Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco.
Rheumatol Int. 2012 Apr;32(4):971-80. doi: 10.1007/s00296-010-1734-5. Epub 2011 Jan 18.
Vertebral fractures are the hallmark of osteoporosis, responsible for increased back pain, impairment of mobility and functional limitations. These factors have an impact on patients' health-related quality of life (QOL). The aim of this study was to evaluate the prevalence of vertebral fractures in Moroccan postmenopausal women and to assess their QOL, using an Arabic validated version of QUALEFFO. The study recruited 347 postmenopausal women in obvious good health. We excluded women who had used a drug or who had chronic diseases affecting bone metabolism. All patients had density measurements and spinal radiography. Each vertebral body (T4-L5) was graded using the semiquantitative method of Genant. The mean age was 60 years. Forty-six percent of patients had at least one vertebral fracture. The prevalence ranged from 31% in patients 50-55 years to 69% in patients 65 years and older. Patients with vertebral fractures were older (61.6 ± 8 vs 57 ± 7 years, P < 0.001), had more frequent history of nonvertebral fractures, and had spine and hip BMD values significantly lower (P < 0.001) than patients without vertebral fractures. In multivariate analysis, older age and a history of nonvertebral fractures were the two independent clinical factors of vertebral fractures. The number of fractures was a determinant of a low QOL, as indicated by an increased score in physical function, social function, mental function, and general health [for all (P < 0.05)]. Patients with higher grades of vertebral deformities, i.e., more severe fractures, had low QOL in these four domains. Patient with thoracolumbar fractures had a worse general health than patients with thoracic or lumbar fractures. We found a high prevalence of vertebral fractures probably explained by socioeconomic factors in Morocco. QOL, assessed by an osteoporosis-specific instrument, is decreased in postmenopausal women as a function of both the number and the severity of the vertebral fractures. Treating women with prevalent fractures may avoid a further decrease in their quality of life.
脊柱骨折是骨质疏松症的标志，会导致背痛加剧、活动能力受损和功能受限。这些因素会对患者的健康相关生活质量（QOL）产生影响。本研究的目的是评估摩洛哥绝经后妇女的脊柱骨折患病率，并使用阿拉伯文验证后的 QUALEFFO 版本评估其 QOL。该研究招募了 347 名明显健康的绝经后妇女。我们排除了使用药物或患有影响骨代谢的慢性疾病的妇女。所有患者均进行了密度测量和脊柱 X 线摄影。使用 Genant 的半定量方法对每个椎体（T4-L5）进行分级。平均年龄为 60 岁。46%的患者至少有一处脊柱骨折。患病率从 50-55 岁患者的 31%到 65 岁及以上患者的 69%不等。有脊柱骨折的患者年龄更大（61.6 ± 8 岁 vs 57 ± 7 岁，P < 0.001），非脊柱骨折的既往史更频繁，脊柱和髋部 BMD 值显著更低（P < 0.001）比没有脊柱骨折的患者。多变量分析显示，年龄较大和非脊柱骨折的既往史是脊柱骨折的两个独立临床因素。骨折数量是 QOL 降低的决定因素，表现在身体功能、社会功能、精神功能和一般健康状况的评分增加[所有（P < 0.05）]。椎体畸形程度较高（即骨折更严重）的患者在这四个领域的 QOL 较低。胸腰椎骨折患者的总体健康状况较胸腰椎骨折患者差。我们发现，摩洛哥的社会经济因素可能导致脊柱骨折的高患病率。使用骨质疏松症特定工具评估的 QOL 随着脊柱骨折数量和严重程度的增加而降低。治疗有普遍骨折的女性可能会避免进一步降低她们的生活质量。
