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

作者：Rhodes Erinn T^*; Goran Michael I; Lieu Tracy A; Lustig Robert H; Prosser Lisa A; Songer Thomas J; Weigen**erg Marc J; Weinstock Ruth S; Gonzalez Tessa; Rawluk Kaitlin; Zoghbi Roula M; Ludwig David S; Laffel Lori M

来源：Journal of Pediatrics, 2012, 160(6): 911-917.

DOI：10.1016/j.jpeds.2011.11.026

Objective To evaluate how adolescents with or at risk for type 2 diabetes mellitus (T2DM) and their parent/guardians (parents) perceive adolescents%26apos; health-related quality of life. %26lt;br%26gt;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. %26lt;br%26gt;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 %26lt; .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 %26lt; .0001) and associated with race/ethnicity (P %26lt; .0001). Number of adolescent co-morbidities (P = .007) and burden of diabetes care (P %26lt; .05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score. %26lt;br%26gt;Conclusions Parents perceive their adolescents%26apos; 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. (J Pediatr 2011;square:square-square).

• 出版日期2012-6