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Boisvert NMJ, McElroy MR, Hayden KA, Doyle-Baker PK. Familial Resemblance of Bone Health in Maternal Lineage Pairs and Triads: A Scoping Review. Life (Basel) 2024; 14:819. [PMID: 39063575 PMCID: PMC11277880 DOI: 10.3390/life14070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Female bone health is influenced by familial resemblance, health parameters and maturational periods (puberty and menopause); this combination has been researched using familial multi-generational cross-sectional studies. AIM This scoping review aimed to compile bone health research which uses sexually mature (grandmother-) mother-daughter pairs (and triads) and to determine the trends in its methodologies and familial comparisons. METHODS The Joanna Briggs Institute methodology for scoping reviews was used. Extraction included study and population characteristics, methodology (with an emphasis on imaging) and family-based results. RESULTS Twenty-nine studies were included, and their generations were categorized into four developmental categories: late adolescent to young adult, pre-menopause, mixed-menopause, and post-menopause. Eleven different pair/triad combinations were observed; the most common was pre-menopausal daughters and post-menopausal mothers. Dual-energy X-ray absorptiometry (DXA) was the most utilized imaging modality, and the hip was the most imaged region of interest (ROI). Regardless of pairing, imaging modality and ROI, there was often a trend toward significant familial resemblance and heritability (h2 and h2L). CONCLUSION This scoping review highlights the trends in bone health linked to familial resemblance, as well as the importance of menopause and late adolescence. This review compiles the commonalities and challenges within these studies to inform future research.
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Affiliation(s)
- Nicole M. J. Boisvert
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Melissa R. McElroy
- Northern Ontario School of Medicine University, Sudbury, ON P3E 5Z6, Canada;
| | - K. Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Patricia K. Doyle-Baker
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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Behanova M, Medibach A, Haschka J, Kraus D, Raimann A, Mindler GT, Zwerina J, Kocijan R. Health-related quality of life and fatigue in adult rare bone disease patients: A cross-sectional study from Austria. Bone 2024; 181:117034. [PMID: 38311305 DOI: 10.1016/j.bone.2024.117034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES To assess physical and mental health domains of health related quality of life (HRQoL) as well as fatigue in rare bone disease (RBD) patients and to compare to patients with osteoporosis (OPO) and healthy controls (CTRL) without known bone diseases and to study associations of Fatique Severity Scale (FSS) with eight domains of HRQoL. METHODS Monocentric, cross-sectional study carried out between 2020 and 2022 in a hospital affiliated with the Vienna Bone and Growth Center (European Reference Network Center for Rare Bone Disease) in Vienna, Austria. The study comprised three types of RBD: Osteogenesis imperfecta, Hypophosphatasia and X-linked Hypophosphatemia. Fatigue was assessed by FSS. The higher score indicates more fatigue severity. HRQoL was assessed by Short-Form Health Survey (SF-36 v2). Physical component (PCS) and mental component summary scores (MCS) were calculated and normalised to a general population. A higher score indicates better HRQoL. Age-adjusted ANCOVA was used to assess differences in PCS and MCS between groups. Spearman correlation was used for associations of FSS with eight domains of HRQoL. RESULTS Study comprised 50 RBD patients [Mean age (SD) 48.8 (±15.9), 26 % male], 51 OPO patients [66.6 (±10.0), 9.8 % male] and 52 controls [50.8 (±16.3), 26.9 % male]. RBD patients had significantly higher mean age-adjusted FSS (3.5, 95 % CI 3.1-4.0) than controls (2.6, 95 % CI 2.2-3.0, p = 0.008), but not in comparison to osteoporotic patients 2.6 (95 % CI 2.2-3.0, p = 0.69). Diminished age-adjusted PCS of HRQoL was observed in RBD patients with a mean score of 37.1 (95 % CI 33.4-40.8), whereas their MCS of 50.1 (95 % CI 46.6-53.7) was comparable to controls (52.9, 95 % CI 49.8-56.0) and osteoporotic patients (50.2, 95 % CI 45.4-54.9). FSS score was negatively correlated with physical and mental component in RBD (ρ = -0.37, p < 0.05 and ρ = -0.54, p < 0.01, respectively) and OPO patients (ρ = -0.37, p < 0.05 and ρ = -0.35, p < 0.01, respectively). CONCLUSIONS The HRQoL in adult patients with rare bone diseases is lower than compared to osteoporotic and control group in this Austrian population. Fatigue has significant negative impact on HRQoL and it is important to address it when meeting with RBD patients in clinical practice.
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Affiliation(s)
- Martina Behanova
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | - Amadea Medibach
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria; Sigmund Freud University Vienna, School of Medicine, Metabolic Bone Diseases Unit, Vienna, Austria
| | - Judith Haschka
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Daniel Kraus
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria
| | - Adalbert Raimann
- Vienna Bone and Growth Center, Vienna, Austria; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Gabriel T Mindler
- Vienna Bone and Growth Center, Vienna, Austria; Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Vienna, Austria
| | - Jochen Zwerina
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria
| | - Roland Kocijan
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA, Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria; Sigmund Freud University Vienna, School of Medicine, Metabolic Bone Diseases Unit, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria.
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Courtney MG, Roberts J, Quintero Y, Godde K. Childhood Family Environment and Osteoporosis in a Population-Based Cohort Study of Middle-to Older-Age Americans. JBMR Plus 2023; 7:e10735. [PMID: 37197319 PMCID: PMC10184016 DOI: 10.1002/jbm4.10735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/19/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Demographic and early-life socioeconomic and parental investment factors may influence later-life health and development of chronic and progressive diseases, including osteoporosis, a costly condition common among women. The "long arm of childhood" literature links negative early-life exposures to lower socioeconomic attainment and worse adult health. We build on a small literature linking childhood socioeconomic status (SES) and bone health, providing evidence of whether associations exist between lower childhood SES and maternal investment and higher risk of osteoporosis diagnosis. We further examine whether persons identifying with non-White racial/ethnic groups experience underdiagnosis. Data from the nationally representative, population-based cohort Health and Retirement Study (N = 5,490-11,819) were analyzed for participants ages 50-90 to assess these relationships. Using a machine learning algorithm, we estimated seven survey-weighted logit models. Greater maternal investment was linked to lower odds of osteoporosis diagnosis (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.69, 0.92), but childhood SES was not (OR = 1.03, 95% CI = 0.94, 1.13). Identifying as Black/African American (OR = 0.56, 95% CI = 0.40, 0.80) was associated with lower odds, and identifying as female (OR = 7.22, 95% CI = 5.54, 9.40) produced higher odds of diagnosis. There were differences in diagnosis across intersectional racial/ethnic and sex identities, after accounting for having a bone density scan, and a model predicting bone density scan receipt demonstrated unequal screening across groups. Greater maternal investment was linked to lower odds of osteoporosis diagnosis, likely reflecting links to life-course accumulation of human capital and childhood nutrition. There is some evidence of underdiagnosis related to bone density scan access. Yet results demonstrated a limited role for the long arm of childhood in later-life osteoporosis diagnosis. Findings suggest that (1) clinicians should consider life-course context when assessing osteoporosis risk and (2) diversity, equity, and inclusivity training for clinicians could improve health equity. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
| | - Josephine Roberts
- Department of Sociology/AnthropologyUniversity of La VerneLa VerneCaliforniaUSA
| | - Yadira Quintero
- Department of Sociology/AnthropologyUniversity of La VerneLa VerneCaliforniaUSA
| | - K. Godde
- Department of Sociology/AnthropologyUniversity of La VerneLa VerneCaliforniaUSA
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Gough Courtney M, Roberts J, Godde K. Structural Inequity and Socioeconomic Status Link to Osteoporosis Diagnosis in a Population-Based Cohort of Middle-Older-Age Americans. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231155719. [PMID: 36789725 PMCID: PMC9932766 DOI: 10.1177/00469580231155719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 02/16/2023]
Abstract
Socioeconomic status (SES) is an important social determinant of health inequities that has been linked to chronic conditions, including osteoporosis, but research tends to focus on socioeconomic disadvantage rather than how socioeconomic advantage may facilitate these inequities. This study accounts for structural inequities and assesses the relationship between early-life and later-life SES, and risk of osteoporosis diagnosis. Data come from the nationally representative, population-based cohort Health and Retirement Study and include individuals ages 50 to 90. The outcome variable is osteoporosis diagnosis. Logistic regression models of the relationship between SES and osteoporosis diagnosis are estimated, accounting for demographic, health, and childhood variables. Higher levels of childhood and adult SES link to lower odds of osteoporosis diagnosis. Structural inequities in income and underdiagnosis of osteoporosis among persons identifying as Black/African American were detected. Accounting for bone density scan access, inequities in osteoporosis diagnosis appear to stem from barriers to accessing health care due to financial constraints. The important role of SES and evidence of structural inequities leading to underdiagnosis suggest the critical importance of clinicians receiving Diversity, Equity, and Inclusion training to reduce health inequities.
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Gao S, Zhao Y. Quality of life in postmenopausal women with osteoporosis: a systematic review and meta-analysis. Qual Life Res 2022; 32:1551-1565. [PMID: 36383282 DOI: 10.1007/s11136-022-03281-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Postmenopausal osteoporosis has become a global trend, which seriously affects women's quality of life. However, the differences remain unclear in health-related quality of life (HRQoL) among postmenopausal women with normal bone mineral density, osteoporosis, and osteoporotic fractures. The aim of this study was to assess health-related quality of life in women with three different bone states. METHODS Databases of PubMed, Embase, Cochrane, and Web of Science were based on the search terms, and the search time was set from the inception of each database to January 2022. A study was included if the researchers used a validated quality of life questionnaire to investigate the quality of life of postmenopausal women with osteoporosis or osteoporotic fractures. The random-effect model was used for meta-analysis, and the mean difference with a 95% confidence interval (95%CI) was calculated. RESULTS Thirteen studies that met the inclusion criteria were systematically reviewed, involving 2897 postmenopausal women, and 12 of them were included in the meta-analysis. Postmenopausal women with osteoporosis had worse overall HRQoL and different HRQoL dimensions compared with postmenopausal women with normal bone density. Compared with postmenopausal women with osteoporosis, postmenopausal women with osteoporotic fractures had worse overall HRQoL and individual dimensions of HRQoL, especially physical component summary (SMD = - 0.61, 95% CI, - 0.98 to - 0.24). Bone mineral density was positively associated with HRQoL, while fragility fracture severity was negatively associated with HRQoL. CONCLUSIONS Postmenopausal osteoporosis and fragility fractures reduce HRQoL to varying degrees in women. More research should be done to reduce the incidence of the disease.
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Affiliation(s)
- Sasa Gao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yongfang Zhao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
- Science and Technology Department of Shanghai University of traditional Chinese medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai, 201203, China.
