Prediction of Mortality in Type 2 Diabetes From Health-Related Quality of Life (ZODIAC-4)
- Nanne Kleefstra, MD12,
- Gijs W.D. Landman, MD3,
- Sebastiaan T. Houweling, MD, PHD24,
- Lielith J. Ubink-Veltmaat, MD, PHD5,
- Susan J.J. Logtenberg, MD1,
- Betty Meyboom-de Jong, MD, PHD6,
- James C. Coyne, PHD7,
- Klaas H. Groenier, PHD6 and
- Henk J.G. Bilo, MD, PHD18
- 1Diabetes Centre, Isala Clinics, Zwolle, the Netherlands
- 2Langerhans Medical Research Group, Zwolle, the Netherlands
- 3Department of Internal Medicine, Isala Clinics, Zwolle, the Netherlands
- 4General Practice Sleeuwijk, Sleeuwijk, the Netherlands
- 5General Practice ‘t Veen, Hattem, the Netherlands
- 6Department of General Practice, University of Groningen, Groningen, the Netherlands
- 7Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
- 8Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands
- Corresponding author: Nanne Kleefstra, Diabetes Centre, Isala Clinics, Zwolle, Netherlands. E-mail: kleefstra{at}langerhans.com
Abstract
OBJECTIVE—To investigate the relationship between health-related quality of life (HRQOL) and mortality in type 2 diabetes.
RESEARCH DESIGN AND METHODS—In 1998, 1,143 primary care patients with type 2 diabetes participated in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study. At baseline, HRQOL was assessed with the RAND-36 and, after almost 6 years, life status was retrieved. Cox proportional hazards modeling was used to investigate the association between HRQOL (continuous data) and mortality with adjustment for selected confounders (smoking, age, sex, diabetes duration, A1C, renal function, BMI, blood pressure, HDL cholesterol, and macrovascular complications).
RESULTS—The Physical Component Summary of the RAND-36 was inversely associated with mortality (hazard ratio [HR] 0.979 [95% CI 0.966–0.992]), as were two separate RAND-36 dimensions.
CONCLUSIONS—This study found that HRQOL is an independent marker of mortality and emphasizes the importance of looking beyond clinical parameters in patients with type 2 diabetes.
- HRQOL, health-related quality of life
- MCS, mental component summary
- PCS, physical component summary
- ZODIAC, Zwolle Outpatient Diabetes project Integrating Available Care
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 4 March 2008. DOI: 10.2337/dc07-2072.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted January 29, 2008.
- Received October 29, 2007.
- DIABETES CARE
