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Estimation of the relationship between body mass index and EQ-5D health utilities in individuals with type 2 diabetes: Evidence from the population-based KORA studies
Journal of Diabetes and its Complications, 07/03/2012
Evidence Based Medicine
Clinical Article
Hunger M et al. - Body mass index (BMI) is strongly associated with health utilities in persons with type 2 diabetes. This suggests that lifestyle measures to reduce obesity can markedly improve patients' health-related quality of life and that the negative effect of potential weight gain should be taken into account when determining patient preferences for different type 2 diabetes treatment options.
Methods- The EQ-5D quality of life questionnaire was administered in a follow-up of 10,385 participants aged 33–94 of the population-based German MONICA/KORA surveys.
- 1033 participants with type 2 diabetes were identified by self-report combined with validated physician diagnoses.
- Semiparametric additive regression models were used to estimate the effect of BMI on EQ-5D health utilities adjusted for age, sex, education and comorbidities.
- BMI was significantly associated with EQ-5D health utilities even after adjustment for macro- and microvascular complications.
- The functional relationship between BMI and utilities was nonlinear, reflecting optimal health around 26kg/m2 and significantly decreasing health utilities with increasing levels of overweight and obesity (-0.09 points between BMI values 26 and 40).
- Among the diabetic complications, the history of a stroke (-0.13) and neuropathy (-0.10) were the strongest predictors of reduced health utility scores.