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Kanto A, Kotani Y, Murakami K, Tamaki J, Sato Y, Kagamimori S, Matsumura N, Iki M. Risk factors for future osteoporosis in perimenopausal Japanese women. Menopause 2022; 29:1176-1183. [PMID: 35969496 PMCID: PMC9512233 DOI: 10.1097/gme.0000000000002034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/10/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE The aims of this study were to investigate trends in bone mineral density (BMD) loss and related factors in early postmenopausal women in Japan, identify risk factors for future osteoporosis, and predict osteoporosis before it occurs. METHODS The study population consisted of women who were 50 to 54 years old at the time of the survey in 2002 or 2006. The study included a questionnaire and physical measurement findings (BMD, height, body weight [WT], body mass index [BMI], and handgrip strength). One hundred sixty-seven women continued to participate in the study and had BMD measurements at the 9- or 10-year follow-up of the Japanese Population-based Osteoporosis study. Statistical analyses were performed using Pearson correlation to examine each factor of physical measurement and BMD for lumbar spine (LS) and femoral neck (FN). The receiver operating characteristic curve of this data was also predictive of osteoporosis in 2011 for 2002 data; BMD at the age of 50 to 54 years was then used to predict the likelihood of being diagnosed with osteoporosis 9 and 10 years later. RESULTS At the baseline in 2002 and 2006, WT, BMI, height, and handgrip strength were positively correlated with BMD. The optimal cutoff values for BMD in 2006 to predict osteoporosis in 2016 were LS less than 0.834 g/cm 2 and FN less than 0.702 g/cm 2 . These data were also predictive of osteoporosis in 2011 for 2002 data; applying this to the 2002 data, LS/FN had a sensitivity of 92%/100%, a specificity of 87%/81%, a positive predictive value of 55%/48%, and a negative predictive value of 98%/100%. The larger WT and BMI also resulted in a greater decrease in BMD of FN after 9 or 10 years. CONCLUSIONS We have identified a cutoff value for BMD to predict future osteoporosis in menopausal women and found a negative correlation between WT and BMI in menopausal women and changes in BMD of the FN over the next 10 years.
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Affiliation(s)
- Akiko Kanto
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Yasushi Kotani
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Kosuke Murakami
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Junko Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical Pharmaceutical University, Osaka, Japan
| | - Yuho Sato
- Department of Human Life, Jin-ai University, Fukui, Japan
| | | | - Noriomi Matsumura
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Masayuki Iki
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
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Shin MK, Kim H, Choi SH, Kim BJ, Kwon O. Sex-specific bi‑directional association between osteoporosis and depression from the national representative data of South Korea. Sci Rep 2022; 12:9500. [PMID: 35680922 PMCID: PMC9184731 DOI: 10.1038/s41598-022-13401-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Both osteoporosis and depression are major health threats, but their interrelationship is not clear. This study elucidated the associations between osteoporosis and depression while considering the temporal sequence of the diagnoses. In this cross-sectional study, data were extracted from the Korean National Health and Nutrition Examination Surveys (2007-2009 and 2015-2019, n = 29,045). Osteoporosis and depression were defined by diagnoses thereof. The odds ratio (OR) of the incident osteoporosis among depression patients without a history of osteoporosis was calculated by multivariable logistic regression adjusted for potential confounders. A reverse association was also assessed. Participants were additionally stratified by their sex and age. As a result, male depression patients aged under 50 years showed higher ORs for osteoporosis than those without depression (OR 9.16, 95% CI 1.78-47.18). Female osteoporosis patients showed lower ORs for depression than those without osteoporosis (OR 0.71, 95% CI 0.58-0.88), especially in women aged 50 years and older. In the sensitivity analysis, the same results were obtained in women by their menopause status. Depression has a strong positive association with the occurrence of osteoporosis in young male adults, and osteoporosis has a negative association with the occurrence of depression in female adults.
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Affiliation(s)
- Min Kyoung Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Hyejin Kim
- Department of Public Health, Yonsei University Graduate School, Seoul, 03722, Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080, Korea
- Department of Psychiatry, Seoul National University Hospital, Seoul, 03080, Korea
| | - Beom-Jun Kim
- Department of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Obin Kwon
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080, Korea.
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, 03080, Korea.
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Cheng Y, Yang H, Liu Z, Hai Y, Liu Y, Zhou L. Will the bone mineral density in postmenopausal women get worse during the COVID-19 pandemic? Med Hypotheses 2022; 162:110803. [PMID: 35221448 PMCID: PMC8863350 DOI: 10.1016/j.mehy.2022.110803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/10/2022] [Accepted: 02/10/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Yunzhong Cheng
- Department of Neurobiology, School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, PR China
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Honghao Yang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Ziyang Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Yuzeng Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
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O'Gorman CA, Minnock S, Mulhall J, Gleeson N. Attention to bone health in follow-up of gynaecological cancers in tertiary care. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455065211070747. [PMID: 34994250 PMCID: PMC8744201 DOI: 10.1177/17455065211070747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Women with gynaecological cancers are at an increased risk of cancer treatment-induced bone loss, which impacts on their quality of life and overall survival. Clinical cancer follow-up reviews focus on cancer status and fail to attend to important health and quality-of-life issues. We questioned whether there was a care-gap between tertiary clinicians and primary care physicians in the management of bone health in this cohort. Significant care-gaps in relation to bone health have been demonstrated in other oncologic settings. The objective of this study was to determine the level of attention to bone health in the care of women living with and beyond gynaecological cancer at a tertiary referral centre for gynaecological oncology. METHODS Retrospective, observational cohort study of attention to bone health in the management and follow-up of gynaecological cancers. RESULTS This study shows that there has been suboptimal attention from the carers at a cancer centre to bone health during the oncological follow up of women undergoing treatment for gynaecological cancer. In those at particular risk of cancer treatment-induced bone loss (iatrogenic menopause and/or external beam pelvic radiotherapy), 52% of women had no reference to bone health in their notes, and 57% had no assessment of bone mineral density. CONCLUSION Tertiary cancer carers may underestimate the importance of bone health or believe that it falls outside the remit of their gynaecologic oncology service. Further research is needed to explore whether these findings are indicative of a true care gap and to gain insight into possible corrective measures.
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Affiliation(s)
- Catherine A O'Gorman
- Department of Gynecological Oncology, St. James' Hospital, Dublin, Ireland.,Department of Gynecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sorcha Minnock
- Department of Gynecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Joseph Mulhall
- Department of Gynecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Noreen Gleeson
- Department of Gynecological Oncology, St. James' Hospital, Dublin, Ireland.,Department of Gynecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Hu J, Zheng W, Zhao D, Sun L, Zhou B, Liu J, Wang O, Jiang Y, Xia W, Xing X, Li M. Health-related quality of life in men with osteoporosis: a systematic review and meta-analysis. Endocrine 2021; 74:270-280. [PMID: 34165773 DOI: 10.1007/s12020-021-02792-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The increased social and economic burdens make osteoporosis in men an emerging public health issue. However, the quality of life among men with osteoporosis is still unclear. This systematic review and meta-analysis aimed to evaluate the health-related quality of life (HRQoL) among men with osteoporosis or osteoporotic fracture. METHODS PubMed, EMBASE, and the Cochrane Library database were systematically searched from inception to May 2021. Studies were included if they used validated questionnaires to measure HRQoL among osteoporotic men. A meta-analysis was performed using a random-effects model or fixed-effects model to calculate the standard mean difference (SMD) or mean difference (MD) with 95% confidential interval (95% CI). RESULTS 14 studies involving 6338 male participants were chosen for systematic review, of which 10 were included in the meta-analysis. Men with osteoporosis had poorer global HRQoL and multiple dimensions of HRQoL than men without osteoporosis. Hip fracture, vertebral fractures, or wrist fractures dramatically impaired HRQoL of men, and physical function was declined even before hip fracture (SMD = -0.60, 95% CI, -0.82 to -0.39). Femoral and lumbar BMD was positively correlated with HRQoL, and a number of fragility fractures and time since fracture had negative effects on HRQoL. Effective anti-osteoporotic drugs could improve HRQoL of men. CONCLUSION The health-related life quality of men was significantly impaired by osteoporosis and fracture of the hip, vertebral, or wrist. We should pay more attention to the diagnosis and treatment of male osteoporosis to improve the life quality of men.
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Affiliation(s)
- Jing Hu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Wenbing Zheng
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Dichen Zhao
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Lei Sun
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Bingna Zhou
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Jiayi Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Ou Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Yan Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Xiaoping Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China
| | - Mei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing, China.
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The effects of low bone mineral density on pain, quality of life and fatigue in patients with epilepsy. MARMARA MEDICAL JOURNAL 2021. [DOI: 10.5472/marumj.1009016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Pulfer S, Ziehfreund S, Gebhard J, Hindelang B, Biedermann T, Brockow K, Zink A. Health-Related Quality of Life and Influencing Factors in Adults with Nonadvanced Mastocytosis-A Cross-Sectional Study and Qualitative Approach. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3166-3175.e2. [PMID: 33965596 DOI: 10.1016/j.jaip.2021.04.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/14/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mastocytosis comprises a heterogeneous group of disorders characterized by an accumulation of mast cells in 1 or more organs. Symptoms range from mild complaints to severe and life-threatening events. Impact on quality of life seems to vary widely, but influencing factors are poorly understood so far. OBJECTIVE To examine impairments, psychological burden, health-related quality of life (HRQOL), and possible influencing factors in patients with mastocytosis. METHODS In semistructured telephone interviews, patients provided information on impairments in everyday life and psychological burden caused by mastocytosis. HRQOL was measured using the Mastocytosis Quality of Life (MC-QoL) questionnaire. Clinical data were collected from patient files. RESULTS A total of 101 adult patients with mastocytosis (74.3% women; mean age, 47.7 ± 13.5 years) were included. Half of the interviewed patients (50.6%) reported disease-related impairments in everyday life, and 42.4% stated a psychological burden. MC-QoL questionnaire scores showed a broad distribution, with a mean total score at a "mild" impairment level (mean total score, 34.7 ± 22.5). One-third of patients felt moderately (22.8%) or severely (13.9%) impaired, whereas one-third reported no impairment at all (30.7%). Symptoms of mast cell activation and perceived food intolerance had the highest impact on HRQOL. Higher age, higher body mass index, higher tryptase level, and longer duration of symptoms, as well as current drug therapy and pathological bone density, were each associated with reduced HRQOL. CONCLUSIONS A high level of suffering and strong associations between impairments and symptom-related factors indicate the importance of addressing patients' concerns and adequate symptom management in mastocytosis.
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Affiliation(s)
- Stephanie Pulfer
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Julia Gebhard
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Benedikt Hindelang
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Knut Brockow
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
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Hemmann P, Friederich M, Körner D, Klopfer T, Bahrs C. Changing epidemiology of lower extremity fractures in adults over a 15-year period - a National Hospital Discharge Registry study. BMC Musculoskelet Disord 2021; 22:456. [PMID: 34011331 PMCID: PMC8135150 DOI: 10.1186/s12891-021-04291-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/19/2021] [Indexed: 01/05/2023] Open
Abstract
Background Demographic changes led to an increasingly ageing population in Germany and thus to possible changes in the frequency of fractures. The primary aim of this study was to report changes in fracture rates of the lower extremities in Germany in 2002 compared to 2017 and to evaluate those changes. Methods Inpatient data from the German National Hospital Discharge Registry (ICD10) for 2002 and 2017 were evaluated. Changes in total counts and incidence rates were analysed for fractures in the following locations: femoral neck, pertrochanteric, subtrochanteric, distal femur, femoral shaft, proximal and distal tibia, tibial shaft, medial and lateral malleolus, and other parts of the lower leg (including bi- and trimalleolar fractures), calcaneus, talus, other tarsal bones, metatarsal bones, greater toe, lesser toe, other fractures of foot or unspecific fractures of foot and toe. Patients were classed into age groups by sex: 15–24, 25–34,35–44, 45–54, 55–64, 65–74, 75–84, 85–90 and > 90 years. Results The total count for lower extremity fractures in men and women increased slightly by 4.5% from 305,764 in 2002 to 319,422 in 2017. Hip and femur fractures increased by 23.5% from 150,565 in 2002 to 185,979 in 2017. The number of these fractures among men increased by 46% and among women by 15.3%. The total count of lower leg fractures decreased by 15.4% from 131,162 in 2002 to 110,924 in 2017. Especially, younger age groups showed a decline for all tibial segments and ankle fractures. For both sexes, the number of lower leg fractures in those 75 years or older increased in all lower leg fracture locations. Most femur and lower leg fractures occurred in women. The incidence of fractures rose sharply from 2002 to 2017, especially for older cohorts. Conclusion The total numbers of lower extremity fractures increased slightly in 2017 compared to 2002 – especially hip and femur fractures among men. The incidence of almost all lower extremity fracture types among older people increased during this time. Women were particularly affected. Therefore, focused prevention programmes should be considered including an extended fracture spectrum in the elderly.
