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Alper HE, Feliciano L, Millien L, Pollari C, Locke S. Post-Traumatic Growth and Quality of Life among World Trade Center Health Registry Enrollees 16 Years after 9/11. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9737. [PMID: 35955093 PMCID: PMC9368472 DOI: 10.3390/ijerph19159737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
A recent study of World Trade Center Health Registry enrollees found that about one-third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees' overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental functioning quality of life scales in a sample of 4760 enrollees from the Registry's Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry's baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sociodemographic and other variables. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: b = 0.15 (-0.45, 0.75), mental: b = 3.61 (2.85, 4.37)). Those who were physically injured during 9/11 showed larger improvements in mental functioning than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.
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Affiliation(s)
- Howard E. Alper
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Leen Feliciano
- Graduate School of Public Health and Health Policy, The City University of New York, New York, NY 10027, USA
| | - Lucie Millien
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Cristina Pollari
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Sean Locke
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
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Soldevila-Boixader L, Mur I, Morata L, Sierra Y, Rivera A, Bosch J, Montero-Saez A, Fernández-Reinales AJ, Martí S, Benito N, Murillo O. Clinical usefulness of quantifying microbial load from diabetic foot ulcers: A multicenter cohort study. Diabetes Res Clin Pract 2022; 189:109975. [PMID: 35777672 DOI: 10.1016/j.diabres.2022.109975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate if microbial load from diabetic foot ulcers (DFUs) can help in predicting outcomes. METHODS A multicenter prospective cohort study was performed in an outpatient setting (September 1, 2017-January 31, 2019) in diabetic patients with DFU.Quantitative cultures from DFU tissue biopsies at a baseline visit were obtained; high and low microbial loads were defined as ≥6logCFU/mL and <6logCFU/mL, respectively. Diagnosis of DFU infection was made and managed according to established guidelines. The outcome was evaluated at 6 month-visit as failure (persistence/new infection/amputation) or cure. RESULTS Out of 65 patients, 52 (80%) had long-standing DFUs (≥4 weeks), with high microbial load in 19 (29%).DFU infection (n = 24, 37%) was not associated with high microbial load in all patients but those with shorter DFU duration.Treatment failure occurred in 20/57 (35%) patients; high DFU microbial load was associated with worse outcome (n = 9/20, 45% failure rate, adjusted OR4.69; 95% CI, 1.22-18.09; p = 0.03),mainly due to the subgroup of patients with high microbial load and long-stand DFUs. CONCLUSIONS Since patients with high microbial load had a worse outcome, quantitative cultures from DFUs can identify patients who would benefit from antibiotic therapy.
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Affiliation(s)
- Laura Soldevila-Boixader
- Department of Infectious Diseases, Bellvitge University Hospital, IDIBELL, University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Isabel Mur
- Infectious Diseases Unit, Santa Creu i Sant Pau Hospital, Sant Pau Biomedical Research Institute, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Laura Morata
- Department of Infectious Diseases, Clinic Hospital Barcelona, IDIBAPS, UB, Barcelona, Spain
| | - Yanik Sierra
- Department of Microbiology, Bellvitge University Hospital, IDIBELL, UB, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Alba Rivera
- Department of Microbiology, Santa Creu i Sant Pau Hospital, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Genetic and Microbiology, UAB, Barcelona, Spain
| | - Jordi Bosch
- Department of Microbiology, Clinic Hospital, Barcelona, Spain
| | - Abelardo Montero-Saez
- Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Sara Martí
- Department of Microbiology, Bellvitge University Hospital, IDIBELL, UB, L'Hospitalet de Llobregat, Barcelona, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - Natividad Benito
- Infectious Diseases Unit, Santa Creu i Sant Pau Hospital, Sant Pau Biomedical Research Institute, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain; Study Group on Osteoarticular Infections of the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIO-SEIMC), Spain
| | - Oscar Murillo
- Department of Infectious Diseases, Bellvitge University Hospital, IDIBELL, University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain; Study Group on Osteoarticular Infections of the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIO-SEIMC), Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain.
