title: A descriptive study of health status and health related quality of life in selected outpatients with type 2 diabetes, pathological body mass index and cardiovascular risk in Spain.
abstract: BACKGROUND
  Ottawa Charter defined health as a resource for everyday life and as an important dimension of health related quality of life (HRqol). Diabetes and obesity have repeatedly been shown as diseases that diminish health status and HRqol. The aim of this study was to measure health status and HRqol in a Spanish sample of obese patients with type 2 diabetes at cardiovascular risk and analyze behavioural, biological and social determinants of health.
  
  
  METHODS
  Outpatients from external specialized clinic in Endocrinology were evaluated.
  
  
  METHODS
  sex, age, family history, employment status, comorbidities, pain, lifestyle habits, anthropometrics, blood pressure, blood analysis and HRqol with COOP/WONCA questionnaire (7 dimensions).
  
  
  METHODS
  univariate, bivariate, multivariate and comparative analysis.
  
  
  RESULTS
  Mean age was 59.1 ± 7.6 [95%IC: 56.6-61.6], 74% were women and 63.2% were physically active. WONCA values were; summary index (SI): 18.7 ± 4 [95%IC: 17.3-20] (maximum 35); physical fitness: 3.3 ± 1, feelings: 2.3 ± 1.1, social activities: 1.5 ± 1, daily activities: 2.1 ± 1.2, change in health: 2.7 ± 0.9, overall health: 3.6 ± 0.7 and pain: 3.5 ± 1.2 (maximum 5). High fibrinogen values (339.3 ± 85.8 [95%IC: 309.8-368.8]) negatively influenced pain visual analogic scale (p = 0.029). Physically active patients (63.2%) had better values in daily activities dimension (p = 0.025). More than the half of the sample (51.5%) reported a good quality of sleep, but the pain worsened it (p = 0.040). High BMI values (34.8 ± 5.8 [95%IC: 32.9-36.7]) harmed the COOP-WONCA SI (p = 0.009). High glycated hemoglobin (HbA1c) values (6.8 ± 1.3 [95%IC: 6.3-7.2]) had a negative impact on COOP-WONCA SI (p = 0.018). Nor tailored diet (15.8%) or being employed (18.4%) influenced the HRqol. The regression that best models COOP-WONCA SI was adjusted for BMI and HbA1c. SI = 3.509 + 0.335BMI +0.330HbA1c.
  
  
  CONCLUSIONS
  HRqol was worse than in general population, but better than in previous studies of diabetes patients, without differences by sex or age, though feelings, daily activities and pain dimensions scored worse than in these studies. Higher levels of HbA1c, obesity and procoagulative state had a negative impact in these last dimensions. Pain impaired quality of sleep and physical activity had a positive impact in daily activities. BMI and HbA1c modeled the HRqol.
authors.affiliation: Specialty Medical Center Grande Covián, SALUD, Avda. Alcalde Caballero, 196, 50014 Zaragoza, Spain ; Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Vidal-Peracho
authors.affiliation: Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Maria Orosia
authors.initials: MO
authors.lastname: Lucha-López
authors.affiliation: Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Ana Carmen
authors.initials: AC
authors.lastname: Lucha-López
authors.affiliation: Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Tricás-Moreno
authors.affiliation: Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Estébanez-De Miguel
authors.affiliation: Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Bernués-Vázquez
keywords: Cardiovascular risk; Diabetes mellitus; Health related quality of life; Health status; Obesity; Type 2