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Affiliation(s)
- Philipp Hemmann
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany.
| | - Maximilian Friederich
- Eberhard Karls University Tuebingen, Medical School, Geissweg 5, 72076, Tuebingen, Germany
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - Tim Klopfer
- Orthopädische Chirurgie Bayreuth, Parsifalstraße 5, 95445, Bayreuth, Germany
| | - Christian Bahrs
- Department of Orthopaedics and Trauma Surgery, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany
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Cho MJ, Moon SH, Lee JH, Lee JH. Association between Osteoporotic Vertebral Compression Fractures and Age, Bone Mineral Density, and European Quality of Life-5 Dimensions in Korean Postmenopausal Women: A Nationwide Cross-sectional Observational Study. Clin Orthop Surg 2021; 13:207-215. [PMID: 34094011 PMCID: PMC8173246 DOI: 10.4055/cios20209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/07/2020] [Accepted: 12/09/2020] [Indexed: 12/25/2022] Open
Abstract
Backgroud The purpose of this study was to investigate the characteristics of osteoporotic vertebral compression fractures (OVCFs) in Korean postmenopausal women and the association between OVCFs and clinical factors such as age, bone mineral density (BMD), and quality of life. Methods According to the population distribution in four regions in Korea, 1,281 postmenopausal female patients were recruited from nationwide orthopedic outpatient clinics. Radiologic, asymptomatic, and within 3 months of OVCF groups were analyzed based on age, fracture location, and prevalence according to BMD. In addition, BMD, T-score, body mass index, and European Quality of Life-5 Dimensions (EQ-5D) were investigated in the three groups, and the differences between groups were compared and analyzed. Results The prevalence of radiologic OVCFs at the T11–L1 was 3.7 times higher in the 70s group (44.0%) than in the 50s group (11.9%). Femur and total hip BMD were significantly lower in patients with thoracolumbar junction fractures than in patients with L2–5 fractures, whereas no difference was observed in lumbar spine BMD. Of the three OVCF groups, the within 3 months of OVCF group had the lowest lumbar spine T-score of −2.445. The asymptomatic OVCF group also showed significantly lower lumbar spine T-score than did the group without radiologic OVCFs (p < 0.001). The EQ-5D showed a significant decrease in the radiologic OVCF group (p < 0.001) and within 3 months of OVCF group (p < 0.001). Conclusions The prevalence of OVCFs in the thoracolumbar junction rapidly increases with old age and low BMD in Korean postmenopausal women. Femur and total hip BMD are more predictive of thoracolumbar junction fractures than lumbar spine BMD. Patients with radiologic OVCFs had a significantly lower quality of life than no OVCF group. Therefore, this study shows it is important to treat and prevent osteoporosis before an OVCF occurs.
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Affiliation(s)
- Min Joon Cho
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Seoung-Hwan Moon
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.,Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Ho Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.,Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
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Hwang IC, Ahn HY. Age-related height loss and health-related quality of life in a nationwide Korean survey. Australas J Ageing 2021; 40:218-222. [PMID: 33605057 DOI: 10.1111/ajag.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/23/2020] [Accepted: 12/10/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study examined the association between self-reported height loss and health-related quality of life (HRQoL) among Korean adults older than 50 years. METHODS Analyses were based on pooled cross-sectional data from 6,123 participants over 50 years of age in the Korean National Health and Nutrition Examination Survey between 2008 and 2011. HRQoL was measured using the EuroQol five-dimensional (EQ-5D) instrument. Height loss was calculated as the difference between the recalled tallest height in participants' past and their currently measured height. RESULTS The inverse association between height loss and HRQoL was dose-dependent and strongest for mobility and usual activity dimensions. Fully adjusted EQ-5D index scores were lower in the height-loss group than in the no height-loss group, and these trends were most notable among men or participants with co-morbid conditions. CONCLUSION Height loss is associated with poor HRQoL among Korean adults.
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Affiliation(s)
- In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, Korea
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SADE I, Çİ̇FÇİ̇ E, İNANIR M, SELÇUK B. Postmenopozal Kadınlarda Kemik Mineral Yoğunluğunun Yaşam Kalitesi Üzerine Etkisi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.844831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Basilici Zannetti E, D'Angelo D, Cittadini N, Celi M, Pennini A, Rocco G, Vellone E, Alvaro R, Tarantino U. Development and Testing of the Quality of Life Osteoporosis Scale-Nonvertebral Fractures (QoLOS-NVFX). Orthop Nurs 2021; 40:33-41. [PMID: 33492909 DOI: 10.1097/nor.0000000000000728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was developing and testing a new tool for measuring quality of life (QoL) in patients with osteoporosis who had experienced nonvertebral fractures (NVFXs). Two main phases were carried out. First, the tool was developed based on expert opinion through three focus groups. Second, the tool was tested with exploratory factor analysis and confirmatory factor analysis in a sample of 458 postmenopausal women. The reliability of the developed Quality of Life Osteoporosis Scale-Nonvertebral Fractures (QoLOS-NVFX) was measured using Cronbach's α, maximal reliability (MR), composite reliability (CR), and average variance extracted (AVE). The QoLOS-NVFX resulted in a unidimensional scale with 23 items and showed good reliability, with a Cronbach's α of 0.94, an MR of 0.96, a CR of 0.96, and an AVE of 0.70. The QoLOS-NVFX shows good psychometric properties and can be used to assess the impact of NVFX on QoL in osteoporotic women. Furthermore, it can be easily used in clinical practice and research.
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Affiliation(s)
- Emanuela Basilici Zannetti
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Daniela D'Angelo
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Noemi Cittadini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Monica Celi
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Annalisa Pennini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Gennaro Rocco
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
| | - Umberto Tarantino
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Daniela D'Angelo, PhD, RN , Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Monica Celi, MD, PhD Student in Orthopaedic Surgeons, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Gennaro Rocco, PhD, RN, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Ercole Vellone, PhD, RN, FESC, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Rosaria Alvaro, MSN, RN, FESC, Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Umberto Tarantino, PhD, MD, Full Professor, Department of Orthopaedics and Traumatology Policlinico Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy
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Marchenkova L, Makarova E. Quality of Life Changes in Women with Osteoporotic Vertebral Fractures and Possibility of its Improvement Using New Complex of Physical Therapy Including Mechanotheraputic Technologies. ACTA ACUST UNITED AC 2020. [DOI: 10.38025/2078-1962-2020-99-5-70-78] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective. To assess quality of life (QOL) in people with osteoporotic (OP) vertebral fractures (VFs) and evaluate effect of new complex of physical rehabilitation including mechanotherapeutic technologies on QOL of those patients.
Material and methods. At the 1st stage the study group was comprised of 60 women 40–80 years old with OP VFs. The comparison group (n=60) was formed from patients with OP without any fracture enrolled by the twin-pair method. 2nd stage was carried out inthe form of a prospective controlled open study. 120 patients with OP VFs were randomized to the intervention group (group 1, n=60)which received a new complex of physical therapy including mechanotherapeutic technologies, and control (group 2, n=60) which received only complex of physical exercises.
Results. In patients with VFs a significant decrease in main QOL domains such as severity of pain, daily living activity, mobility, mental state, general health and general QUALEFFO-41 scale was revealed (p<0.05 vs comparison group). Administration of a new physical rehabilitation complex resulted in pain reduction and improvement of such QOL aspects as house jobs, mobility and mental state(p<0.05 at 21st day vs baseline). Therapy effect on pain syndrome, daily living activity, mobility and overall QOL remains for at least 4 weeks after the rehabilitation course (p<0.05 at 70th day vs baseline).
Conclusion. New physical therapy complex including mechanotherapeutic technologies can be recommended for rehabilitation of patients with osteoporotic VFs to increase QOL and to reduce back pain.
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Affiliation(s)
- L.A. Marchenkova
- National Medical Research Center of Rehabilitation and Balneology, Moscow, Moscow, Russian Federation
| | - E.V. Makarova
- National Medical Research Center of Rehabilitation and Balneology, Moscow, Moscow, Russian Federation
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Evaluation of pain, quality of life, and patient satisfaction in parenterally treated patients with postmenopausal osteoporosis. Turk J Phys Med Rehabil 2020; 66:262-270. [PMID: 33089082 PMCID: PMC7557633 DOI: 10.5606/tftrd.2020.4114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/20/2019] [Indexed: 01/10/2023] Open
Abstract
Objectives
This study aims to evaluate pain, quality of life, and patient satisfaction in parenterally treated patients with postmenopausal osteoporosis (OP). Patients and methods
Between May 2016 and January 2018, a total of 138 patients (mean age 63.78 years; range, 50 to 70 years) with postmenopausal OP were retrospectively analyzed. All patients were previously treated with denosumab (DEN) and parenteral forms of bisphosphonates such as zoledronic acid (ZOL) and ibandronate (IBN). The pain severity was evaluated using the Visual Analog Scale (VAS) and Brief Pain Inventory-Short Form (BPI-SF). The quality of life was evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (Qualeffo-41). For the evaluation of patient satisfaction, a three-item questionnaire including satisfaction with the medication, route, and frequency of administration was applied. Results
Of the patients, 50 received DEN, 48 received ZOL, and 40 received IBN treatment. There was no significant difference in any of the pain parameters. All domains of the Qualeffo-41 were similar among the three groups. The patients in the DEN group were more satisfied with their medication (DEN: 88%, ZOL: 43.75%, and IBN: 52.5%), its administration route (DEN: 84%, ZOL: 43.8%, and IBN: 57.5%), and the frequency of its administration (DEN: 84%, ZOL: 56.25%, and IBN: 52.5%) (p=0.0001). Conclusion Neither of the medication showed a superior effect on quality of life. However, patients were more satisfied with medications used in a six-month interval and applied subcutaneously. Of these three treatment options, DEN seems to be a step ahead in terms of patient satisfaction.