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López-Sánchez J, Esteban C, Iglesias MJ, González LM, Quiñones JE, González-Muñoz JI, Tabernero G, Iglesias RA, Fraile P, Muñoz-González JI, Muñoz-Bellvís L. Factors affecting diabetic patient's long-term quality of life after simultaneous pancreas-kidney transplantation: a single-center analysis. Langenbecks Arch Surg 2021; 406:873-882. [PMID: 33416988 DOI: 10.1007/s00423-020-02059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Pancreas transplantation (PT) is one of the few ways to restore euglycemia within diabetic patients; however, the high morbidity caused by surgical complications and the need for immunosuppressive therapy has raised controversy about PT improving the health-related quality-of-life (HRQoL). The aim of this study is to assess the long-term (≥ 5 years after PT) HRQoL and to identify the factors affecting it. METHODS A single-center, cross-sectional study of 49 sequential PT was performed. All patients conducted a telephone interview to fulfill the modification of Medical Outcome Health Survey Short Form questionnaire (SF-36v2) and were compared to similar post-PT studies from the literature. RESULTS Patients with a history of replacement renal therapy (RRT) or neuropathy undergoing a PT were associated to a worse bodily pain (P = 0.03) and physical function (P = 0.04), respectively, whereas those with retinopathy showed an improved Role Emotional (P = 0.04). Multivariate analysis revealed the presence of RRT as the only independent prognostic factor for a worse bodily pain [relative risk = 3.9; 95% confidence interval (1.1-14.6)], (P = 0.04). Furthermore, nearly all PT recipients (91.8%) claimed an overall better health than prior to PT. CONCLUSION Our study confirms that PT recipients' HRQoL improves after PT, showing similar HRQoL scores across different populations and suggests that patients in predialysis could benefit from an improved HRQoL if transplanted on the early stages of the disease.
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Affiliation(s)
- Jaime López-Sánchez
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Carmen Esteban
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Manuel J Iglesias
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Luis M González
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - José E Quiñones
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Juan I González-Muñoz
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Guadalupe Tabernero
- Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Rosa A Iglesias
- Department of Endocrinology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Pilar Fraile
- Department of Nephrology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Javier I Muñoz-González
- Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain.,Cancer Research Center (IBMCC, USAL-CSIC), Department of Medicine and Cytometry Service (NUCLEUS), Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Universidad de Salamanca, Salamanca, Spain
| | - Luis Muñoz-Bellvís
- Department of General and Gastrointestinal Surgery, Pancreas Transplant Program, Hospital Universitario de Salamanca, Salamanca, Spain. .,Biomedical Research Institute of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain. .,Department of Surgery, Hospital Universitario de Salamanca, Paseo San Vicente, 88-132, 37007, Salamanca, Spain.
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Trend in health-related quality of life and health utility and their decrements due to non-communicable diseases and risk factors: analysis of four population-based surveys between 1998 and 2015. Qual Life Res 2020; 29:2921-2934. [PMID: 32623685 DOI: 10.1007/s11136-020-02560-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To revisit the population norms of health-related quality of life (HRQoL) and health utility for the Hong Kong general population, compare these scores over past health surveys, and assess the association of scores with non-communicable diseases (NCDs) and their risk factors. METHODS HRQoL data measured by the standard Short Form 12 Health Survey-version 2 (SF-12v2) were extracted from the surveys in 1998, 2003/2004, 2008/2009 and 2014/2015. SF-12v2 data were mapped to the Short-form 6-dimension (SF-6D) preference-based measure to generate the health utility scores. Population weighting based on the sex and age in the second quarter of 2015 was applied when generating population normative values. Linear regression models were fitted to assess the effect of the number of NCDs and modifiable lifestyle factors on HRQoL and health utility. RESULTS The general population mean scores of SF-12v2 domains and SF-6D in 2014/15 were higher compared to past surveys. Linear increases in General Health, Vitality and Mental Health domains were observed from 1998 to 2014/15. More doctor-diagnosed NCDs, insufficient physical activity and fruit/vegetable consumption, poor sleep quality and insufficient or excessive amount of sleep (< 6/≥ 10 h) were all associated with worse physical- and mental-related HRQoL and health utility. CONCLUSION This study compared HRQoL and health utility in the Hong Kong general population derived from multiple surveys and found an improving trend over twenty years. More NCDs were associated with worse HRQoL. It is suggested that promoting adequate physical activity, consumption of fruit/vegetable and 6-9 h of sleep could improve health.
