Specific associations of insulin resistance with impaired health-related quality of life in the Hertfordshire Cohort Study.
ABSTRACT Insulin resistance is a metabolic abnormality that underlies Type 2 diabetes, the metabolic syndrome and cardiovascular disease, but it may also be associated with more global health deficits. This study assessed associations of insulin resistance with health-related quality of life (HRQoL) in different domains of physical and mental health in a large elderly population study. Cross-sectional data of 1212 participants from the Hertfordshire Cohort Study were analysed. Insulin resistance was assessed by the homeostatic model assessment (HOMA-IR), and HRQoL was measured using the SF-36 health survey. Poor HRQoL was defined by a score lower than the sex-specific 10th percentile of each scale, and logistic regressions yielded odds ratios in relation to the HOMA-IR scores. Subsequent analyses adjusted for the influence of age, smoking, alcohol consumption, social class, BMI, coronary heart disease and depression. Results showed an increase in poor HRQoL with an increase in HOMA-IR scores for physical functioning (OR = 2.29; CI: 1.67-3.13), vitality (OR = 1.45; CI: 1.05-2.00), and general health (OR = 1.62; CI: 1.19-2.21). In men, but not in women, associations with physical functioning were independent of confounding variables. The results indicate that insulin resistance is associated with poor HRQoL in domains of physical health, but not in domains of mental health.
- SourceAvailable from: Kenneth J Gruber
[Show abstract] [Hide abstract]
- "The SF-36 has been shown to have very good psychometric properties, with high internal consistency and testretest reliability values from studies of populations with a range of ages and health conditions in the U.S.  and  and worldwide , ,  and . But, only a few studies have investigated the properties of the SF-36 with Asian samples, primarily Chinese residing in mainland China. "
ABSTRACT: This study investigated the psychometric properties of the 36-item Short-Form Health Survey (SF-36) (China version) in older Chinese with diabetes living in Beijing, China. The SF-36 was administered to community-based sample of 182 older adults with diabetes living in Beijing. Data collection was conducted in face-to-face interviews. Reliability and validity were assessed using internal consistency, convergent and discriminant analyses. Exploratory principal components analyses (PCA) were conducted to compare the sample's response patterns with the hypothesized scale constructs. Item level validation of the scale supported the assumptions of the hypothesized structure. Internal consistency reliability (Cronbach's alpha >.70) of the subscales were acceptable except for the General Health subscale (.67). PCA confirmed general support of the two hypothesized dimensional factors and eight concepts (factors). The physical component summary (PCS) and the mental component summary (MCS) explained 62.26% of the variance and the eight factors components explained 67.39% of the variance. Known-group comparisons of scale scores indicated significantly higher levels of functionality for respondents with no blood pressure, heart, or depressive symptomatology problems. The Chinese version of the SF-36 showed good reliability and validity and was culturally equivalent. The scale is appropriate for use with older Chinese adults with diabetes.Diabetes research and clinical practice 04/2010; 88(3):273-81. DOI:10.1016/j.diabres.2010.03.005 · 2.54 Impact Factor
- Diabetes Obesity and Metabolism 12/2007; 9(6):917-9. DOI:10.1111/j.1463-1326.2007.00731.x · 5.46 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We aimed to investigate the association of the clinical variables of the metabolic syndrome (MS) and psychological parameters on health-related quality of life (HRQL) in obesity. In particular, our aim was to investigate the relative impact of physical symptoms, somatic diseases and psychological distress on both the physical and the mental domains of HRQL. Cross-sectional study. A cohort of 1822 obese outpatients seeking treatment in medical centers. HRQL was measured by the standardized summary scores for physical (PCS) and mental (MCS) components of the Short Form 36 Health Survey (SF-36). Patients were grouped according to tertiles of PCS and MCS. Metabolic and psychological profiles of PCS and MCS tertiles were compared by discriminant analysis. The profile of metabolic and psychological variables was tertile-specific in 62.4 and 68.3% of patients in the lowest and highest tertiles of PCS, respectively, while concordance was low in the mid-tertile (32.8%). Concordance was very high in the lowest (74.4%) and in the highest (75.5%) tertiles of MCS, and was fair in the mid-tertile (53.2%). The main correlates of PCS were obesity-specific and general psychological well-being, BMI, body uneasiness, binge eating, gender and psychiatric distress. Only hypertension and hyperglycemia qualified as correlates among the components of MS. The components of MS did not define MCS. Psychological well-being is the most important correlate of HRQL in obesity, both in the physical and in the mental domains, whereas the features of MS correlate only to some extent with the physical domain of HRQL.International journal of obesity (2005) 02/2008; 32(1):185-91. DOI:10.1038/sj.ijo.0803687 · 5.39 Impact Factor