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Hemmann P, Ziegler P, Konrads C, Ellmerer A, Klopfer T, Schreiner AJ, Bahrs C. Trends in fracture development of the upper extremity in Germany-a population-based description of the past 15 years. J Orthop Surg Res 2020; 15:65. [PMID: 32085794 PMCID: PMC7035769 DOI: 10.1186/s13018-020-1580-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
Background Recent studies investigating fracture development in Germany are not available especially with regard to demographic change. The primary aim of this study was to report trends in fracture development of the upper extremity in Germany between 2002 and 2017 and to evaluate changes over time. Methods Evaluating inpatient data from the German National Hospital Discharge Registry (International Classification of Diseases, ICD-10) between 2002 and 2017. Total count, incidences and percentage changes of the following fracture localizations were analysed: proximal humerus, distal humerus, proximal ulna, proximal radius, ulna diaphysis (including Monteggia lesion) and distal radius. Ten age groups for men and women were formed: 35–44, 45–54, 55–64, 65–74; 75–84; 85–90, and > 90 (years). Results The total count of proximal humeral fractures increased from 40,839 (2002, men/women 9967/30,872) to 59,545 (2017, men/women 14,484/45,061). Distal humeral fractures increased from 5912 (2002, men/women 1559/4353) to 6493 (2017, men/women1840/4653). The total count of forearm fractures increased from 68,636 (2002, men/women 17,186/51,450) to 89,040 (2017, men/women 20,185/68,855). Women were affected in 70–75% of all cases with rising incidences among nearly every age group in female patients. Conclusion Total count of nearly every evaluated fracture increased. Also, incidences increased especially in the older female age groups. Fracture development already seems to reflect demographic changes in Germany.
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Affiliation(s)
- P Hemmann
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany.
| | - P Ziegler
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - C Konrads
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - A Ellmerer
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - T Klopfer
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - A J Schreiner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - C Bahrs
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
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21
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Builova TV, Marchenkova LA. [Multidisciplinary approach to the rehabilitation of patients with osteoporosis]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2020; 97:58-67. [PMID: 32356636 DOI: 10.17116/kurort20209702158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The article outlines the modern concept of rehabilitation of patients with osteoporosis (OP), the cornerstone of which is the use of a multidisciplinary approach. This approach involves not only the participation of specialists of various specializations and levels in the process of rehabilitation treatment, but the formation of a new functional unit - a multidisciplinary team, whose members actively interact with each other from the first days to the completion of the rehabilitation course at every stage of the course; they together make a rehabilitation diagnosis based on the International Classification of Functioning, Disability and Health (ICF); they formulate rehabilitation goals, evaluate rehabilitation potential, discuss and develop a rehabilitation program and evaluate its effectiveness by using modern scales, tests and questionnaires to assess the change in the condition of the patient"s life at all levels and the quality of life in general. Taking into account the principle of multidisciplinarity, approaches to preparation of rehabilitation programs for patients with OP are described using various methods: those of therapeutic gymnastics, mechanotherapy, physiotherapy, balneotherapy, occupational therapy, psychotherapy, drug treatment and orthosis. Particular attention in the process of rehabilitation of patients with OP is given to physical therapy and orthosis, which are aimed at reducing pain, improving coordination, posture, as well as reducing the risk of falls and fractures. The literature review presented in the article allows us to conclude that the use of a multidisciplinary approach in the rehabilitation of patients with OP makes it possible to significantly improve the quality of life of patients even with severe forms of the disease.
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Affiliation(s)
- T V Builova
- N.I. Lobachevsky National Research Nizhny Novgorod State University, Nizhny Novgorod, Russia
| | - L A Marchenkova
- National Medical Research Center for rehabilitation and balneology, Moscow, Russia
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22
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Hopman WM, Berger C, Joseph L, Morin SN, Towheed T, Anastassiades T, Adachi JD, Hanley DA, Prior JC, Goltzman D. Longitudinal assessment of health-related quality of life in osteoporosis: data from the population-based Canadian Multicentre Osteoporosis Study. Osteoporos Int 2019; 30:1635-1644. [PMID: 31069440 DOI: 10.1007/s00198-019-05000-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/22/2019] [Indexed: 01/22/2023]
Abstract
UNLABELLED 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. INTRODUCTION 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- W M Hopman
- 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.
| | - C Berger
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - L Joseph
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - S N Morin
- Department of Medicine, McGill University, Montréal, QC, Canada
| | - T Towheed
- Division of Rheumatology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - T Anastassiades
- Division of Rheumatology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - J D Adachi
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - D A Hanley
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada
| | - J C Prior
- Department of Medicine/Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - D Goltzman
- Department of Medicine, McGill University, Montréal, QC, Canada
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23
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Uemura Y, Taguri M, Kawahara T, Chiba Y. Simple methods for the estimation and sensitivity analysis of principal strata effects using marginal structural models: Application to a bone fracture prevention trial. Biom J 2019; 61:1448-1461. [PMID: 31652011 DOI: 10.1002/bimj.201800038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 03/04/2019] [Accepted: 06/19/2019] [Indexed: 11/08/2022]
Abstract
In randomized clinical trials, it is often of interest to estimate the effect of treatment on quality of life (QOL), in addition to those on the event itself. When an event occurs in some patients prior to QOL score assessment, investigators may compare QOL scores between patient subgroups defined by the event after randomization. However, owing to postrandomization selection bias, this analysis can mislead investigators about treatment efficacy and result in paradoxical findings. The recent Japanese Osteoporosis Intervention Trial (JOINT-02), which compared the benefits of a combination therapy for fracture prevention with those of a monotherapy, exemplifies the case in point; the average QOL score was higher in the combination therapy arm for the unfractured subgroup but was lower for the fractured subgroup. To address this issue, principal strata effects (PSEs), which are treatment effects estimated within subgroups of individuals stratified by potential intermediate variable, have been discussed in the literature. In this paper, we describe a simple procedure for estimating the PSEs using marginal structural models. This procedure utilizes SAS code for the estimation. In addition, we present a simple sensitivity analysis method for examining the resulting estimates. The analyses of JOINT-02 data using these methods revealed that QOL scores were higher in the combination therapy arm than in the monotherapy arm for both subgroups.
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Affiliation(s)
- Yukari Uemura
- Biostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan.,Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Masataka Taguri
- Department of Science, Yokohama City University School of Data Science, Kanazawa-ku, Yokohama, Japan.,Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
| | - Takuya Kawahara
- Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osakasayama, Osaka, Japan
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24
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Estimation of Prevalence of Osteoporosis Using OSTA and Its Correlation with Sociodemographic Factors, Disability and Comorbidities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132338. [PMID: 31269706 PMCID: PMC6650858 DOI: 10.3390/ijerph16132338] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 06/30/2019] [Accepted: 06/30/2019] [Indexed: 01/10/2023]
Abstract
Osteoporosis is a growing concern for an aging society. The study aimed to estimate the prevalence of older adults who were at risk of osteoporosis and explore factors associated with osteoporosis. The relationship between the risk of osteoporosis, chronic conditions and disability was also explored. We hypothesized that respondents with high risk index of osteoporosis would be associated with greater disability. Participants aged 60 years and above (N = 2565) who were representative of Singapore’s multiethnic population were recruited. The Osteoporosis Self-Assessment Tool for Asians (OSTA) was used to classify the risk of osteoporosis. Information on sociodemographic details and chronic diseases were collected, while severity of disability was measured using the World Health Organization Disability Assessment Schedule 2.0. The overall prevalence of the respondents who were at risk of osteoporosis was 52%. Those belonging to an older age, Chinese, female, never married or widowed, lower education and retired were associated with a higher risk of osteoporosis. A diagnosis of diabetes or hypertension was a protective factor against the risk of osteoporosis. High risk of osteoporosis was not associated with disability. Our findings highlighted specific factors associated with the risk of osteoporosis that could be useful for the prevention of osteoporosis and fractures.
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25
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Kanazawa I, Takeno A, Tanaka KI, Yamane Y, Sugimoto T. Osteoporosis and vertebral fracture are associated with deterioration of activities of daily living and quality of life in patients with type 2 diabetes mellitus. J Bone Miner Metab 2019; 37:503-511. [PMID: 30191456 DOI: 10.1007/s00774-018-0948-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/03/2018] [Indexed: 12/25/2022]
Abstract
Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fracture. However, whether diabetes-related osteoporosis independently contributes to the deterioration of activities of daily living (ADLs) and quality of life (QOL) is unclear. This cross-sectional study investigated the association between osteoporosis, ADLs, and QOL in 309 patients with T2DM. ADLs and QOL were assessed using Barthel Index (BI) and a SF-36 questionnaire. Multiple logistic regression analyses adjusted for age, gender, T2DM duration, body mass index, hemoglobin A1c, estimated GFR, diabetic neuropathy, retinopathy, nephropathy, cardiovascular disease, cerebrovascular disease, peripheral artery disease, and anti-diabetic treatments were conducted. The number of patients with osteoporosis or vertebral fracture was 166 (53.7%) and 118 (38.2%), respectively. Osteoporosis was significantly associated with lower general health (GH), social functioning (SF), and role emotional (RE) (OR 2.56, 1.79, and 1.92, respectively; all p values < 0.05 at least) and marginally associated with lower BI (OR 2.39, p = 0.068). Moreover, the presence of vertebral fracture grade 2 or 3 was significantly associated with lower BI, bodily pain (BP), GH, vitality, SF, and RE (OR 2.58, 2.01, 3.64, 1.99, 2.18, and 1.97, respectively; all p values < 0.05 at least). Osteoporosis and severe vertebral fracture were associated with the deterioration of ADLs and QOL independently of other diabetic complications. Therefore, the management of diabetes-related osteoporosis is an important strategy to avoid the deterioration of ADLs and QOL in T2DM.
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Affiliation(s)
- Ippei Kanazawa
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, 693-8501, Japan.
| | - Ayumu Takeno
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, 693-8501, Japan
- Masuda Red Cross Hospital, Masuda, Japan
| | - Ken-Ichiro Tanaka
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, 693-8501, Japan
- Masuda Red Cross Hospital, Masuda, Japan
| | | | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, 693-8501, Japan
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26
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Ciubean AD, Ungur RA, Irsay L, Ciortea VM, Borda IM, Onac I, Vesa SC, Buzoianu AD. Health-related quality of life in Romanian postmenopausal women with osteoporosis and fragility fractures. Clin Interv Aging 2018; 13:2465-2472. [PMID: 30584286 PMCID: PMC6284528 DOI: 10.2147/cia.s190440] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Osteoporosis is a common skeletal disorder characterized by decreased bone mass and increased susceptibility to fractures, which are associated with pain and decrease in physical function, social function, and well-being, which are all aspects of quality of life (QoL). The purpose of this study was to evaluate the burden of osteoporosis and fragility fractures in Romanian postmenopausal women from Cluj County using the 36-Item Short Form Health Survey (SF-36) and Quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) questionnaires. Materials and methods An analytical cross-sectional study on 364 postmenopausal women was carried out between June 2016 and August 2017 in the Clinical Rehabilitation Hospital in Cluj-Napoca, Cluj County, Romania. Data were collected by interview and from the medical documents: clinical and demographic data, personal medical history, risk factors for osteoporosis, and bone mineral density at the lumbar spine and femur. The patients included in the study were asked to complete the Romanian versions of the SF-36 and QUALEFFO-41 questionnaires. Results Women with osteoporosis had significantly lower scores in the SF-36 domains (P<0.001) than healthy controls. In the osteoporosis group, a significant association was found in the SF-36 pain domain, where women with a history of fracture had higher scores (P=0.035). As for QUALEFFO-41, a statistical significance was found in the total score (P<0.05), revealing a significantly lower QoL in osteoporotic women with a history of fracture. Conclusion The SF-36 scores registered a loss of QoL in women with osteoporosis. The QUALEFFO-41 total score was significantly lower in the osteoporosis associated with fracture, revealing a lower health-related QoL in these patients.