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Rashidi A, Higgs P, Carruthers S. Aboriginal people with chronic HCV: The role of community health nurses for improving health-related quality of life. Collegian 2020. [DOI: 10.1016/j.colegn.2019.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hernáez Á, Zomeño MD, Dégano IR, Pérez-Fernández S, Goday A, Vila J, Civeira F, Moure R, Marrugat J. Exceso de peso en España: situación actual, proyecciones para 2030 y sobrecoste directo estimado para el Sistema Nacional de Salud. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.07.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Setiati S, Laksmi PW, Aryana IGPS, Sunarti S, Widajanti N, Dwipa L, Seto E, Istanti R, Ardian LJ, Chotimah SC. Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition. BMC Geriatr 2019; 19:182. [PMID: 31269921 PMCID: PMC6609407 DOI: 10.1186/s12877-019-1198-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/24/2019] [Indexed: 12/16/2022] Open
Abstract
Background Information about frailty status and its transition is important to inform clinical decisions. Predicting frailty transition is beneficial for its prevention. While Indonesia is the 4th largest geriatric population in Asia, data about frailty transition is limited. This study aimed to obtain data on prevalence of frailty, its risk factors, frailty state transition and its prognostic factors, as well as to develop prognostic score for frailty state transition. Methods Multicenter study on subjects aged ≥60 years old was done to obtain the prevalence of frailty status and to identify risk factors of frailty. Prospective cohort over 12 months was done to obtain data on frailty state transition. Multiple logistic regression analysis was performed to identify its prognostic factors from several clinical data, which then were utilized to develop prognostic score for frailty state worsening. Results Cross-sectional data from 448 subjects showed that 25.2% of the subjects were frail based on Frailty index-40 items. Risk factors of frailty were age (OR 2.72; 95% CI 1.58–4.76), functional status (OR 2.89; 95% CI 1.79–4.67), and nutritional status (OR 3.75; 95% CI 2.29–6.13). Data from the 162 subjects who completed the cohort showed 27.2% of the cohort had frailty state worsening. Prognostic factors for frailty state worsening were being 70 years or older (OR 3.9; 95% CI 1.2–12.3, p < 0.05), negative QoL, i.e., fair and poor QoL (OR 2.5; 95% CI 1.1–5.9, p < 0.05), and slow gait speed (OR 2.8; 95% CI 1.3–6.4, p < 0.05). The internal validation of the prognostic score consisted of those three variables showed good performance. Conclusion The prevalence of frailty in this study among Indonesian elderly in outpatient setting was 25.2%. The risk factors of frailty were age, functional status and nutritional status. The prognostic factors for frailty state worsening were being 70 years old or older, negative QoL (fair or poor quality of life), and slow gait speed. A prognostic score to predict frailty state worsening in 12 months had been developed.
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Affiliation(s)
- Siti Setiati
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. .,Clinical Epidemiology and Evidence Based Medicine Unit, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Pangeran Diponegoro No. 71, Jakarta, 10430, Indonesia.
