Prediction of mortality in type 2 diabetes from health-related quality of life (ZODIAC-4).
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.
Kleefstra
Nanne
N
Diabetes Centre, Isala Clinics, Zwolle, Netherlands. kleefstra@langerhans.com
Landman
Gijs W D
GW
Houweling
Sebastiaan T
ST
Ubink-Veltmaat
Lielith J
LJ
Logtenberg
Susan J J
SJ
Meyboom-de Jong
Betty
B
Coyne
James C
JC
Groenier
Klaas H
KH
Bilo
Henk J G
HJ
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