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Affiliation(s)
- Alina Deniza Ciubean
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania,
| | - Rodica Ana Ungur
- Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, .,Department of Rehabilitation Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,
| | - Laszlo Irsay
- Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, .,Department of Rehabilitation Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, .,Department of Rehabilitation Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,
| | - Ileana Monica Borda
- Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, .,Department of Rehabilitation Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,
| | - Ioan Onac
- Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, .,Department of Rehabilitation Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,
| | - Stefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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27
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Napoli N, Langdahl BL, Ljunggren Ö, Lespessailles E, Kapetanos G, Kocjan T, Nikolic T, Eiken P, Petto H, Moll T, Lindh E, Marin F. Effects of Teriparatide in Patients with Osteoporosis in Clinical Practice: 42-Month Results During and After Discontinuation of Treatment from the European Extended Forsteo® Observational Study (ExFOS). Calcif Tissue Int 2018; 103:359-371. [PMID: 29909449 PMCID: PMC6153867 DOI: 10.1007/s00223-018-0437-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 05/25/2018] [Indexed: 02/05/2023]
Abstract
This study aimed to describe clinical outcomes in patients prescribed teriparatide and followed up for 18 months after stopping the drug in real-life conditions. The Extended Forsteo® Observational Study analysed incident clinical fractures in 6-month intervals using logistic regression with repeated measures. Changes in back pain (visual analogue scale) and health-related quality of life (HRQoL; EQ-5D questionnaire) were analysed using mixed models for repeated measures. Patients were analysed if they had a post-baseline visit, regardless of whether and for how long they took teriparatide. Of 1531 patients analysed (90.7% female, mean age: 70.3 years), 76 (5.0%) never took teriparatide. Median treatment duration was 23.6 months. The adjusted odds of clinical fracture decreased by 47% in the > 12- to 18-month treatment period (p = 0.013) compared with the first 6-month period, with no statistically significant reduction in the > 18- to 24-month interval. The clinical fracture rate remained stable during the 18 months' post-teriparatide, when approximately 98% of patients took osteoporosis medication (51% bisphosphonates). Clinical vertebral fractures were reduced at every time period compared with the first 6 months. Adjusted mean back pain scores decreased and EQ-5D scores increased significantly at each post-baseline observation. In a real-life clinical setting, the risk of clinical fractures declined during 24 months of teriparatide treatment. This reduction was maintained 18 months after stopping teriparatide. In parallel, patients reported significant improvements in back pain and HRQoL. The results should be interpreted in the context of the non-controlled design of this observational study.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, University Campus Bio-Medico, Alvaro del Portillo 21, 00128, Rome, Italy.
| | | | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Eric Lespessailles
- University Orléans, Orléans, France
- Regional Hospital of Orléans, Orléans, France
| | | | | | | | - Pia Eiken
- Department of Cardiology, Nephrology and Endocrinology, Hillerød Hospital, Hillerød, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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28
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Hu Z, Man GCW, Kwok AKL, Law SW, Chu WWC, Cheung WH, Qiu Y, Cheng JCY. Global sagittal alignment in elderly patients with osteoporosis and its relationship with severity of vertebral fracture and quality of life. Arch Osteoporos 2018; 13:95. [PMID: 30194552 DOI: 10.1007/s11657-018-0512-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/29/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED We compared global sagittal alignment and quality of life in osteoporotic patients with and without vertebral compression fracture (VCF) and determined its relationship with VCF severity. The findings revealed osteoporotic patients with VCF showed decreased quality of life and worse global sagittal alignment, which was significantly associated with VCF severity. INTRODUCTION The aim of this study was to compare the global sagittal alignment and quality of life in elderly osteoporotic patients with and without vertebral compression fracture (VCF), and to investigate the relationship between global sagittal alignment and severity of VCF. METHODS A consecutive series of 72 female patients with osteoporosis aged over 60 years and 31 age-matched females without osteoporosis were prospectively enrolled. The patients were divided into VCF and non-VCF group. Patient's clinical demography, nature of VCF, and bone mineral density (BMD) were also recorded. Spinal deformity index was used to evaluate severity of VCF. EOS® biplanar imaging system was then used to evaluate global sagittal parameters: T1 pelvic angle (TPA) and global sagittal angle (GSA). In addition, quality of life was assessed with self-reported questionnaires: the Oswestry Disability Index (ODI) and Short-form 12 (SF-12). RESULTS Osteoporotic patients and controls were found to be significantly different in terms of TPA, GSA, and BMD. And in patients with VCF, they were found to have significantly higher TPA and GSA. TPA and GSA were significantly correlated with SF-12 and ODI. The number of VCF and SDI significantly correlated with global sagittal alignment. Using regression analysis, parameters significantly associated with abnormal global alignment were the number of VCF (OR = 1.13) and SDI (OR = 1.84). CONCLUSION Osteoporotic patients with VCF showed worse global sagittal alignment and decreased quality of life. The number and severity of VCF had a negative influence on global sagittal balance, which indicates that poorer sagittal global alignment may imply worse quality of life and more severe VCF.
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Affiliation(s)
- Zongshan Hu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.,The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China
| | - Gene C W Man
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.,The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China
| | - Anthony K L Kwok
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Sheung-Wai Law
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Winnie W C Chu
- The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China.,Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.,The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China
| | - Yong Qiu
- The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China.,Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jack C Y Cheng
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. .,The Joint Scoliosis Research Center of the Chinese University of Hong Kong-Nanjing University, Shatin, Hong Kong, China.
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29
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Khani Jeihooni A, Forghani Fasaei I, Kashfi SM, Khiyali Z, Mobasheri F. Quality of Life in Patients With Osteoporosis People. JOURNAL OF HOLISTIC NURSING AND MIDWIFERY 2018. [DOI: 10.29252/hnmj.28.4.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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30
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Miyakoshi N, Kudo D, Hongo M, Kasukawa Y, Ishikawa Y, Shimada Y. Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers. Osteoporos Int 2017; 28:3153-3160. [PMID: 28785980 DOI: 10.1007/s00198-017-4184-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/30/2017] [Indexed: 01/14/2023]
Abstract
UNLABELLED This study compared spinal alignment, muscular strength, and quality of life (QOL) between women with postmenopausal osteoporosis and healthy volunteers. The results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness. INTRODUCTION Increased spinal kyphosis is common in patients with osteoporosis and negatively impacts quality of life (QOL). Muscular strength is also important for QOL in patients with osteoporosis. However, spinal kyphosis and muscle weakness also occur in healthy individuals with advancing age. The purposes of this study were thus to compare spinal alignment, muscular strength, and QOL between women with postmenopausal osteoporosis and healthy volunteers. METHODS Participants comprised 236 female patients with postmenopausal osteoporosis (mean age, 68.7 years) and 93 healthy volunteer women (mean age, 71.0 years). Body mass index (BMI), angles of spinal kyphosis, back extensor strength, grip strength, and QOL were compared between groups. RESULTS BMI, back extensor strength, and grip strength were significantly higher in the volunteer group than in the osteoporosis group (p < 0.01). Both thoracic kyphosis and lumbar lordosis were significantly greater in the osteoporosis group than in the volunteer group (p < 0.01). With regard to QOL, the 36-Item Short-Form Health Survey (SF-36) subscale scores of role physical, bodily pain, general health, and role emotional were all significantly lower in the osteoporosis group than in the volunteer group (p < 0.05 each). SF-36 physical component summary (PCS) score was significantly lower in the osteoporosis group than in the volunteer group (p < 0.001). SF-36 PCS score correlated positively with thoracic kyphosis and negatively with BMI only in the osteoporosis group (p < 0.05 each). CONCLUSIONS These results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness.
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Affiliation(s)
- N Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - D Kudo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - M Hongo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Y Kasukawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Y Ishikawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Y Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Modi A, Sen S, Adachi JD, Adami S, Cortet B, Cooper AL, Geusens P, Mellström D, Weaver JP, van den Bergh JP, Keown PA, Sajjan S. Association of gastrointestinal events with quality of life and treatment satisfaction in osteoporosis patients: results from the Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC OS). Osteoporos Int 2017; 28. [PMID: 28643048 PMCID: PMC5624972 DOI: 10.1007/s00198-017-4116-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED The purpose of this study was to assess the association of GI events with HRQoL and treatment satisfaction. The effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D, OPAQ-SV, and treatment satisfaction scores among patients with vs without baseline GI events. The presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction in patients being treated for osteoporosis. INTRODUCTION The goal of this study was to assess the association of gastrointestinal (GI) events with health-related quality of life (HRQoL) and treatment satisfaction in patients being treated for osteoporosis. METHODS MUSIC OS was a multinational, prospective, observational study examining the impact of GI events on osteoporosis management in postmenopausal women. In this analysis, HRQoL and treatment satisfaction were assessed at baseline, 6, and 12 months and compared between patients with and without GI events. Covariate-adjusted scores were calculated using multivariate least-squares regression analysis, and differences between the mean scores of patients with and without baseline and post-baseline GI events were determined. RESULTS Among the 2959 patients in the analysis, unadjusted scores at each time point were lower (i.e., worse) for patients with GI events than patients without GI events. In adjusted analyses, the effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D and OPAQ-SV scores at 12 months among patients with vs without baseline GI events (-0.04 for the EQ-5D utility score, -5.07 for the EQ-5D visual analog scale, -3.35 for OPAQ physical function, -4.60 for OPAQ emotional status, and -8.50 for OPAQ back pain; P ≤ 0.001 for all values). Decrements in month 12 treatment satisfaction scores were -6.46 for patients with baseline GI events and -7.88 for patients with post-baseline GI events. CONCLUSIONS The presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction in patients being treated for osteoporosis.
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Affiliation(s)
- A Modi
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA.
| | - S Sen
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - J D Adachi
- St Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| | - S Adami
- Department of Medicine, University of Verona, Verona, Italy
| | - B Cortet
- Department of Rheumatology, University Hospital of Lille, Lille Cedex, France
| | - A L Cooper
- Bridge Medical Center, Crawley, West Sussex, UK
| | - P Geusens
- Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - D Mellström
- Department of Internal Medicine and Geriatrics, Gothenburg University, Gothenburg, Sweden
| | - J P Weaver
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - J P van den Bergh
- Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - P A Keown
- Syreon Corporation, Vancouver, Canada
| | - S Sajjan
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
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Grbovic V, Skevin AJ, Ilic KP, Tomic AL, Nurkovic J, Jeremic D, Djordjevic D. Correlations Between Clinical Parameters and Health-Related Quality of Life in Postmenopausal Osteoporotic Women. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2016. [DOI: 10.1515/sjecr-2016-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The purpose of this study was to assess the correlation between health-related quality of life (HRQoL) and clinically relevant osteodensitometric and biochemical parameters in postmenopausal osteoporotic women. Bone mineral density (BMD) and T scores of the lumbar vertebrae and femoral neck were assessed in 100 osteoporotic women (56 without previous fractures and 44 with previous fractures) using dual x-ray absorptiometry. The Fracture Risk Assessment Tool (FRAX) index for major osteoporotic and hip fractures was calculated based on demographic data and hip BMD. Venous blood samples were taken from each subject for biochemical analysis (serum calcium, phosphorus, alkaline phosphatase and vitamin D levels). HRQoL was assessed using the QUALEFFO-41 questionnaire (domains: Health perception, Pain, and Physical, Social and Mental function). Basic participant characteristics (age, menopause length, body mass index, smoking habits, hereditary tendency towards fracture, fracture history) correlated with some of the QUALEFFO-41 domains, but the correlation coefficients were low (r<0.3), except in the case of the correlation between Pain and fracture history (r=0.638). Of the six variables included in the multiple regression model, fracture history was shown to be the most significant predictor with respect to the following three QUALEFFO-41 domains: Pain (b=20.511), Social function (b=2.548) and Health perception (b=3.185). Correlation analysis showed that after adjustment for basic characteristics, BMD and T score of the femoral neck and Pain (r=0.331 and r=0.449, respectively), Social function (r=0.422 and r=0.419) and Health perception (r=0.434 for T score of the femoral neck) exhibited the strongest correlations. Vitamin D was negatively correlated with Mental function, while the other biochemical parameters exhibited variable correlations with the QUALEFFO- 41 domains (r≈0.2-0.5). Our study confirmed the previously established relationship between BMD of the femoral neck and HRQoL in patients with osteoporosis and demonstrated correlations between various blood bone metabolism parameters and HRQoL that have not been previously investigated.
