title: 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.
authors.affiliation: MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. ws@mrc.soton.ac.uk
authors.forename: Wolff
authors.initials: W
authors.lastname: Schlotz
authors.forename: Phil
authors.initials: P
authors.lastname: Ambery
authors.forename: Holly E
authors.initials: HE
authors.lastname: Syddall
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Crozier
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: David I W
authors.initials: DI
authors.lastname: Phillips
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology*; D004739:England; D005260:Female; D006304:Health Status; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D018434:Sickness Impact Profile; D012923:Social Class; D011795:Surveys and Questionnaires