目标:2型糖尿病(T2D)不成比例地影响生活在具有挑战性的社会经济条件下的青少年。然而,在这种情况下,T2D对生活质量(QOL)的影响尚不清楚。我们在这项研究中的目的是评估QOL并确定其生物学,心理,以及来自相似社会人口统计学背景的有和没有T2D的青少年的社会决定因素。血糖稳定性之间的关系,早期并发症,还检查了T2D和QOL的治疗。
方法:92名患有T2D的青少年和59名有风险的对照者从改善2型糖尿病青少年肾脏并发症的研究(iCARE)队列中纳入。主要结果是QOL(儿科QOL量表[PedsQL])。生物协变量包括年龄,性别,体重指数z评分,糖化血红蛋白,估计肾小球滤过率,和尿白蛋白:肌酐比值。心理因素包括感知压力(14项感知压力量表)和精神困扰(6项凯斯勒量表)。社会因素包括粮食安全(家庭粮食安全调查模块)和收入五分之一。使用多元线性回归分析来确定有和没有T2D的青少年之间与QOL相关的因素。在T2D队列中。
结果:T2D青少年的平均总生活质量分数低于对照组(67.0±14.8vs71.7±16.2,p=0.04)。年龄,性别,土著种族百分比在群体之间没有显着差异。T2D的平均持续时间为2.3±2.0年。在多变量分析中,QOL与糖尿病状态无关,但是精神困扰(β=-1.46,p<0.001)与粮食不安全生活质量(β=-6.26,p=0.037)之间呈负相关。在两种分析中,生物因素和QOL之间均未见差异。
结论:与T2D青少年生活质量下降相关的重要因素包括精神困扰和食物不安全,指出有针对性干预的领域。
OBJECTIVE: Type 2 diabetes (T2D) disproportionately impacts adolescents living in challenging socioeconomic conditions. However, the impacts of T2D on quality of life (QOL) in this context are unknown. Our aim in this study was to evaluate QOL and identify its biological, psychological, and social determinants among adolescents living with and without T2D from similar sociodemographic backgrounds. Relationships between glycemic stability, early complications, and treatments of T2D and QOL were also examined.
METHODS: Ninety-two adolescents with T2D and 59 at-risk controls were included from the Improving Renal Complications in Adolescents With Type 2 Diabetes Through Research (iCARE) cohort. The main outcome was QOL (Pediatric QOL Inventory [PedsQL]). Biological covariates included age, sex, body mass index z score, glycated hemoglobin, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio. Psychological factors included perceived stress (14-item Perceived Stress Scale) and mental distress (6-item Kessler scale). Social factors included food security (Household Food Security Survey Module) and income quintile. Multivariate linear regression analyses were used to identify factors associated with QOL between adolescents with and without T2D, and within the T2D cohort.
RESULTS: Mean total QOL scores among adolescents with T2D were lower than in controls (67.0±14.8 vs 71.7±16.2, p=0.04). Age, sex, and percent Indigenous ethnicity were not significantly different between groups. Mean duration of T2D was 2.3±2.0 years. In the multivariate analysis, QOL was not associated with diabetes status, but negative associations were seen between mental distress (β=-1.46, p<0.001) and food insecurity QOL (β=-6.26, p=0.037). No differences were seen between biological factors and QOL in either analysis.
CONCLUSIONS: Significant factors associated with decreased QOL in adolescents living with T2D include mental distress and food insecurity, indicating areas for targeted intervention.