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Affiliation(s)
- Vesna Grbovic
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Aleksandra Jurisic Skevin
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Katarina Parezanovic Ilic
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Aleksandra Lucic Tomic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Jasmin Nurkovic
- Department of Biomedical Sciences, State University of Novi Pazar, Serbia
| | - Dejan Jeremic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Dusica Djordjevic
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia
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Al-Sari UA, Tobias J, Clark E. Health-related quality of life in older people with osteoporotic vertebral fractures: a systematic review and meta-analysis. Osteoporos Int 2016; 27:2891-900. [PMID: 27262840 DOI: 10.1007/s00198-016-3648-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/20/2016] [Indexed: 11/30/2022]
Abstract
Health-related quality of life in osteoporotic patients with vertebral fracture is of increasing interest, but relevant studies have yielded debatable results. This systematic review and meta-analysis of 16 observational studies demonstrate a clear association between physical health status and presence of vertebral fracture after accounting for age. This meta-analysis was conducted to identify if there are any differences between physical and/or mental health-related quality of life (HRQoL) in older people with osteoporosis based on conventional T-score definitions and the presence or absence of vertebral fracture. A comprehensive search was undertaken using the databases of PubMed, Embase, Medline, Web of Science, and the "grey" literature from 1950 to the end of April 2015. Search terms for vertebral fracture (VF) included VF, osteoporotic fracture, fragility fracture, and spinal fracture. Quality of life was searched using the following terms: quality of life, health-related quality of life, HRQoL, and QoL. Strict inclusion and exclusion criteria were used. The standardized mean difference (SMD) was calculated for each HRQoL domain by the difference in means between case and control groups divided by the pooled SD of participants. Sixteen eligible studies were identified involving 3131 men and women. There was evidence of publication bias and heterogeneity. The meta-analysis showed worse physical (SMD = 0.53, 95 % confidence interval (CI) 0.38 to 0.68; P < 0.001) and mental (SMD = 0.19, 95 % CI 0.05 to 0.33; P = 0.009) HRQoL in osteoporotic older people with vertebral fracture compared to those without fracture. Similar differences were observed for physical HRQoL in further analyses accounting for possible confounding effects of age. Sub-analysis to assess associations between number/severity of fractures and time since fracture was not possible due to small numbers of studies that accounted for age. Osteoporotic older people with vertebral fracture have worse physical HRQoL than osteoporotic older people without vertebral fracture, even after accounting for age differences.
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Affiliation(s)
- U A Al-Sari
- Academic Rheumatology, Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - J Tobias
- Academic Rheumatology, Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - E Clark
- Academic Rheumatology, Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
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Langdahl BL, Ljunggren Ö, Benhamou CL, Marin F, Kapetanos G, Kocjan T, Lespessailles E, Napoli N, Nikolic T, Petto H, Moll T, Lindh E. Fracture Rate, Quality of Life and Back Pain in Patients with Osteoporosis Treated with Teriparatide: 24-Month Results from the Extended Forsteo Observational Study (ExFOS). Calcif Tissue Int 2016; 99:259-71. [PMID: 27137783 PMCID: PMC4960288 DOI: 10.1007/s00223-016-0143-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/12/2016] [Indexed: 11/16/2022]
Abstract
We describe the pre-planned interim analysis of fracture outcomes, health-related quality of life (HRQoL) and back pain in patients with severe osteoporosis treated with teriparatide for up to 24 months in the Extended Forsteo (Forsteo(®) is a registered trade name of Eli Lilly and Company) Observational Study (ExFOS), a prospective, multinational, observational study. Data on incident clinical fractures, HRQoL (EQ-5D questionnaire) and back pain [100 mm visual analogue scale (VAS)] were collected. The number of patients with fractures was summarised in 6-month intervals and fracture rate over each 6-month period was assessed using logistic regression for repeated measures. Changes from baseline in EQ-5D and back pain VAS were analysed using mixed models for repeated measures. Of 1454 patients in the active treatment cohort, 90.6 % were female and 14.4 % were taking glucocorticoids. During teriparatide treatment (median duration 23.7 months), 103 patients (7.1 %) sustained a total of 122 incident clinical fractures (21 % vertebral, 79 % non-vertebral). A 49 % decrease in the odds of fractures and a 75 % decrease in the odds of clinical vertebral fractures were observed in the >18- to 24-month period versus the first 6-month period (both p < 0.05). EQ-5D scores and back pain VAS scores were significantly improved from baseline at each post-baseline observation during teriparatide treatment. In conclusion, patients with severe osteoporosis showed a significant reduction in the incident fracture rate during 24 months of teriparatide treatment in routine clinical practice, accompanied by a significant improvement in HRQoL and reduction in back pain. Results should be interpreted in the context of the non-controlled design of this observational study.
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Affiliation(s)
- Bente L Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus, Denmark.
| | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | | | | | | | - Eric Lespessailles
- Orléans Hospital, Orléans, France
- EA-4708-I3MTO, University of Orléans, Orléans, France
| | | | | | | | - Thomas Moll
- Eli Lilly and Company, Windlesham, Surrey, UK
| | - Erik Lindh
- Eli Lilly and Company, Windlesham, Surrey, UK
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Wang CC, Lu HT, Dusetzina SB, Wu CH. The Association Between Long-Term Bisphosphonate Use and the Risk of Fracture Among Women Aged 50 or Older with Osteoporosis. J Womens Health (Larchmt) 2016; 25:738-46. [PMID: 27096405 DOI: 10.1089/jwh.2015.5617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Osteoporosis is a prevalent disease, and bisphosphonates can effectively reduce the risk of osteoporotic fractures. However, the association between the length of the medication treatment and the risk of fractures remains unclear. The purpose of this study was to evaluate the association between long-term bisphosphonate use (treatment duration ≥5 years) and the risk of fractures among women with osteoporosis aged 50 or older. MATERIALS AND METHODS We conducted a retrospective cohort study by using the 2001-2011 National Health Insurance Research Database in Taiwan. We included women who were 50 years or older, who had a diagnosis of osteoporosis, and who were newly initiating oral bisphosphonates between January 1, 2002 and December 31, 2003. The index date was the date of the first dispensing of oral bisphosphonate during the enrollment period. Women were considered to be using bisphosphonates until they had a gap in supply of more than 3 months. We classified bisphosphonate use as long term (≥5 years) and regular (<5 years) based on its length of use. The dependent variable was the time to the first observed clinical fracture. Cox-proportional hazard regression models were used to evaluate the association between long-term bisphosphonate use and the risk of fractures. RESULTS The study included 1342 women with a mean age of 71 years. Of them, 83 (6.2%) were long-term bisphosphonate users. A total of 185 (13.8%) had a fracture. After adjustments, long-term bisphosphonate use was not associated with a lower risk of fractures than was regular bisphosphonate use (adjusted hazard ratio: 1.49, 95% CI: 0.91-2.45). CONCLUSION This study found no evidence of a lower risk of fractures to be associated with long-term bisphosphonate use among women aged 50 or older with osteoporosis in Taiwan. Orthopedists as well as other healthcare providers should be aware of the limited benefits of long-term bisphosphonate use.
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Affiliation(s)
- Chi-Chuan Wang
- 1 School of Pharmacy, National Taiwan University , Taipei, Taiwan
| | - Hsien-Tsung Lu
- 2 Department of Orthopedics, Taipei Medical University Hospital , Taipei, Taiwan .,3 Graduate Institute of Medical Sciences, College of Medicine , Taipei Medical University
| | - Stacie B Dusetzina
- 4 Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.,5 Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , North Carolina
| | - Chung-Hsuen Wu
- 6 School of Pharmacy, College of Pharmacy, Taipei Medical University , Taipei, Taiwan .,7 Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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Albayrak I, Aydogmus M, Ozerbil OM, Levendoglu F. The association between bone mineral density, quality of life, quality of sleep and fatigue. Acta Clin Belg 2016; 71:92-8. [PMID: 26271996 DOI: 10.1179/2295333715y.0000000061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES This study was undertaken to examine quality of life (QoL), the quality of sleep and fatigue level in postmenopausal women with osteoporosis (OP) but without fractures, to assess the associations between these parameters and to compare the results with those for subjects who have osteopenia or normal bone mineral density (BMD). METHODS In this study, 113 postmenopausal osteoporosis (PMO) subjects without fractures, 172 subjects with osteopenia and 102 subjects with normal BMD were included. The severity of pain, QoL, quality of sleep and fatigue were assessed using the visual analogue scale (VAS), the QoL Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41), the Pittsburgh Sleep Quality Index (PSQI) and the Checklist of Individual Strength (CIS) questionnaire. RESULTS No statistically significant differences between the three groups were found in terms of VAS and QUALEFFO-41 total scores (p > 0.05). On the other hand, PSQI and CIS total scores were significantly different in the PMO and osteopenia groups (P = 0.015 and 0.007, respectively) compared to the group with normal BMD. CONCLUSIONS During the follow-up and treatment of women with PMO or osteopenia, QoL, quality of sleep and fatigue should be assessed and incorporated into treatment decisions, even in the absence of fractures.
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Affiliation(s)
- Ilknur Albayrak
- a Selcuk University Medical Faculty , Department of Physical Medicine and Rehabilitation , Konya , Turkey
| | - Mehmet Aydogmus
- a Selcuk University Medical Faculty , Department of Physical Medicine and Rehabilitation , Konya , Turkey
| | - Onder Murat Ozerbil
- a Selcuk University Medical Faculty , Department of Physical Medicine and Rehabilitation , Konya , Turkey
| | - Funda Levendoglu
- a Selcuk University Medical Faculty , Department of Physical Medicine and Rehabilitation , Konya , Turkey
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Xu L, Sun W, Qin X, Zhu X, Qiu Y, Zhu Z. The reliability and validity of the simplified Chinese version of Male QUALEFFO-26. Rheumatol Int 2015; 36:489-94. [PMID: 26693934 DOI: 10.1007/s00296-015-3410-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
Abstract
The aim of the study was to investigate the reliability and validity of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-26) in male osteoporosis patients from Chinese population. The simplified Chinese version of Male QUALEFFO-26 was translated and adapted on the basis of QUALEFFO-31, which was assigned to the cases and controls together with SF-36. Reliability was assessed using the intra-class correlation coefficient (ICC) and Cronbach's α. Validity was assessed with Pearson's correlation analysis between the similar domains of the two questionnaires. Receiver operating characteristics (ROC) curve analysis was carried out to determine the ability of male QUALEFFO-26 to discriminate between cases and controls. The ICC was 0.83 for pain domain, 0.79 for mental domain and 0.81 for physical function. Cronbach's α of each domain ranged from 0.82 to 0.89. Pearson correlation coefficients indicated significantly high correlations between corresponding domains of QUALEFFO-26 and SF-36, with r ranging from -0.523 to -0.832. ROC analysis showed that all the domains of QUALEFFO-26 were significantly predictive of vertebral deformity, with the values of AUC ranging from 0.68 to 0.84. The simplified Chinese version of Male QUALEFFO-26 was a valid, reliable and repeatable instrument showing favorable psychometric characteristics. The questionnaire can be used in male osteoporosis patients from Chinese population.
