乳腺癌幸存者中糖尿病与生活质量的关联。
Associations between Diabetes and Quality of Life among Breast Cancer Survivors.
作者信息
Tang Zheng, Wang Jiwei, Zhang Hao, Sun Li, Tang Furong, Deng Qinglong, Yu Jinming
机构信息
Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai 200032, China.
Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
出版信息
PLoS One. 2016 Jun 22;11(6):e0157791. doi: 10.1371/journal.pone.0157791. eCollection 2016.
OBJECTIVE
We aimed to investigate the associations between diabetes and quality of life (QOL) among breast cancer survivors.
METHODS
A cross-sectional survey was conducted at 34 Cancer Recovery Clubs across China from May 2014 to January 2015. Quality of life was measured by the Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire-Breast Cancer Module 23 (QLQ-BR23, simplified Chinese version). Information on social-demography, diagnosis and treatment of tumors, and diabetes mellitus were collected by self-reported questionnaires. Univariate analyses of covariance (ANCOVA) was performed to assess the difference in QOL between patients with or without diabetes mellitus, and multiple linear regression models were used to examine the associations after controlling for confounders.
RESULTS
Diabetes, both of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) significantly reduced QOL. This effect of diabetes on QOL is independent of tumor size, regional lymph node metastasis, distant metastasis and tumor stage index (TNM). After adjusting for different social-demography, diagnosis and treatment of the tumor, the tumor's stage and other chronic comorbidities, breast cancer survivors with diabetes got significantly lower scores in functional dimensions (including physical, role, emotional and social functionings measured by EORTC QLQ-C30; body image (BRBI) and future perspective (BRFU) measured by QLQ-BR23, as well as economic difficulties than those without diabetes (Padjusted<0.05). Diabetic patients also obtained higher scores in symptom dimensions, including fatigue, nausea and vomiting, pain, dyspnoea, insomnia, constipation and diarrhoea measured by EORTC QLQ-C30; side effects, breast symptoms and upset by hair loss measured by QLQ-BR23 (Padjusted<0.05). Compared to patients with T1DM, those with T2DM are likely to suffer more by loss of functioning.
CONCLUSIONS
Diabetes was associated with the decreased QOL for breast cancer survivors.
目的
我们旨在调查乳腺癌幸存者中糖尿病与生活质量（QOL）之间的关联。
方法
2014年5月至2015年1月期间，在中国34个癌症康复俱乐部开展了一项横断面调查。生活质量通过生活质量问卷核心30项（EORTC QLQ-C30）和生活质量问卷乳腺癌模块23项（QLQ-BR23，简体中文版）进行测量。通过自我报告问卷收集社会人口统计学、肿瘤诊断与治疗以及糖尿病方面的信息。进行单因素协方差分析（ANCOVA）以评估糖尿病患者与非糖尿病患者生活质量的差异，并使用多元线性回归模型在控制混杂因素后检验关联。
结果
1型糖尿病（T1DM）和2型糖尿病（T2DM）均显著降低生活质量。糖尿病对生活质量的这种影响独立于肿瘤大小、区域淋巴结转移、远处转移和肿瘤分期指数（TNM）。在调整不同的社会人口统计学、肿瘤诊断与治疗、肿瘤分期及其他慢性合并症后，患有糖尿病的乳腺癌幸存者在功能维度（包括EORTC QLQ-C30测量的身体、角色、情感和社会功能；QLQ-BR23测量的身体形象（BRBI）和未来展望（BRFU））以及经济困难方面的得分显著低于无糖尿病者（调整后P<0.05）。糖尿病患者在症状维度的得分也更高，包括EORTC QLQ-C30测量的疲劳、恶心和呕吐、疼痛、呼吸困难、失眠、便秘和腹泻；QLQ-BR23测量的副作用、乳腺症状和脱发困扰（调整后P<0.05）。与T1DM患者相比，T2DM患者更易出现功能丧失。
结论
糖尿病与乳腺癌幸存者生活质量下降有关。
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