Malavige L S, Jayaratne S D, Kathriarachchi S T, Sivayogan S, Ranasinghe P, Levy J C
Oxford Centre for Diabetes, Endocrinology and Metabolism, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Diabet Med. 2014 Jun;31(6):699-706. doi: 10.1111/dme.12412. Epub 2014 Mar 29.
To identify predictors of poor quality of life among men with diabetes from a comprehensive set of sexual, clinical, socio-economic and lifestyle variables.
This was a cross-sectional observational-study of 253 men with Type 2 diabetes, randomly selected from a clinic in Colombo, Sri Lanka. Erectile dysfunction was assessed using the five-item International Index of Erectile Function and quality of life was assessed using the Sri Lankan version of the 36-item short form health survey questionnaire and the disease-specific Psychological Impact of Erectile Dysfunction scale. The presence of premature ejaculation, reduced libido, socio-demographic and lifestyle data was obtained using an interviewer-administered questionnaire. Significant predictors of quality of life were identified by stepwise multivariate linear regression models for short form-36 subscales, summary scales and two scales of Psychological Impact of Erectile Dysfunction.
Significant predictors on the physical summary scale of the 36-item short form were erectile dysfunction (β = 7.93, 95% CI 3.70-12.17, P < 0.001) and reduced libido (β = 5.20, 95% CI 0.82-9.59, P < 0.05). Predictors on the mental health summary scale of the 36-item short form were erectile dysfunction (β = 5.82, 95% CI 2.26-9.37, P < 0.01), BMI > 27.5 kg/m(2) (β = 9.12, 95% CI 1.38-17.44, P < 0.05), ischaemic heart disease (β = 6.39, 95% CI 0.74-12.04, P < 0.05) and insulin therapy (β = 5.28, 95% CI 0.34-10.22, P < 0.05). Significant predictors in the sexual experience scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 6.57, 95% CI 4.63-8.51, P < 0.001), reduced libido (β =4.33, 95% CI 2.34-6.32, P < 0.001) and postural hypotension (β = 3.99, 95% CI 0.13-7.85, P < 0.05). Predictors on the emotional life scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 2.96, 95% CI 1.37-4.58, P < 0.001), reduced libido 2.75 (β = 2.75, 95% CI 1.12-4.40, P < 0.01), younger age (β = 1.05, 95% CI 0.35-1.75, P < 0.01) and postural hypotension (β = 3.39, 95% CI 0.35-6.45, P < 0.05).
Erectile dysfunction was a strong predictor of poor generic and disease-specific quality of life among other sexual and clinical variables in men with diabetes.
从一系列全面的性、临床、社会经济和生活方式变量中，识别糖尿病男性生活质量不佳的预测因素。
这是一项对253名2型糖尿病男性进行的横断面观察性研究，这些男性是从斯里兰卡科伦坡的一家诊所中随机选取的。使用国际勃起功能指数五项指标评估勃起功能障碍，使用斯里兰卡版36项简短健康调查问卷和特定疾病的勃起功能障碍心理影响量表评估生活质量。通过访谈式问卷获取早泄、性欲减退、社会人口统计学和生活方式数据。通过逐步多元线性回归模型，针对36项简短问卷的分量表、汇总量表以及勃起功能障碍心理影响的两个量表，确定生活质量的显著预测因素。
在36项简短问卷的身体汇总量表上，显著的预测因素是勃起功能障碍（β = 7.93，95%置信区间3.70 - 12.17，P < 0.001）和性欲减退（β = 5.20，95%置信区间0.82 - 9.59，P < 0.05）。在36项简短问卷的心理健康汇总量表上，预测因素是勃起功能障碍（β = 5.82，95%置信区间2.26 - 9.37，P < 0.01）、体重指数>27.5 kg/m²（β = 9.12，95%置信区间1.38 - 17.44，P < 0.05）、缺血性心脏病（β = 6.39，95%置信区间0.74 - 12.04，P < 0.05）和胰岛素治疗（β = 5.28，95%置信区间0.34 - 10.22，P < 0.05）。在勃起功能障碍心理影响的性体验量表上，显著的预测因素是勃起功能障碍（β = 6.57，95%置信区间4.63 - 8.51，P < 0.001）、性欲减退（β = 4.33，95%置信区间2.34 - 6.32，P < 0.001）和体位性低血压（β = 3.99，95%置信区间0.13 - 7.85，P < 0.05）。在勃起功能障碍心理影响的情感生活量表上，预测因素是勃起功能障碍（β = 2.96，95%置信区间1.37 - 4.58，P < 0.001）、性欲减退（β = 2.75，95%置信区间1.12 - 4.40，P < 0.01）、较年轻的年龄（β = 1.05，95%置信区间0.35 - 1.75，P < 0.01）和体位性低血压（β = 3.39，95%置信区间0.35 - 6.45，P < 0.05）。
在糖尿病男性的其他性和临床变量中，勃起功能障碍是总体和特定疾病生活质量不佳的有力预测因素。