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Affiliation(s)
- Leilei Xu
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Weixiang Sun
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Xiaodong Qin
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Xiufen Zhu
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Yong Qiu
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Zezhang Zhu
- Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
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Ma L, Li Y, Wang J, Zhu H, Yang W, Cao R, Qian Y, Feng M. Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population. PLoS One 2015; 10:e0127849. [PMID: 26061550 PMCID: PMC4465171 DOI: 10.1371/journal.pone.0127849] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 04/20/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To explore the association between quality of life and social support in elderly osteoporosis patients in a Chinese population. METHODS A total of 214 elderly patients who underwent bone mineral density screening were divided into two groups: elderly patients with primary osteoporosis (case group, n = 112) and normal elderly patients (control group, n = 102). Quality of life and social support were compared between the two groups. RESULTS Quality of life and social support were significantly different between the case and control groups. The physical function, role-physical, bodily pain, general health, vitality, social-functioning, role-emotional and mental health scores in case group were significantly lower than those in the control group (P < 0.01). The objective support, subjective support, utilization of support, and total scores in case group were significantly lower than those in the control group (P < 0.01). Quality of life and social support were positively correlated in the case group (r = 0.672, P < 0.01). CONCLUSION Quality of life and social support in elderly patients with osteoporosis in China were poorer than in elderly patients without osteoporosis and were positively correlated. Our findings indicate that increased efforts to improve the social support and quality of life in elderly osteoporosis patients are urgently needed in China. Further longitudinal studies should be conducted to provide more clinical evidence to determine causative factors for the observed association between risk factors and outcomes.
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Affiliation(s)
- Lina Ma
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yun Li
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jieyu Wang
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Hong Zhu
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Wei Yang
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ruojin Cao
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yuying Qian
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ming Feng
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
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Impact of physical activity on health-related quality of life in osteoporotic and osteopenic postmenopausal women: A systematic review. Int J Nurs Sci 2015. [DOI: 10.1016/j.ijnss.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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40
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Huang CY, Liao LC, Tong KM, Lai HL, Chen WK, Chen CI, Lu CY, Chen FJ. Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modeling. Osteoporos Int 2015; 26:875-83. [PMID: 25477231 DOI: 10.1007/s00198-014-2963-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED Participants with physical limitation and high degree of pain had poor mental and physical health-related quality of life. In addition, the more support and exercise that the participants had, the more likely they were to report better health-related quality of life. INTRODUCTION Osteoporosis is a public health threat worldwide. The aim of this study is to examine the effects of individual demographics, disease characteristics, and social support on health-related quality of life (HrQoL) of adults with osteoporosis. Most psychosocial studies focused on the relationships but not the specific construct of social support on HrQoL. METHODS In a correlational design, face-to-face, structured interviews were employed to collect information. Study questionnaires included a demographic sheet, the modified Social Support Inventory, and the Short-Form 36 scales on a convenience sample of 161 individuals recruited from four outpatient centers. Using the structural equation modeling approach, all relationships among factors, mediators, and HrQoL were analyzed. RESULTS The mean duration of osteoporosis was longer than 5 years. Participants who exercised more than three times per week had greater HrQoL than individuals who exercised less frequently. Participants with physical limitation and high degree of pain had poor mental and physical HrQoL. The more support that the participants perceived, the more likely they were to report better HrQoL. The best fitted structural equation modeling (SEM) model included individual demographics and physical function, and social support as significant predictors on HrQoL, with informational support and physical function acting as mediators in those relationships. Moreover, this structural model explained 35, 42, and 40 % of the variance on activity of daily living (ADL), physical, and mental health-related quality of life. CONCLUSIONS The more informational support that individuals have, the more likely they were to report better HrQoL. Individuals with osteoporosis who have lower pain and more exercise are considered having better HrQoL. Further longitudinal research will help clarify the direction of these relationships.
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Affiliation(s)
- C-Y Huang
- Department of Nursing, I-Shou University, No. 8, Yida Rd, Yanchao district, Kaohsiung, 82445, Taiwan,
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An association between abnormal bone turnover, systemic inflammation, and osteoporosis in patients with chronic pancreatitis: a case-matched study. Am J Gastroenterol 2015; 110:336-45. [PMID: 25623657 DOI: 10.1038/ajg.2014.430] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 12/01/2014] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Because of deteriorating exocrine function, malabsorption renders chronic pancreatitis (CP) patients at risk of osteoporosis and fracture. However, the pathogenesis of low bone mineral density (BMD) has not been characterized. We hypothesized that bone turnover is elevated in CP, and we sought to investigate an association between bone metabolism and systemic inflammation. METHODS Twenty-nine CP patients and twenty-nine matched controls were recruited. Bone-turnover markers procollagen 1 amino-terminal propeptide (P1NP), OC (osteocalcin; bone formation markers), and carboxy-terminal telopeptide of type I collagen (CTX-I; bone resorption marker) were measured along with vitamin D (25-hydroxyvitamin D, 25OHD), parathyroid hormone (PTH), interleukin 6 (IL-6), high-sensitivity (hs) C-reactive protein (CRP), and sex/thyroid hormones. BMD was measured by dual-energy X-ray absorptiometry. Smoking status was noted. RESULTS Of the CP patients, 31% had osteoporosis and 44.8% osteopenia (controls: 6.9 and 51.7%, respectively; P=0.019). BMD was lower for patients at the lumbar spine (P=0.014) and femoral neck (P=0.029). Patients had elevated bone formation (P1NP (P=0.0068), OC (P=0.033)) and bone resportion (CTX-I (P=0.016)) compared with controls. Patients had lower 25OHD compared with controls (P=0.0126) and higher inflammatory markers (hsCRP, P=0.0013). Sex and thyroid hormone levels were similar. Patients with lowest 25OHD levels had highest P1NP. In a multivariable model, age, PTH, and smoking were predictive of 25OHD. Patients with osteoporosis had higher P1NP, PTH, and IL-6 and lower 25OHD. Using analysis of variance, inflammation (hsCRP) was highest in those with lowest 25OHD and lowest BMD. CONCLUSIONS For the first time, bone turnover was shown to be abnormal in CP, and importantly, an association between low 25-OHD, smoking, and systematic inflammation was identified. Moreover, those with osteoporosis had the highest systemic inflammation. Together these factors provide an avenue for potential modification of risk factors, which may ultimately reduce bone loss and avert fractures in this group.
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Janovszky Á, Vereb T, Szabó A, Piffkó J. [Current approaches for early detection and treatment of medication-related osteonecrosis of jaw]. Orv Hetil 2014; 155:1960-6. [PMID: 25434516 DOI: 10.1556/oh.2014.30046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Owing to the increased life expectancy, the incidence of rheumatoid disorders and oncologic cases with bone metastasis has dramatically increased. Despite the beneficial effects of the applied antiresorptive and antiangiogenic drugs (e.g. bisphosphonates), serious side effects such as jaw osteonecrosis may also develop. The aim of the authors was to summarize present knowledge about the possibilities of prevention and treatment in medication-related osteonecrosis of the jaw. Based on literature data, currently used detection methods for medication-related osteonecrosis of the jaw (including their advantages and limitations) are summarized. In addition, novel trends of surgical and adjuvant therapeutic approaches are also reviewed. The authors conclude that possibilities of prevention and efficacy of therapeutic interventions in this disorder are still limited possibly due to an incomplete knowledge of the underlying pathomechanism. An interdisciplinary cooperation for prevention and attentive monitoring in order to decrease the incidence of iatrogenic oral and maxillofacial complications seems to be particularly important.
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Affiliation(s)
- Ágnes Janovszky
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
| | - Tamás Vereb
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
| | - Andrea Szabó
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Sebészeti Műtéttani Intézet Szeged
| | - József Piffkó
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
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Dobbins AG, Brennan SL, Williams LJ, Holloway KL, Pasco JA. Adulthood Fracture and Quality of Life: A Population-Based Study of Australian Men. JOURNAL OF MEN'S HEALTH 2014. [DOI: 10.1089/jomh.2014.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wilson S, Sharp CA, Davie MWJ. Health-related quality of life in women referred for bone density assessment: relationships with bone mineral density, fracture and co-morbidity. Qual Life Res 2014; 24:1235-43. [PMID: 25413779 DOI: 10.1007/s11136-014-0851-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To identify variables that might influence health-related quality of life (HRQoL) in patients with and without a history of fracture, attending bone mineral density (BMD) assessment prior to diagnosis of osteoporosis. METHODS This cross-sectional study included 312 newly referred postmenopausal women attending for a DXA scan, without a diagnosis of osteoporosis. Data were obtained from the medical history and the General Practitioner's letter. HRQoL, using SF36 was scored using published algorithms with reference to an age-related population from England. Regression analyses were used to determine relationships between HRQoL and BMD, age, fracture status and co-morbidities. RESULTS For all patients, the age-related physical component summary (PCS) and mental component summary (MCS) scores were 46 ± 10 and 47 ± 10, respectively. Controlling for confounding variables, low BMD at the femoral neck was associated with worse PCS scores (p = 0.010) and MCS scores (p = 0.034) in patients without fracture. In patients with a history of fracture, this relationship was less evident, and younger age (p < 0.00), increasing BMI (p = 0.016) and number of co-morbidities (p = 0.042) were associated with reductions in PCS scores. CONCLUSIONS Patients referred for BMD assessment before a diagnosis of osteoporosis had reduced PCS scores. In patients without fracture, low BMD contributed to this reduction in health-related quality of life. Low PCS scores in patients with fracture were seen only in younger subjects with osteoporosis.
