title: 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.
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].
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Social and Preventive Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. nrlz_ibrahim@yahoo.com.
authors.forename: Norliza
authors.initials: N
authors.lastname: Ibrahim
authors.forename: Foong Ming
authors.initials: FM
authors.lastname: Moy
authors.forename: Intan Attikah Nur
authors.initials: IA
authors.lastname: Awalludin
authors.forename: Zainudin
authors.initials: Z
authors.lastname: Ali
authors.forename: Ikram Shah
authors.initials: IS
authors.lastname: Ismail
mesh_terms: D000704:Analysis of Variance; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000523:psychology*; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D011236:Prediabetic State / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires