Good metabolic control is associated with better quality of life in 2,101 adolescents with type 1 diabetes
Good metabolic control is associated with better quality of life in 2,101 adolescents with type 1 diabetes
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DOI：
10.2337/diacare.24.11.1923
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发表时间：
2001-11-01
期刊：
影响因子：
16.2
通讯作者：
Åman, J
中科院分区：
文献类型：
--
作者：
Hoey, H;Aanstoot, HJ;Åman, J
目的：目前尚不清楚是良好代谢控制的需求还是不良代谢控制的后果对青少年糖尿病患者的生活质量（QOL）有更大的影响。这项研究的目的是在一个大型的国际糖尿病青少年及其家庭队列中评估这些关系。研究设计和方法：该研究涉及2101名10-18岁的青少年，来自欧洲、日本和北美17个国家的21个中心。临床和人口统计数据是从1998年3月到8月收集的。集中分析HbA(1c)（正常范围4.4-6.3%，平均5.4%）。青少年生活质量通过先前开发的青少年糖尿病生活质量（DQOL）问卷进行评估，测量糖尿病的影响，对糖尿病的担忧，生活满意度和健康感知。父母和卫生专业人员使用新编制的问卷评估家庭负担。结果：平均HbA（1c）为8.7%（范围4.8-17.4）。较低的HbA（1c）与青少年较低的影响（P < 0.0001）、较少的担忧（P < 0.05）、较高的满意度（P < 0.0001）和较好的健康感知（P < 0.0001）相关。女生比男生更早出现焦虑感增加（P < 0.01）、满意度较低、健康感知较差（P < 0.01）。家长和卫生专业人员对负担的认知随青少年年龄的增长而下降（P < 0.0001）。少数民族患者在影响（P < 0.0001）、忧虑（P < 0.05）和健康感知（P < 0.01）方面得分较低。青少年和父母之间或青少年和职业之间的得分没有相关性。结论：在多元回归模型中，较低的HbA（1c）与所有四个亚量表中较好的青少年生活质量以及父母和卫生专业人员评估的较低的家庭负担显著相关。
OBJECTIVE - It is unclear whether the demands of good Metabolic control or the consequences of poor control have a greater influence on quality of life (QOL) for adolescents with diabetes. This study aimed to assess these relations in a large international cohort of adolescents with diabetes and their families.RESEARCH DESIGN AND METHODS - The study involved 2,101 adolescents, aged 10-18 years, from 21 centers in 17 countries in Europe, Japan, and North America. Clinical and demographic data were collected from March through August 1998. HbA(1c) was analyzed centrally (normal range 4.4-6.3%; mean 5.4%). Adolescent QOL was assessed by a previously developed Diabetes Quality of Life (DQOL) questionnaire for adolescents, measuring the impact of diabetes, worries about diabetes, satisfaction with life, and health perception. Parents and health professionals assessed family burden using newly constructed questionnaires.RESULTS - Mean HbA(1c) was 8.7% (range 4.8-17.4). Lower HbA(1c) was associated with lower impact (P < 0.0001), fewer worries (P < 0.05), greater satisfaction (P < 0.0001), and better health perception (P < 0.0001) for adolescents. Girls showed increased worries (P < 0.01), less satisfaction, and poorer health perception (P < 0.01) earlier than boys. Parent and health professional perceptions of burden decreased with age of adolescent (P < 0.0001). Patients from ethnic minorities had poorer scores for impact (P < 0.0001), worries (P < 0.05), and health perception (P < 0.01). There was no correlation between adolescent and parent or between adolescent and professional scores.CONCLUSIONS - in a multiple regression model, lower HbA(1c) was significantly associated with better adolescent-rated QOL on all four subscales and with lower perceived family burden as assessed by parents and health professionals.