| | - Purwita Wijaya Laksmi
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I G P Suka Aryana
- Division of Geriatric, Departement of Internal Medicine, Faculty of Medicine, Universitas Udayana, Sanglah Teaching Hospital, Bali, Bali, Indonesia
| | - Sri Sunarti
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, dr. Syaiful Anwar Hospital, Malang, East Java, Indonesia
| | - Novira Widajanti
- Division of Geriatric, Departement of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Lazuardhi Dwipa
- Division of Geriatric,Department of Internal Medicine, Faculty of Medicine, Universitas Padjajaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Euphemia Seto
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rahmi Istanti
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Laurentius Johan Ardian
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Sabrina Chusnul Chotimah
- Division of Geriatric, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Salmerón D, Gómez García F, Pons-Fuster E, Pérez-Sayáns M, Lorenzo-Pouso AI, López-Jornet P. Screening for prediabetes and risk of periodontal disease. Diabetes Metab Syndr 2019; 13:1661-1666. [PMID: 31336538 DOI: 10.1016/j.dsx.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 03/05/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Diabetes and periodontitis are non-transmissible chronic disorders that exhibit a mutual relationship. A study was made to evaluate the risk of prediabetes and periodontal disease, and to explore the association between them. METHODS A descriptive cross-sectional study was made of 186 individuals over 18 years of age, without prediabetes or diabetes, or cognitive impairment. Subjects undergoing dental treatment and pregnant women were excluded. Prediabetes risk was assessed based on the Finnish Diabetes Risk Score (FINDRISC), and the individual risk of development and/or progression of periodontal disease was explored with a periodontal disease risk questionnaire. RESULTS A total of 135 gingival risk questionnaires and 142 FINDRISC questionnaires were correctly completed. The proportion of subjects with a low, moderate and high risk of periodontal disease was 60.36%, 38.74% and 0.9%, respectively. With regard to the FINDRISC, the proportion of individuals with low, slightly increased, moderately increased and high risk of prediabetes was 54.4%, 32.8%, 8%, and 4.8%, respectively. A significant linear correlation between the two scores was observed (r = 0.3659, p < 0.0005). The variables associated with a slightly increased risk of prediabetes were age, overweight and smoking, while the variables associated with a moderately increased or high risk were age 40-65 years, tooth loss, overweight and smoking. CONCLUSIONS These questionnaires may be of benefit to patients and can contribute to develop a chronic care model characterized by collaboration among different healthcare professionals.
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Affiliation(s)
- Diego Salmerón
- Faculty of Medicine, University of Murcia, Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
| | - Francisco Gómez García
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Clínica Odontológica Universitaria Hospital Morales Meseguer Adv, Marques de los velez s/n, Murcia, 30008, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Eduardo Pons-Fuster
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain; Colaborate Oral Medicine, Clínica Odontológica Universitaria Hospital Morales Meseguer, Adv. Marques de los velez s/n, Murcia, 30008, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Entrerríos s/n, Santiago de Compostela, C.P 15782, Spain.
| | - Alejandro I Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Entrerríos s/n, Santiago de Compostela, C.P 15782, Spain.
| | - Pia López-Jornet
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Clínica Odontológica Universitaria Hospital Morales Meseguer Adv, Marques de los velez s/n, Murcia, 30008, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain.
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Hernáez Á, Zomeño MD, Dégano IR, Pérez-Fernández S, Goday A, Vila J, Civeira F, Moure R, Marrugat J. Excess Weight in Spain: Current Situation, Projections for 2030, and Estimated Direct Extra Cost for the Spanish Health System. ACTA ACUST UNITED AC 2018; 72:916-924. [PMID: 30473259 DOI: 10.1016/j.rec.2018.10.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 07/13/2018] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES Excess weight promotes the development of several chronic diseases and decreases quality of life. Its prevalence is increasing globally. Our aim was to estimate the trend in excess weight between 1987 and 2014 in Spanish adults, calculate cases of excess weight and its direct extra costs in 2006 and 2016, and project its trend to 2030. METHODS We selected 47 articles in a systematic literature search to determine the progression of the prevalence of overweight, nonmorbid obesity, and morbid obesity and average body mass index between 1987 and 2014. We projected the expected number of cases in 2006, 2016, and 2030 and the associated direct extra medical costs. RESULTS Between 1987 and 2014, the prevalence of overweight, obesity, and morbid obesity increased by 0.28%/y (P=.004), 0.50%/y (P <.001) and 0.030%/y (P=.006) in men, and by 0.10%/y (P=.123), 0.25%/y (P=.078), and 0.042%/y (P=.251) in women. The mean body mass index increased by 0.10 kg/m2/y in men (P <.001) and 0.26 kg/m2/y in women (significantly only between 1987 and 2002, P <.001). We estimated 23 500 000 patients with excess weight in 2016, generating 1.95 billion €/y in direct extra medical costs. If the current trend continues, between 2016 and 2030, there will be 3 100 000 new cases of excess weight, leading to 3.0 billion €/y of direct extra medical costs in 2030. CONCLUSIONS Excess weight in Spanish adults has risen since the creation of population registries, generating direct extra medical costs that represent 2% of the 2016 health budget. If this trend continues, we expect 16% more cases in 2030 and 58% more direct extra medical costs.
