Health-Related Quality of Life in Adolescents with or at Risk for Type 2 Diabetes Mellitus

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• 作者：Erinn T. Rhodes ; MD ; MPH¹ ; ³ ; ^{Erinn.Rhodes@childrens.harvard.edu} ; Michael I. Goran ; PhD⁴ ; ⁵ ; Tracy A. Lieu ; MD ; MPH² ; ³ ; ⁶ ; Robert H. Lustig ; MD⁷ ; Lisa A. Prosser ; MS ; PhD⁶ ; ⁸ ; Thomas J. Songer ; PhD⁹ ; Marc J. Weigensberg ; MD⁵ ; Ruth S. Weinstock ; MD ; PhD¹⁰ ; Tessa Gonzalez ; MD¹¹ ; Kaitlin Rawluk ; MPH¹² ; Roula M. Zoghbi ; MPH¹³ ; David S. Ludwig ; MD ; PhD¹ ; ³ ; Lori M. Laffel ; MD ; MPH³ ; ¹⁴
• 关键词：BMI ; Body mass index ; HRQOL ; Health-related quality of life ; HUI3 ; Health Utilities Index&ndash ; Mark 3 ; IR ; Insulin resistance ; PedsQL ; The Pediatric Quality of Life Inventory&ndash ; Generic Core Scales 4.0 ; SS ; Summary score ; T1DM ; Type 1 diabetes mellitu
• 刊名：The Journal of Pediatrics
• 出版年：2012
• 出版时间：June, 2012
• 年：2012
• 卷：160
• 期：6
• 页码：911-917
• 全文大小：147 K

文摘

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Objective

To evaluate how adolescents with or at risk for type 2 diabetes mellitus (T2DM) and their parent/guardians (parents) perceive adolescents¡¯ health-related quality of life.

Study design

We interviewed overweight/obese, 12- to 18-year-old youth with T2DM, prediabetes, or insulin resistance and one parent from 5 US sites. Assessments included Pediatric Quality of Life Inventory (PedsQL), Health Utilities Index, family conflict, and diabetes burden.

Results

In 108 adolescents, diagnoses included 40.7 % with T2DM, 25.0 % with prediabetes, and 34.3 % with insulin resistance. PedsQL summary score (SS) was higher in adolescents than parents (P = .02). Parents rated physical functioning lower than adolescents (P < .0001), but there were no differences in psychosocial health. Adolescent PedsQL SS did not differ with diagnosis, but was inversely associated with adolescent body mass index z-score (P = .0004) and family conflict (P < .0001) and associated with race/ethnicity (P < .0001). Number of adolescent co-morbidities (P = .007) and burden of diabetes care (P < .05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score.

Conclusions

Parents perceive their adolescents¡¯ physical functioning as more impaired than adolescents themselves. Contextual factors including severity of obesity, race/ethnicity, family conflict, and burden of diabetes care influence health-related quality of life. Family-based approaches to treatment and prevention of T2DM may benefit from increased attention to the biopsychosocial context.