险因素或血管疾病的糖尿病患者的 HRQOL 低于同时患有其他血管危险因素或血管疾病的非糖尿病患者。当我们将分析重点放在 EQ-5D 维度上时，我们观察到既没有血管疾病风险因素也没有诊断出血管疾病的糖尿病患者与非糖尿病患者相比，报告出现问题的可能性不大。然而，患有其他血管疾病风险因素或诊断出血管疾病的糖尿病患者在 EQ-5D 的 5 个维度中的 4 个维度上更有可能报告中度或严重问题。
结论
患有糖尿病的人的 HRQOL 不一定低于非糖尿病患者。控制与血管疾病相关的危险因素是提高生活质量的关键因素。另一方面，患有血管疾病或血管疾病危险因素与糖尿病患者的生活质量显著降低有关。
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