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Affiliation(s)
- Álvaro Hernáez
- Grupo de Investigación en Riesgo Cardiovascular, Nutrición y Envejecimiento, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Facultad de Ciencias de la Salud Blanquerna, Universitat Ramón Llull, Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - M Dolores Zomeño
- Facultad de Ciencias de la Salud Blanquerna, Universitat Ramón Llull, Barcelona, Spain; Grupo de Investigación en Riesgo Cardiovascular y Nutrición-REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Programa de Doctorado en Alimentación y Nutrición, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain
| | - Irene R Dégano
- Grupo de investigación REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Pérez-Fernández
- Grupo de investigación REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto Goday
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación en Riesgo Cardiovascular y Nutrición-REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Servicio de Endocrinología, Hospital del Mar, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Vila
- Grupo de investigación REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Civeira
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Unidad de Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Ricardo Moure
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Departamento de Bioquímica y Biomedicina Molecular, Institut de Biomedicina IBUB, Universitat de Barcelona, Barcelona, Spain
| | - Jaume Marrugat
- Grupo de investigación REGICOR, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
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Makrilakis K, Liatis S, Tsiakou A, Stathi C, Papachristoforou E, Perrea D, Katsilambros N, Kontodimopoulos N, Niakas D. Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study. BMC Endocr Disord 2018; 18:32. [PMID: 29843700 PMCID: PMC5975583 DOI: 10.1186/s12902-018-0261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/18/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes mellitus is usually preceded by a pre-diabetic stage before the clinical presentation of the disease, the influence of which on persons' quality of life is not adequately elucidated. The purpose of this study was to compare the Health-Related Quality of Life (HRQOL) of persons with pre-diabetes with that of diabetes or normal glucose tolerance (NGT), using the validated HRQOL-15D questionnaire. METHODS The HRQOL-15D scores of 172 people with pre-diabetes (108 with Impaired Fasting Glucose [IFG], 64 with Impaired Glucose Tolerance [IGT], aged 58.3 ± 10.3 years) and 198 with NGT (aged 54.4 ± 10.1 years) from the Greek part of the DEPLAN study (Diabetes in Europe - Prevention using Lifestyle, Physical Activity and Nutritional Intervention), were compared to 100 diabetes patients' scores (aged 60.9 ± 12.5 years, diabetes duration 17.0 ± 10.0 years, HbA1c 7.2 ± 1.2%), derived from the outpatient Diabetes Clinic of a University Hospital. RESULTS The diabetes patients' HRQOL-15D score (0.8605) was significantly lower than the pre-diabetes' (0.9008) and the controls' (0.9092) (p < 0.001). There were no differences in the total score between the controls and the group with pre-diabetes. However, examination of individual parameters of the score showed that people with IGT had lower scores compared to the control group, as related to the parameters of "mobility" and "psychological distress". No differences were found in any component of the HRQOL-15D score between the control group and the IFG group, nor between the two groups with pre-diabetes (IFG vs. IGT). CONCLUSIONS Persons with pre-diabetes had a similar HRQOL score with healthy individuals, and a higher score than persons with diabetes. Specific components of the score, however, were lower in the IGT group compared to the controls. These findings help clarify the issue of HRQOL of persons with pre-diabetes and its possible impact on prevention.
