The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: Results from a cross-sectional survey

Background: This study aimed to determine the associations of various clinical factors with generic health-related quality of life (HRQOL) scores among Hong Kong Chinese patients with type 2 diabetes mellitus (T2DM) in the outpatient primary care setting using the short-form 12 (SF-12).Methods: A cross-sectional survey of 488 Chinese adults with T2DM recruited from a primary care outpatient clinic was conducted from May to August 2008. Data on the standard Chinese (HK) SF-12 Health Survey and patients' socio-demographics were collected from face-to-face interviews. Glycaemic control, body mass index (BMI), chronic co-morbidities, diabetic complications and treatment modalities were determined for each patient through medical records. Associations of socio-demographic and clinical factors with physical component summary (PCS-12) and mental component summary scores (MCS-12) were evaluated using multiple linear regression.Results: The socio-demographic correlates of PCS-12 and MCS-12 were age, gender and BMI. After adjustment for socio-demographic variables, the BMI was negatively associated with PCS-12 but positively associated with MCS-12. The presence of diabetic complications was associated with lower PCS-12 (regression coefficient:-3.0 points, p < 0.05) while being on insulin treatment was associated with lower MCS-12 (regression coefficient:-5.8 points, p < 0.05). In contrast, glycaemic control, duration of T2DM and treatment with oral hypoglycaemic drugs were not significantly associated with PCS-12 or MCS-12.Conclusions: Among T2DM subjects in the primary care setting, impairments in the physical aspect of HRQOL were evident in subjects who were obese or had diabetic complications whereas defects in the mental aspect of HRQOL were observed in patients with lower BMI or receiving insulin injections. © 2013 Wong et al.; licensee BioMed Central Ltd.published_or_final_versio

Associations of family meals with adolescent perception of family relationship and compliance with parental guidance in Hong Kong: results of a representative cross-sectional survey

Family meals are beneficial for adolescent development, but evidence from Chinese populations has been limited. This study aimed to examine the associations between family meal frequency and adolescent perception of family relationship and compliance with parental guidance in Hong Kong. During the period from October to December 2016, a stratified random sample of 3359 students were recruited from 25 secondary schools in Hong Kong. Students completed questionnaires about family characteristics, relationship quality, and meal frequency by paper-and-pencil in class. Multiple regression analyses were conducted to examine the associations between family meal frequency and perceived family relationship and compliance with parental guidance overall and by subgroups. After adjusting for sociodemographic and school confounders, family breakfast and dinner frequency were significantly associated with adolescent compliance (breakfast: B = 0.07, p &lt; 0.001; dinner: B 0.07, p &lt; 0.001) and perception of family relationship (breakfast: B = 0.10, p &lt; 0.001; dinner: B = 0.25, p &lt; 0.001). Risk factors for infrequent family meals included older age, not born in Hong Kong, less educated fathers, and unmarried parents. Our findings support the associations of regular family meals with adolescent perception of high family bond and compliance with parental guidance. Interventions are needed to enhance quality family meal interactions in disadvantaged families

Effects of Patient Empowerment Programme (PEP) on clinical outcomes and health service utilization in type 2 diabetes mellitus in primary care: an observational matched cohort study.

To evaluate the effects of a large population-based patient empowerment programme (PEP) on clinical outcomes and health service utilization rates in type 2 diabetes mellitus (T2DM) patients in the primary care setting.A stratified random sample of 1,141 patients with T2DM enrolled to PEP between March and September 2010 were selected from general outpatient clinics (GOPC) across Hong Kong and compared with an equal number of T2DM patients who had not participated in the PEP (non-PEP group) matched by age, sex and HbA1C level group.Clinical outcomes of HbA1c, SBP, DBP and LDL-C levels, and health service utilization rates including numbers of visits to GOPC, specialist outpatient clinics (SOPC), emergency department (ED) and inpatient admissions, were measured at baseline and at 12-month post-recruitment. The effects of PEP on clinical outcomes and health service utilization rates were assessed by the difference-in-difference estimation, using the generalized estimating equation models.Compared with non-PEP group, PEP group achieved additional improvements in clinical outcomes over the 12-month period. A significantly greater percentage of patients in the PEP group attained HbA1C≤7% or LDL-C≤2.6 mmol/L at 12-month follow-up compared with the non-PEP group. PEP group had a mean 0.813 fewer GOPC visits in comparison with the non-PEP group.PEP was effective in improving the clinical outcomes and reduced the general outpatient clinic utilization rate over a 12-month period. Empowering T2DM patients on self-management of their disease can enhance the quality of diabetes care in primary care.ClinicalTrials.gov NCT01935349

Flow of Participants on the Subject Assignment, Follow-up and Analysis.

<p>Flow of Participants on the Subject Assignment, Follow-up and Analysis.</p

Baseline Characteristics of Participants in PEP group and non-participants in non-PEP group.

<p>PEP = Patient Empowerment Programme; SD = Standard Deviation; DM = Diabetes Mellitus.</p><p>*Statistically different (P<0.05) by independent t-test or Chi-square test.</p

The change from baseline to post-assessment on Clinical Outcomes.

<p>The change from baseline to post-assessment on Clinical Outcomes.</p

Comparisons of within-subject changes from baseline to post-assessment and Difference-in-difference estimates of the PEP on Clinical Outcomes and 12-month Health Service Utilization.

<p>PEP = Patient Empowerment Programme;HbA1c = Haemoglobin A1c; SBP = Systolic Blood Pressure; DBP = Diastolic Blood Pressure; LDL-C = Low Density Lipoprotein – Cholesterol;</p><p>GOPC = General Outpatient Clinic; SOPC = Specialist Outpatient Clinic; ED = Emergency Department; CI = Confidence interval;</p><p>*P-value of testing significance using paired t-test.</p>†<p>P-value of testing significance using independent t-test or Chi-square test, where appropriate.</p>‡<p>P-value of testing significance in adjusted difference-in-difference estimate (The result of Generalized Estimating Equation was attached in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0095328#pone.0095328.s001" target="_blank">Table S1</a>).</p