Li Meichen, Liu Na, Jiang Guli, Zeng Hongli, Guo Jianwen, Wu Darong, Zhou Hui, Wen Zehuai, Zhou Li
The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Health Management Center, Guangzhou 11th People's Hospital, Guangzhou, China.
Front Endocrinol (Lausanne). 2025 May 23;16:1518204. doi: 10.3389/fendo.2025.1518204. eCollection 2025.
The association of prediabetes and diabetes on health-related quality of life (HRQoL) remains inconclusive in current epidemiological research. In this investigation, we administered 5-level EuroQoL-5 dimension version (EQ-5D-5L) to systematically assess HRQoL across glycemic strata (diabetes, prediabetes, and normal glycemic levels) in Guangzhou, and to offer baseline data that can be easily compared to other regions in China or across countries.
This investigation utilized baseline cross-sectional data extracted from a three-year prospective cohort study conducted at the Health Management Center of Guangzhou 11th People's Hospital. Propensity score matching was implemented at a 1:1:4 ratio to balance participants across diabetes, prediabetes, and normal glycemic group. HRQoL outcomes, operationalized through EQ-Index and EQ visual analog scale (EQ-VAS) measurements, were compared across groups using one-way ANOVA or Wilcoxon rank-sum tests. Multivariate linear regression was constructed to adjust for potential confounders, followed by subgroup analyses stratified by sex, age categories, body mass index (BMI) classifications, and hypertension comorbidity status.
A total of 18,605 participants were included in the study. After propensity score matching, 533 participants allocated to the prediabetes group, 533 to the diabetes group, and 2064 to the normal glycemic group. Intergroup comparisons demonstrated significantly lower EQ-VAS scores in the diabetes group (79.11) compared to both prediabetes (80.67) and normal glycemic group (81.65). Similarly, the diabetes group exhibited the lowest EQ-Index scores (0.968) relative to prediabetes (0.972) and normal glycemic group (0.972). Multivariate linear regression adjusted with sex, age, BMI, etc. revealed a 2.139-point reduction in EQ-VAS scores for the diabetes group versus normal glycemic group (95% CI: -3.748, -0.530; =0.009). Subgroup analyses identified particularly compromised HRQoL in diabetes and prediabetes populations among female participants, individuals with obesity, and those aged ≥60 years.
Prediabetes and diabetes mellitus are associated with diminished HRQoL compared to normal glycemic levels, with a more pronounced negative associations observed among female populations, older adults, and individuals with obesity. These findings emphasize the clinical necessity for implementing targeted interventions to optimize HRQoL outcomes in these high-risk subgroups, which aligns with the fundamental objectives of contemporary diabetes management frameworks.
ClinicalTrials.gov ID: NCT05315895.
在当前的流行病学研究中，糖尿病前期和糖尿病与健康相关生活质量（HRQoL）之间的关联尚无定论。在本研究中，我们使用5级欧洲五维度健康量表（EQ-5D-5L）系统评估了广州不同血糖分层（糖尿病、糖尿病前期和正常血糖水平）人群的HRQoL，并提供了可与中国其他地区或其他国家轻松比较的基线数据。
本研究利用从广州市第十一人民医院健康管理中心进行的一项为期三年的前瞻性队列研究中提取的基线横断面数据。采用1:1:4的倾向得分匹配法，以平衡糖尿病组、糖尿病前期组和正常血糖组的参与者。通过EQ指数和EQ视觉模拟量表（EQ-VAS）测量得出HRQoL结果，使用单因素方差分析或Wilcoxon秩和检验对各组进行比较。构建多元线性回归模型以调整潜在混杂因素，随后按性别、年龄类别、体重指数（BMI）分类和高血压合并症状态进行亚组分析。
本研究共纳入18,605名参与者。经过倾向得分匹配后，533名参与者被分配到糖尿病前期组，533名被分配到糖尿病组，2064名被分配到正常血糖组。组间比较显示，糖尿病组的EQ-VAS得分（79.11）显著低于糖尿病前期组（80.67）和正常血糖组（81.65）。同样，糖尿病组的EQ指数得分（0.968）相对于糖尿病前期组（0.972）和正常血糖组（0.972）最低。经性别、年龄、BMI等因素调整的多元线性回归分析显示，糖尿病组的EQ-VAS得分比正常血糖组降低了2.139分（95%CI：-3.748，-0.530；P=0.009）。亚组分析发现，女性参与者、肥胖个体和年龄≥60岁的人群中，糖尿病和糖尿病前期人群的HRQoL受损尤为明显。
与正常血糖水平相比，糖尿病前期和糖尿病与HRQoL降低有关，在女性人群、老年人和肥胖个体中观察到更明显的负相关。这些发现强调了对这些高危亚组实施针对性干预以优化HRQoL结果的临床必要性，这与当代糖尿病管理框架的基本目标一致。
ClinicalTrials.gov标识符：NCT05315895。
