Kintzoglanakis Kyriakos, Pavlou-Skantzis Leonidas, Themeli Tatiana, Kyprianou Miltiades, Paschou Stavroula A
Local Health Team unit of Thebes, Thebes, Boeotia, Greece.
General Hospital of Thebes, Thebes, Boeotia, Greece.
Hormones (Athens). 2024 Sep;23(3):407-414. doi: 10.1007/s42000-024-00545-y. Epub 2024 Mar 15.
To examine the determinants of health-related quality of life (HRQoL) of patients with type 2 diabetes (PwD) and multimorbidity (MM) (at least one co-occurring condition besides T2D) among sociodemographic, disease-related, and MM variables and the association of MM with therapeutic targets.
A total of 179 PwD attending primary care (PC) in Greece answered the 15 dimension HRQoL (15D) questionnaire between August 2019 and October 2020. Sociodemographic, disease-related, and MM characteristics were recorded. MM was categorized as concordant or discordant based on whether or not it was related to the pathophysiology of T2D. Independent predictors of the 15D score were examined in stepwise regression models among sociodemographic, disease-related, and MM variables and the association of MM with glycated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) was assessed.
The mean 15D score was 0.85 ± 0.11 and the mean MM count was 4.3 ± 1.8. Significant predictors of a higher 15D score were male gender, married state, higher monthly income, and more physical activity. Significant predictors of a lower 15D score were employment, depression, musculoskeletal disease, coronary artery disease, neuropathy, and MM count, but discordant had a stronger effect than concordant MM. Increasing MM count was not significantly correlated with A1C and was correlated with lower LDL-C.
Non-medical (physical activity and sociodemographic) rather than disease-related characteristics and discordant more than concordant co-occurring conditions affected HRQoL of multimorbid PwD who did not have worse (A1C) or achieved better (LDL-C) therapeutic targets. A generalist approach to the non-medical needs and overall health conditions of PwD could be promoted in PC within the social determinants of health and MM.
在社会人口统计学、疾病相关和共病变量中，研究2型糖尿病患者（PwD）和多重疾病（MM）（除2型糖尿病外至少一种并发疾病）与健康相关生活质量（HRQoL）的决定因素，以及MM与治疗目标的关联。
2019年8月至2020年10月期间，希腊179名在基层医疗（PC）机构就诊的PwD患者回答了15维度健康相关生活质量（15D）问卷。记录社会人口统计学、疾病相关和MM特征。根据MM是否与2型糖尿病的病理生理学相关，将其分类为一致或不一致。在社会人口统计学、疾病相关和MM变量的逐步回归模型中，研究15D评分的独立预测因素，并评估MM与糖化血红蛋白（A1C）和低密度脂蛋白胆固醇（LDL-C）的关联。
15D评分的平均值为0.85±0.11，MM计数的平均值为4.3±1.8。15D评分较高的显著预测因素为男性、已婚状态、月收入较高和体育活动较多。15D评分较低的显著预测因素为就业、抑郁、肌肉骨骼疾病、冠状动脉疾病、神经病变和MM计数，但不一致的MM比一致的MM影响更强。MM计数增加与A1C无显著相关性，与较低的LDL-C相关。
非医学（体育活动和社会人口统计学）而非疾病相关特征以及不一致的并发疾病比一致的并发疾病对患有多重疾病的PwD的HRQoL影响更大，这些患者的糖化血红蛋白（A1C）没有更差或低密度脂蛋白胆固醇（LDL-C）达到更好的治疗目标。在健康和MM的社会决定因素范围内，基层医疗中可推广针对PwD非医学需求和整体健康状况的全科方法。