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Affiliation(s)
- Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Afroditi Tsiakou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Chryssoula Stathi
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Eleftheria Papachristoforou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Despoina Perrea
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | - Nicholas Katsilambros
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | | | - Dimitrios Niakas
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Hellenic Open University, Patras, Greece
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Hunger M, Holle R, Meisinger C, Rathmann W, Peters A, Schunk M. Longitudinal changes in health-related quality of life in normal glucose tolerance, prediabetes and type 2 diabetes: results from the KORA S4/F4 cohort study. Qual Life Res 2014; 23:2515-20. [PMID: 24729056 DOI: 10.1007/s11136-014-0689-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to examine how transition between normal glucose tolerance, prediabetes and diabetes over a 7 year period is associated with change in health-related quality of life (HRQL) in an elder German population-based cohort. METHODS We used data from 1,046 participants of the KORA S4/F4 cohort study aged 55-74 years at baseline. Based on an oral glucose tolerance test, prediabetes was defined as impaired fasting glucose and/or impaired glucose tolerance. HRQL was assessed with the SF-12 questionnaire. Using linear regression, we estimated mean change in HRQL over time, depending on glucose status at baseline and follow-up, adjusted by demographic and lifestyle variables. RESULTS Individuals progressing to prediabetes or diabetes experienced a greater loss in the physical component score than patients with persistent normal glucose tolerance (-2.31 and -7.44 vs. -1.08), but the difference was only significant for subjects converting to diabetes. Subjects with prediabetes at baseline and diabetes at follow-up had a significant loss in mental health compared to subjects with persistent prediabetes. CONCLUSIONS There is first evidence that worsening of glucose metabolism over time is associated with deteriorating HRQL, however, further and larger longitudinal studies are needed to confirm these findings.
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Affiliation(s)
- Matthias Hunger
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany,
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12
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Ibrahim N, Moy FM, Awalludin IAN, Ali Z, Ismail IS. The health-related quality of life among pre-diabetics and its association with body mass index and physical activity in a semi-urban community in Malaysia--a cross sectional study. BMC Public Health 2014; 14:298. [PMID: 24684809 PMCID: PMC3976088 DOI: 10.1186/1471-2458-14-298] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 03/20/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND People with pre-diabetes are at high risk of developing type 2 diabetes and cardiovascular diseases. Measurements of health-related quality of life (HRQOL) among pre-diabetics enable the health care providers to understand their overall health status and planning of interventions to prevent type 2 diabetes. Therefore we aimed to determine the HRQOL and physical activity level; and its association with Body Mass Index (BMI) among pre-diabetics. METHODS This was a cross sectional study carried out in two primary care clinics in a semi-urban locality of Ampangan, Negeri Sembilan, Malaysia. Data was collected through self-administered questionnaires assessing the demographic characteristics, medical history, lifestyle and physical activity. The Short Form 36-items health survey was used to measure HRQOL among the pre-diabetics. Data entry and analysis were performed using the SPSS version 19. RESULTS A total of 268 eligible pre-diabetics participated in this study. The prevalence of normal weight, overweight and obesity were 7.1%, 21.6% and 71.3% respectively. Their mean (SD) age was 52.5 (8.3) years and 64.2% were females. Among the obese pre-diabetics, 42.2% had both IFG and IGT, 47.0% had isolated IFG and 10.8% had isolated IGT, 36.2% had combination of hypertension, dyslipidemia and musculoskeletal diseases. More than 53.4% of the obese pre-diabetics had family history of diabetes, 15.7% were smokers and 60.8% were physically inactive with mean PA of <600 MET-minutes/week. After adjusted for co-variants, Physical Component Summary (PCS) was significantly associated with BMI categories [F (2,262)=11.73, p<0.001] where pre-diabetics with normal weight and overweight had significantly higher PCS than those obese; normal vs obese [Mdiff=9.84, p=0.006, 95% CIdiff=2.28, 17.40] and between overweight vs obese [Mdiff=8.14, p<0.001, 95% CIdiff=3.46, 12.80]. CONCLUSION Pre-diabetics who were of normal weight reported higher HRQOL compared to those overweight and obese. These results suggest a potentially greater risk of poor HRQOL among pre-diabetics who were overweight and obese especially with regard to the physical health component. Promoting recommended amount of physical activity and weight control are particularly important interventions for pre-diabetics at the primary care level.
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Affiliation(s)
- Norliza Ibrahim
- Department of Social and Preventive Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Zainudin Ali
- State Health Department of Negeri Sembilan, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia
| | - Ikram Shah Ismail
- Diabetes Association, Petaling Jaya, 46200 Selangor, Malaysia
- Department of Medicine, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia
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