The relationship between Type D personality and health related quality of life (HRQoL) in coronary artery disease patients is becoming more established, however, the factors that may explain this association remain unclear. The objective of the study was to examine the mediating effects of mental distress and social support on the relationship between the Type D personality and HRQoL in CAD patients with heart failure. A total of 855 CAD patients with heart failure were assessed on Type D personality, mental distress, perceived social support and HRQoL with the following self-administered questionnaires: the Type D personality scale - 14, the Hospital Anxiety and Depression scale, the Multidimensional Scale of Perceived Social Support and the Minnesota Living with Heart Failure Questionnaire. The prevalence of Type D personality within the study population was 33.5%. Type D personality, anxiety symptoms, depressive symptoms and social support were all found to be determinants of decreased HRQoL (p’s < 0.001), once age, gender, NYHA functional class and acute myocardial infarction were adjusted for. Anxiety, depressive symptoms and social support were found to mediate the relationship between Type D personality and HRQoL. Type D personality exerted a stable effect on HRQoL over 24 months follow-up period. Type D personality has an independent significant effect on the HRQoL in CAD patients with heart failure, and this relation is mediated by anxiety and depressive symptoms, social support.

Background: Insulin resistance is the primary cause of metabolic syndrome, which in turn reflects a real variety of risk factors, closely linked to each other. Thus, we aimed to investigate health-related quality of life scores according to the presence of insulin resistance among citizens of Palanga in Lithuania, in the survey in 2003 and 2013. Methods: A randomized epidemiological study was performed out for 835 subjects. All study participants were evaluated according to for socio-demographic characteristics, behavioral factors, health-related quality of life and self-perceived health using questionnaires. Fasting blood samples were draw from all participants for biochemical tests for the glucose and insulin. Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance. Results: All study participants were stratified into groups without and with insulin resistance in the survey in 2003 and 2013 years follow up. Participants with insulin resistance were more likely to be male, with higher body mass index, had lower than higher education, and with moderate self-related health. In subjects with insulin resistance, after adjusting with various factors, logistic regression analysis showed, that within 10 years, a significantly higher chance of deteriorating health-related quality of life in the areas of: physical functioning (odss ratio [OR] = 1.15, p < 0.001), emotional role limitations (OR = 1.07, p = 0.034), social functioning (OR = 1.26, p = 0.004), pain (OR = 1.09, p = 0.005) and general health perception (OR = 1.07, p = 0.022). Conclusions: People with insulin resistance are significantly more likely to have a deterioration in their health-related quality of life in the areas of physical functioning, emotional role limitations, social functioning, pain and general health perception after 10 years period. Key messages: Over the course of ten years, significant changes were observed in domains of physical functioning, social functioning and general health perception in subjects with insulin resistance. Results of this study provide evidence that individuals with insulin resistance have a significantly higher chance of deteriorating health-related quality of life within 10 years.