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. MEASUREMENTS: sex, age, family history, employment status, comorbidities, pain, lifestyle habits, anthropometrics, blood pressure, blood analysis and HRqol with COOP/WONCA questionnaire (7 dimensions). STATISTICS: 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.