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绝经后妇女骨质疏松症和骨折对健康相关生活质量的影响。

Impact of osteoporosis and bone fracture on health-related quality of life in postmenopausal women.

机构信息

Instituto Palacios de Salud y Medicina de la Mujer , Madrid.

出版信息

Climacteric. 2014 Feb;17(1):60-70. doi: 10.3109/13697137.2013.808182. Epub 2013 Jul 30.

Abstract

BACKGROUND

Osteoporosis is responsible for fragility fractures, which are associated with decreased physical and social function. The GINERISK study was a cross-sectional epidemiological study conducted in 4157 Spanish postmenopausal women initially diagnosed with osteoporosis according to WHO criteria within the last 2 years.

AIM

The aim of the study was to explore the impact of osteoporosis on health-related quality of life (HRQoL).

METHOD

Menopause-specific and generic HRQoL were assessed, respectively, with the specific Cervantes Scale and the generic SF-12v2 Health Survey. The impact of osteoporosis on HRQoL was ultimately evaluated in 3328 (80.1%) women who had measurements for both bone mineral densitometry (BMD) and HRQoL.

RESULTS

Menopause-specific or generic HRQoL, respectively, were worse in women with current osteoporosis and prior osteoporotic bone fracture (BF) in comparison with current osteoporosis without BF or whose T-score had increased above -2.5 on the BMD after receiving osteoporosis drug therapy. Impaired HRQoL was found both in Spanish postmenopausal female populations and the Spanish general female population. Women with osteoporosis with BF had physical and mental summary component scores in the 20th and 30th percentiles, respectively, of the Spanish general population. Higher risk for cardiovascular death was also associated with greater HRQoL impairment. The use of selective estrogen receptor modulators in women with a BMD T-score ≤ -2.5 was associated with lower impact of osteoporosis on HRQoL, particularly in the domains of physical health and sexuality.

CONCLUSION

The HRQoL analysis results in this study demonstrated a loss of quality of life in postmenopausal women with osteoporosis and confirmed that this loss is greater in women with prior osteoporotic fracture.

摘要

背景

骨质疏松症可导致脆性骨折,从而降低身体和社会功能。GINERISK 研究是一项横断面流行病学研究,共纳入 4157 名西班牙绝经后女性,这些女性在过去 2 年内根据世卫组织标准被诊断为骨质疏松症。

目的

本研究旨在探讨骨质疏松症对健康相关生活质量(HRQoL)的影响。

方法

分别采用 Cervantes 量表和 SF-12v2 健康调查量表评估绝经特异性和通用型 HRQoL。最终,对 3328 名(80.1%)同时进行骨密度(BMD)和 HRQoL 测量的女性评估了骨质疏松症对 HRQoL 的影响。

结果

与当前骨质疏松症但无骨折史或 BMD 经骨质疏松症药物治疗后 T 值增加至-2.5 以上的患者相比,当前骨质疏松症伴骨折史的女性其绝经特异性或通用型 HRQoL 更差。在西班牙绝经后女性人群和西班牙一般女性人群中均发现 HRQoL 受损。伴骨折史的骨质疏松症女性的生理和心理综合评分分别处于西班牙一般人群的第 20 和第 30 百分位。心血管死亡风险越高,HRQoL 受损越严重。BMD T 值≤-2.5 的女性使用选择性雌激素受体调节剂与骨质疏松症对 HRQoL 的影响降低相关,特别是在生理健康和性功能领域。

结论

本研究的 HRQoL 分析结果表明,骨质疏松症绝经后女性的生活质量下降,且伴骨折史的女性生活质量下降更明显。

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