Health-related quality of life in patients with type 1 diabetes-association with diabetic complications (the FinDiane Study)
Health-related quality of life in patients with type 1 diabetes-association with diabetic complications (the FinDiane Study)
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DOI：
10.1093/ndt/gfp709
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发表时间：
2010-06-01
影响因子：
6.1
通讯作者：
Groop, Per-Henrik
中科院分区：
文献类型：
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作者：
Ahola, Aila J.;Saraheimo, Markku;Groop, Per-Henrik
背景。1型糖尿病的日常治疗与频繁监测血糖水平和胰岛素给药引起的麻烦可能会影响患者的健康相关生活质量（HRQoL）。1型糖尿病还会增加并发症的风险，这可能会进一步降低患者的HRQoL。我们旨在评估1型糖尿病患者的HRQoL及其与糖尿病并发症的关系。来自芬兰糖尿病肾病研究（FinnDiane Study）的1070例1型糖尿病患者（46%为男性，平均年龄46 +/- 12岁，糖尿病持续时间29 +/- 13年）参与了这项横断面研究。使用15D仪器获得1023例患者的HRQoL数据。在研究肾病时，根据患者的白蛋白排泄率将患者分为不同的组。激光治疗的患者被归类为增殖性视网膜病变。平均15D评分为0.899±0.095，男女无差异。在有或无糖尿病并发症的患者中，HRQoL随年龄的增加而下降。在Tobit回归模型中，大量蛋白尿（-0.036）、透析（-0.082）、肾移植（-0.053）、血糖控制不良（-0.006）、衰老（-0.002）和糖尿病持续时间较长（-0.001）解释了HRQoL的降低。在相应的模型中，增殖性视网膜病变的存在对HRQoL没有显著的负面影响。在15D仪器的单个维度中，肾病影响了除5个维度外的所有维度，而视网膜病变影响了视力、活动能力、饮食和日常活动。15D评分随年龄增长而下降。肾病而非视网膜病变的存在降低了1型糖尿病患者的主观HRQoL。
Background. The daily treatment of type 1 diabetes with frequent monitoring of blood glucose levels and nuisance caused by insulin administration may affect patients' health-related quality of life (HRQoL). Type 1 diabetes is further burdened with an increased risk of complications which may additionally reduce a patient's HRQoL. We aimed to assess HRQoL and its association with diabetic complications in a large sample of patients with type 1 diabetes.Methods. Altogether, 1070 patients with type 1 diabetes (46% men, mean age 46 +/- 12 years, diabetes duration 29 +/- 13 years) from the Finnish Diabetic Nephropathy Study (FinnDiane Study) participated in this cross-sectional study. Data on HRQoL were obtained from 1023 patients using the 15D instrument. When studying nephropathy, pa-tients were divided into groups based on their albumin excretion rate. Laser-treated patients were classified as having proliferative retinopathy.Results. The mean 15D score was 0.899 +/- 0.095 with no differences between men and women. HRQoL decreased with increasing age among patients with and without diabetic complications. In the Tobit regression model, macroalbuminuria (-0.036), dialysis (-0.082), renal transplant (-0.053), poor glycemic control (-0.006), ageing (-0.002) and longer diabetes duration (-0.001) explained the reduction in HRQoL. In a corresponding model, the presence of proliferative retinopathy did not have a significant negative influence on HRQoL. Of individual dimensions of the 15D instrument, nephropathy affected all but five dimensions, while retinopathy affected vision, mobility, eating and usual activities.Conclusions. The 15D scores decreased with increasing age. The presence of nephropathy, but not retinopathy, reduced the subjective HRQoL in patients with type 1 diabetes.