Impact of diabetes, overweight and obesity on health related quality of life of adolescents: meta-analysis

Introduction: diabetes mellitus and weight problems have negative clinical, epidemiological and economic consequences and deteriorate the Health Related Quality of Life (HRQoL) of adolescents. In the literature the characteristics of researches on HRQoL of adolescents with these diseases are unknown. Objectives: To evaluate the impact of diabetes, overweight and obesity on HRQoL in adolescents. Methods: Meta-analysis using seven multidisciplinary databases with an exhaustive search with inclusion and exclusion criteria, assessment of methodological quality of studies and analysis of reproducibility. HRQoL was assessed using the Pediatric Quality of Life Inventory. Confidence intervals for proportions, weighted mean, Forest Plot and sensitivity analysis with Student's t test for independent means were used in analyses. Results: 3,789 studies were identified of which only ten met the research protocol. The population was 8.908 adolescents from seven different countries. In type 1 diabetes the physical health average was 85.0; 78.4 for psychosocial health; 74.9 for emotional state; 86.0 for social relations and 74.1 in school; while for type 2 diabetes were, respectively, 82.0; 74.1; 70.0; 83.1 and 69.2. In adolescents with overweight the physical health was 85.5; psychosocial 75.0; emotional 71.3; social relations 80.7 and school 73,0; in obesity the scores of HRQoL were, respectively, 81.3; 72.3; 69.4; 75.3 and 72.1. The sensitivity analysis showed that none of the studies changes the HRQoL profile in clinically significant scores. Conclusion: HRQoL in adolescents with type 1 diabetes, type 2 diabetes, overweight and obesity are not significantly different from the clinical point of view; in the four diseases the dimensions related with emotional health and school are more affected that the physical health.