title: Prediction of mortality in type 2 diabetes from health-related quality of life (ZODIAC-4).
abstract: OBJECTIVE
  To investigate the relationship between health-related quality of life (HRQOL) and mortality in type 2 diabetes.
  
  
  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.
authors.affiliation: Diabetes Centre, Isala Clinics, Zwolle, Netherlands. kleefstra@langerhans.com
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.forename: Sebastiaan T
authors.initials: ST
authors.lastname: Houweling
authors.forename: Lielith J
authors.initials: LJ
authors.lastname: Ubink-Veltmaat
authors.forename: Susan J J
authors.initials: SJ
authors.lastname: Logtenberg
authors.forename: Betty
authors.initials: B
authors.lastname: Meyboom-de Jong
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011788:Quality of Life