SFE2004 Poster Session Diabetes, metabolism and cardiovascular (24 abstracts)
Increased insulin resistance is strongly associated with decreased physical quality of life in elderly subjects from the Hertfordshire Cohort Study, independent of established IHD
PD Ambery 1 , SR Crozier 2 , EM Dennison 2 , A Aihie Sayer 2,3 , D Phillips 2 , C Cooper 2 & Herts Cohort Study Group 2
1GlaxoSmithKline UK, Uxbridge, Middx; 2MRC Epidemiology Resource Centre, Southampton, UK; 32University Geriatric Medicine, University of Southampton.
Introduction
The association between Type 2 diabetes and decreased quality of life (QoL) scores has been well documented. Insulin resistance (IR) is a key factor in the pathogenesis of both cardiovascular disease and Type 2 diabetes. In this study we assess the impact of increasing IR on QoL scores in patients yet to develop or with previously unknown diabetes diagnosed at screening review, and consider the effect of IHD as a potential confounder of these associations
Method
SF-36 scores were collected on 1,310 subjects from the Hertfordshire cohort between 1998 and 2002. Quartiles of HOMA-R were determined. Odds ratios (OR) for being in the lowest fifth of each SF-36 domain per increase of one quartile of IR were calculated. The analysis of the Physical Functioning (PF) domain was repeated amongst those with and without IHD.
Results
High IR was associated with poorer PF, Role-Physical, General Health Perception domains. The OR for poor PF was 1.56 per quartile of IR (95%CI 1.37, 1.78), P<0.001. There were similar relationships with Vitality and Bodily Pain, but not with Role-Emotional, Social Functioning or Mental Health (MH) domains (OR for poor MH was 1.04 per quartile of IR (95%CI 0.92, 1.17), P=0.53). Even after excluding IHD there was still a strong association between poorer PF and higher IR (OR 1.48 95%CI 1.28,1.72).
Discussion
This study suggests that increased morbidity associated with insulin resistance translates into significantly decreased physical QoL. This underlines the importance of early recognition of IR, so that intervention may prevent or delay subsequent morbidity burden and reduced physical QoL. The association between IR and poor physical functioning is not explained by cardiovascular co-morbidity, but could be mediated by other chronic disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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