Barcenilla-Wong A L, Chen J S, Cross M J, March L M
Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW 2065, Australia.
J Osteoporos. 2015;2015:717914. doi: 10.1155/2015/717914. Epub 2015 Jul 30.
This prospective study aimed to examine the impact of fracture incidence on health-related quality of life (HRQOL) among postmenopausal women. Study subjects were Australian female community-dwellers in the Global Longitudinal Study of Osteoporosis in Women (GLOW). Self-administered questionnaires were collected annually from 2007 to 2010. Outcomes were the Medical Outcomes Study Short Form-36 (SF-36 physical function (SF36PFS) and vitality (SF36VS) scores), European Quality of Life (EQ-5D), and self-reported general health (GH) of excellent/good. Questionnaires were divided into prior to, the 1st, the 2nd, and the 3rd year after incident fracture assessments. Generalized linear models with generalised estimating equations (GEE) were employed for the analysis. The 2,872 participants (age: median 65; interquartile range 60-73 years) provided a total of 10,436 assessments including 266, 165 and 76 assessments for the 1st, the 2nd, and the 3rd year after incident fracture, respectively. Multivariate adjustments showed reductions in HRQOL measures peaking at the 1st year for SF36VS (coefficient -3.0; 95% CI: -5.1, -0.8) and EQ-5D (coefficient -0.03; 95% CI: -0.06, -0.00) and at the 2nd year for SF36PFS (coefficient -3.0; 95% CI: -5.6, -0.5) and GH (odds ratio 0.92; 95% CI: 0.70, 1.19). Fracture incidence reduced HRQOL including vitality and physical function among relatively young, healthy postmenopausal women and the reduction in European Quality of Life measure was clinically important.
这项前瞻性研究旨在探讨骨折发生率对绝经后女性健康相关生活质量(HRQOL)的影响。研究对象为参与女性骨质疏松症全球纵向研究(GLOW)的澳大利亚社区居住女性。2007年至2010年每年收集自我管理问卷。研究结果包括医学结局研究简表36项(SF - 36身体功能(SF36PFS)和活力(SF36VS)得分)、欧洲生活质量量表(EQ - 5D)以及自我报告的健康状况为优秀/良好的总体健康(GH)。问卷分为骨折事件评估前、骨折后第1年、第2年和第3年。采用带有广义估计方程(GEE)的广义线性模型进行分析。2872名参与者(年龄中位数65岁;四分位间距60 - 73岁)共提供了10436次评估,其中骨折后第1年、第2年和第3年分别有266次、165次和76次评估。多变量调整显示,HRQOL指标下降,SF36VS在第1年达到峰值(系数 - 3.0;95%置信区间:- 5.1,- 0.8),EQ - 5D在第1年达到峰值(系数 - 0.03;95%置信区间:- 0.06,- 0.00),SF36PFS在第2年达到峰值(系数 - 3.0;95%置信区间:- 5.6,- 0.5),GH在第2年达到峰值(优势比0.92;95%置信区间:0.70,1.19)。骨折发生率降低了相对年轻、健康的绝经后女性的HRQOL,包括活力和身体功能,欧洲生活质量量表指标的下降具有临床意义。