Kingston General Health Research Institute, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Department of Public Health Sciences, Faculty of Medicine, Queen's University, Kingston, Ontario, Canada.
Osteoporos Int. 2019 Aug;30(8):1635-1644. doi: 10.1007/s00198-019-05000-y. Epub 2019 May 8.
Little is known about the association between health-related quality of life (HRQOL) and osteoporosis in the absence of fracture, and how HRQOL may change over time. This study provides evidence of substantially reduced HRQOL in women and men with self-reported and/or BMD-confirmed osteoporosis, even in the absence of fragility fracture.
Fragility fractures have a detrimental effect on the health-related quality of life (HRQOL) of those with osteoporosis. Less is known about the association between HRQOL and osteoporosis in the absence of fracture.
Canadian Multicentre Osteoporosis Study participants completed the SF-36, a detailed health questionnaire and measures of bone mineral density (BMD) at baseline and follow-up. We report the results of participants ≥ 50 years with 10-year follow-up. Self-reported osteoporosis at baseline and BMD-based osteoporosis at follow-up were ascertained. Multivariable linear regression models were developed for baseline SF-36 domains, component summaries, and change over time, adjusting for relevant baseline information.
Baseline data were available for 5266 women and 2112 men. Women in the osteoporosis group had substantially lower SF-36 baseline scores, particularly in the physically oriented domains, than those without osteoporosis. A similar but attenuated pattern was evident for the men. After 10-year follow-up (2797 women and 1023 men), most domain scores dropped for women and men regardless of osteoporosis status, with the exception of mentally-oriented ones. In general, a fragility fracture was associated with lower SF-36 scores and larger declines over time.
This study provides evidence of substantially reduced HRQOL in women and men with self-reported and/or BMD-confirmed osteoporosis, even in the absence of fragility fracture. HRQOL should be thoroughly investigated even prior to fracture, to develop appropriate interventions for all stages of the disease.
本研究旨在探讨在无脆性骨折的情况下，健康相关生活质量（HRQOL）与骨质疏松症之间的关联，以及 HRQOL 如何随时间变化。
加拿大骨质疏松多中心研究的参与者在基线和随访时完成了 SF-36 量表、详细的健康问卷和骨密度（BMD）测量。我们报告了随访时间为 10 年、年龄≥50 岁的参与者的结果。在基线时通过自我报告和 BMD 确定骨质疏松症。使用多变量线性回归模型对基线 SF-36 各领域、综合评分和随时间的变化进行分析，调整了相关的基线信息。
基线数据可用于 5266 名女性和 2112 名男性。与无骨质疏松症的女性相比，骨质疏松症组的女性 SF-36 基线评分明显较低，尤其是在身体导向的领域。男性也存在类似但程度较轻的情况。在 10 年的随访（2797 名女性和 1023 名男性）后，大多数女性和男性的领域评分都下降了，无论骨质疏松症状况如何，只有心理导向的领域除外。一般来说，脆性骨折与 SF-36 评分降低和随时间的更大下降有关。
本研究提供了证据表明，即使在无脆性骨折的情况下，自我报告和/或 BMD 证实的骨质疏松症也会导致女性和男性的 HRQOL 显著降低。即使在骨折发生之前，也应彻底调查 HRQOL，以便为疾病的各个阶段制定适当的干预措施。
