日本 2 型糖尿病老年患者患者报告结局中身体功能障碍的决定因素及其影响。
Determinants and impact of physical impairment in patient-reported outcomes among older patients with type 2 diabetes mellitus in Japan.
机构信息
Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital,Tokyo,Japan.
Department of Geriatrics and Community Healthcare, Graduate School of Medicine, University of Nagoya,Nagoya,Japan.
出版信息
Curr Med Res Opin. 2021 Mar;37(3):393-402. doi: 10.1080/03007995.2020.1846170. Epub 2020 Nov 23.
OBJECTIVE
To investigate the predictive factors associated with physical impairment among older patients with type 2 diabetes mellitus (T2DM) in Japan and to examine the potential impact of physical impairment on patient-reported health outcomes in this population.
METHODS
A cross-sectional analysis was conducted using patient-reported data from the 2012-2014 Japan National Health and Wellness Survey. Physical impairment was measured using the Physical Component Summary (PCS) score of the Short-Form 36-Item Health Survey (SF-36) three-component model (using Japanese norms). Older T2DM patients (≥65 years old; = 1511) were dichotomized into physically impaired (PCS ≤ 25th percentile; = 378) and non-physically impaired (PCS > 25th percentile; = 1133). Work productivity (absenteeism, presenteeism and overall work impairment), activity impairment and healthcare resource utilization were compared between these groups.
RESULTS
Age, female sex, low and high body mass index (BMI), diabetes-related complications, cardiovascular events, unawareness of having hypoglycemic events in the past 3 months, and lack of regular exercise were significant factors associated with physical impairment in multivariable analysis. The physically impaired group reported significantly more regular outpatient visits (13.48 vs. 10.16, respectively, < .001), 1% or greater absenteeism (16.7% vs. 4.1%, = .005), greater presenteeism (27.8% vs. 12.2%, = .001), overall work impairment (30.0% vs. 13.0%, = .001) and overall activity impairment (39.5% vs. 17.2%, .001) than the non-physically-impaired group after adjusting for covariates.
CONCLUSIONS
This study identified age, BMI, diabetes-related comorbidities, history of cardiovascular events and lack of exercise as key predictors associated with physical impairment in older patients with T2DM in Japan, which predicted low work productivity as well as activity impairment. This study provides support that physical impairment in patients with T2DM may lead to low work productivity and activity impairment.
UNLABELLED
Supplemental data for this article is available online at https://doi.org/10.1080/03007995.2020.1846170.
目的
调查日本 2 型糖尿病（T2DM）老年患者身体功能障碍的相关预测因素，并研究该人群中身体功能障碍对患者报告的健康结局的潜在影响。
方法
使用 2012-2014 年日本国民健康和健康调查的患者报告数据进行横断面分析。使用健康调查短表 36 项（SF-36）三组分模型的身体成分综合（PCS）评分（采用日本标准）衡量身体功能障碍。将年龄≥65 岁的老年 T2DM 患者（n=1511）分为身体功能障碍（PCS≤第 25 百分位数；n=378）和非身体功能障碍（PCS＞第 25 百分位数；n=1133）两组。比较两组之间的工作生产力（旷工、出勤和整体工作障碍）、活动障碍和医疗资源利用情况。
结果
多变量分析显示，年龄、女性、低体重指数和高体重指数、糖尿病相关并发症、心血管事件、过去 3 个月对低血糖事件的认知不足以及缺乏规律运动是身体功能障碍的显著相关因素。与非身体功能障碍组相比，身体功能障碍组报告的定期门诊就诊次数更多（分别为 13.48 次和 10.16 次，P＜0.001），1%或更高的旷工率（分别为 16.7%和 4.1%，P=0.005）、更高的出勤障碍率（分别为 27.8%和 12.2%，P=0.001）、整体工作障碍率（分别为 30.0%和 13.0%，P=0.001）和整体活动障碍率（分别为 39.5%和 17.2%，P＜0.001）。
结论
本研究确定了年龄、体重指数、糖尿病相关合并症、心血管事件史和缺乏运动是与日本老年 T2DM 患者身体功能障碍相关的关键预测因素，这些因素预测了低工作生产力和活动障碍。本研究表明，T2DM 患者的身体功能障碍可能导致低工作生产力和活动障碍。
未加说明
本文相关补充数据可在 https://doi.org/10.1080/03007995.2020.1846170 上获取。
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