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Affiliation(s)
- Sally Wilson
- School of Sport Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd, LL57 2PZ, UK,
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Relationship between sagittal spinal alignment and the incidence of vertebral fracture in menopausal women with osteoporosis: a multicenter longitudinal follow-up study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24:737-43. [DOI: 10.1007/s00586-014-3637-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/20/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022]
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Ljunggren O, Benhamou CL, Dekker J, Kapetanos G, Kocjan T, Langdahl BL, Napoli N, Petto H, Nikolić T, Lindh E. Study description and baseline characteristics of the population enrolled in a multinational observational study of extended teriparatide use (ExFOS). Curr Med Res Opin 2014; 30:1607-16. [PMID: 24720366 DOI: 10.1185/03007995.2014.907561] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To better characterize patients who are currently being prescribed teriparatide in Europe, this article describes the study design and baseline characteristics of participants of the Extended Forsteo * Observational Study (ExFOS). RESEARCH DESIGN AND METHODS ExFOS is a noninterventional, multicenter, prospective, observational study in men and women with osteoporosis treated with teriparatide during the course of normal clinical practice for up to 24 months and with a post-treatment follow-up of at least 18 months. MAIN OUTCOME MEASURES Baseline characteristics, including history of fracture and back pain, and health-related quality of life (HRQoL, assessed using the EuroQol-5 Dimension [EQ-5D]). RESULTS Of 1607 patients enrolled, 90.9% were women. At baseline, mean (standard deviation [SD]) age was 70.3 (9.8) years, and 85.8% of patients had a history of fracture (64.7% with ≥2 fragility fractures). Of those with historic fractures, 90.8% had vertebral fractures (67.8% had thoracic fractures). The mean (SD) of reported bone mineral density T-scores were -3.0 (1.2), -2.4 (1.0), and -2.5 (0.9) for lumbar spine, total hip (left), and femoral neck (left), respectively. Overall, 39.3% of patients had experienced ≥1 fall during the 12 months before enrollment. At baseline, 11.4% of patients were osteoporosis-treatment naïve and 15% were currently using glucocorticoids. The mean (SD) visual analog scale score for back pain during the last month was 50.7 (26.9), and 62.1% of patients experienced daily or almost daily back pain. The median EQ-5D health state value at baseline was 0.62 (first and third quartiles: 0.19, 0.74). CONCLUSIONS Baseline characteristics of the ExFOS study cohort indicate that patients prescribed teriparatide in Europe have severe osteoporosis with highly prevalent vertebral fractures, frequent and disabling back pain, and a poor HRQoL, despite previous pharmacotherapy for osteoporosis. Limitations include non-randomization, lack of a comparator group, and patient self-report for data on prior medication and fracture history.
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Affiliation(s)
- O Ljunggren
- Uppsala University, Department of Medical Sciences , Uppsala , Sweden
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Nuti R, Caffarelli C, Guglielmi G, Gennari L, Gonnelli S. Undiagnosed vertebral fractures influence quality of life in postmenopausal women with reduced ultrasound parameters. Clin Orthop Relat Res 2014; 472:2254-61. [PMID: 24728662 PMCID: PMC4048413 DOI: 10.1007/s11999-014-3588-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 03/17/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoporosis, a multifactorial systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to increased bone fragility, is a worldwide public health problem. Vertebral fractures affect approximately 20% of postmenopausal women and are a hallmark of osteoporosis, but they may pass unnoticed, although they may lead to long-term immobility and disability. QUESTIONS/PURPOSES The aims of the present study were (1) to determine the prevalence and the severity of vertebral fractures in a large cohort of Italian women aged 60 years or older with reduced values of quantitative ultrasound parameters; and (2) to assess whether vertebral fractures and other variables may be associated with health-related quality of life. METHODS A total of 2450 women without back pain aged 60 years or older, after the completion of the Quality of Life Questionnaire of the European Foundation for Osteoporosis QUALEFFO, underwent quantitative ultrasound evaluation of the calcaneus; in those with a stiffness t-score of ≤ -2 (n = 1194), radiographic evaluation of the thoracic and lumbar spine was carried out and then quantitative morphometry was performed by dedicated software (MorphoXpress). The radiographic analysis was carried out on 885 women who presented films of adequate quality. Multivariate regression was used to adjust for confounding variables. RESULTS Of those who underwent radiographic analysis, 681 had no vertebral fractures, and 204 women (23.1%) had one or more previously undiagnosed vertebral fractures. The prevalence of previously undiagnosed vertebral fractures increased with advancing age with more than 30% of women older than 75 years having at least one fracture. Older age, body mass index, and severe vertebral fractures were independently associated with a worse total QUALEFFO score. CONCLUSIONS We found that approximately one in four women showed evidence of undiagnosed vertebral fractures, and there was a strong age effect trend. Moreover, the severity grade of vertebral fractures, more than the number of fractures, was associated with a worsening of health-related quality of life as assessed by QUALEFFO. These findings confirm the clinical relevance of an early diagnosis of vertebral fractures and seem to support the usefulness of quantitative ultrasound measurements in the stratification of postmenopausal women at increased fracture risk. LEVEL OF EVIDENCE Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ranuccio Nuti
- />Department of Internal Medicine, Surgery and Neurosciences, Policlinico Le Scotte, University of Siena, Viale Bracci 2, 53100 Siena, Italy
| | - Carla Caffarelli
- />Department of Internal Medicine, Surgery and Neurosciences, Policlinico Le Scotte, University of Siena, Viale Bracci 2, 53100 Siena, Italy
| | - Giuseppe Guglielmi
- />Department of Radiology, Scientific Institute Hospital, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Luigi Gennari
- />Department of Internal Medicine, Surgery and Neurosciences, Policlinico Le Scotte, University of Siena, Viale Bracci 2, 53100 Siena, Italy
| | - Stefano Gonnelli
- />Department of Internal Medicine, Surgery and Neurosciences, Policlinico Le Scotte, University of Siena, Viale Bracci 2, 53100 Siena, Italy
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Altinok ML, Glintborg D, Depont Christensen R, Hallas J, Andersen M. Prescription of antidepressants is increased in Danish patients with polycystic ovary syndrome and is associated with hyperandrogenism. A population-based cohort study. Clin Endocrinol (Oxf) 2014; 80:884-9. [PMID: 24224860 DOI: 10.1111/cen.12365] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 09/12/2013] [Accepted: 11/11/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Quality of life is impaired in polycystic ovary syndrome (PCOS). In this study, we compared the time to first prescription of antidepressants (ADM) in PCOS vs two control groups. DESIGN Register-based cohort study. PATIENTS One thousand and one hundred and twenty-four premenopausal women with hirsutism and/or PCOS, premenopausal women with hypertension (HT, n = 301), and age- and sex-matched population controls (controls, n = 4110). MEASUREMENTS Prescriptions for ADM on secondary care contacts from regional registers. RESULTS The median age at cohort entry in PCOS, HT and controls was 29, 34 and 29 years, respectively. Among PCOS, HT and controls, 227 (20%), 74 (25%) and 633 (15%), respectively, had prescriptions of ADM. The median time to first prescription of ADM in the PCOS, HT and control cohorts was 6·8, 6·6 and 7·2 years, respectively. The adjusted hazard ratio for time to prescription of ADM for HT vs PCOS was 1·36 [95% CI (1·02-1·82)], P = 0·039, and for controls vs PCOS, it was 0·75 [95% CI (0·64-0·88)], P < 0·001. Within patients with PCOS, hyperandrogenism contributed significantly to the model, likelihood ratio test P = 0·009. The adjusted hazard ratio for hyperandrogenism vs no hyperandrogenism was 1·97 (1·12-3·45), P = 0·018. CONCLUSION Patients with PCOS had moderately but significantly decreased time to first prescription of ADM compared with age-matched healthy women, whereas patients with HT had the shortest time to prescription. In PCOS, prescription of ADM was associated with the presence of hyperandrogenism.
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Affiliation(s)
- M L Altinok
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense C, Denmark
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Ohta H, Uemura Y, Nakamura T, Fukunaga M, Ohashi Y, Hosoi T, Mori S, Sugimoto T, Itoi E, Orimo H, Shiraki M. Serum 25-hydroxyvitamin D level as an independent determinant of quality of life in osteoporosis with a high risk for fracture. Clin Ther 2014; 36:225-35. [PMID: 24462224 DOI: 10.1016/j.clinthera.2013.12.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/18/2013] [Accepted: 12/07/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Deteriorated quality of life (QOL) is a major problem in osteoporotic women. However, little is known regarding the determinants of QOL in patients with osteoporosis. OBJECTIVE Our aim was to explore the role of vitamin D status on QOL score in osteoporosis with high fracture risk. METHODS Patients were osteoporotic women aged ≥70 years and with ≥1 risk factor for incident fracture, namely prevalent osteoporotic fracture, bone mineral density (BMD) >-3.0 SD of young adult mean, or high bone turnover marker. Health-related QOL was assessed using the Japanese Osteoporosis Quality of Life Questionnaire (JOQOL). When patients were classified into quartiles by total QOL score). Serum 25-hydroxyvitamin D (25[OH]D) level was measured by immunoassay. RESULTS A total of 1585 osteoporotic women were included in the study (age range, 70-95 years). Age, body mass index, serum 25(OH)D status (low, normal, or high), bone mineral density, number of prevalent vertebral fractures, presence of hypertension, presence of osteoarthritis, and history of falls were significantly correlated with QOL quartile. Multivariate liner regression analysis indicated that low serum 25(OH)D level (<20 ng/mL) was an independent determinant of total QOL score quartile (P = 0.0055). The conventional determinants of QOL-age (P < 0.0001), body mass index (P = 0.0060), number of prevalent vertebral fractures (P < 0.0001), presence of osteoarthritis (P = 0.0074), and history of fall (P = 0.0098)-were also independent determinants of total QOL score. CONCLUSIONS These results strongly suggest that low serum 25(OH)D level was a significant determinant of QOL in these osteoporotic women, independently of the conventional factors that reduce QOL. Maintenance of serum 25(OH)D levels >20 ng/mL may be required to maintain patients' QOL in osteoporosis.
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Affiliation(s)
- Hiroaki Ohta
- Department of Clinical Medical Research Center, International University of Health and Welfare, Women's Medical Center of Sanno Medical Center, Tokyo, Japan
| | - Yukari Uemura
- Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan
| | | | | | - Yasuo Ohashi
- Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Takayuki Hosoi
- Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Satoshi Mori
- Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | | | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi, Japan
| | | | - Masataka Shiraki
- Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, Nagano, Japan.
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Qu X, Zhang X, Zhai Z, Li H, Liu X, Li H, Liu G, Zhu Z, Hao Y, Dai K. Association between physical activity and risk of fracture. J Bone Miner Res 2014; 29:202-11. [PMID: 23813682 DOI: 10.1002/jbmr.2019] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 06/04/2013] [Accepted: 06/10/2013] [Indexed: 11/08/2022]
Abstract
Prospective studies that have examined the association between physical activity and fracture risks have reported conflicting findings. We performed a meta-analysis to evaluate this association. We searched MEDLINE (1966 to February 1, 2013), EMBASE (1980 to February 1, 2013), and OVID (1950 to February 1, 2013) for prospective cohort studies with no restrictions. Categorical, heterogeneity, publication bias, and subgroup analyses were performed. There were 22 cohort studies with 1,235,768 participants and 14,843 fractures, including 8874 hip, 690 wrist, and 927 vertebral fractures. The pooled relative risk (RR) of total fractures for the highest versus lowest category of physical activity was 0.71 (95% confidence interval [CI], 0.63-0.80). The analysis of fracture subtypes showed a statistically significant inverse relationship between a higher category of physical activity and risk of hip and wrist fracture. The risk of hip or wrist fracture was 39% and 28% lower, respectively, among individuals with the highest category of physical activity than among those with the lowest category (95% CI, 0.54-0.69 and 0.49-0.96, respectively). The association between physical activity and vertebral fracture risk was not statistically related (RR, 0.87; 95% CI, 0.72-1.03). There was no evidence of publication bias. There was a statistically significant inverse association between physical activity and total fracture risk, especially for hip and wrist fractures. Additional subject-level meta-analyses are required for a more reliable assessment of subgroups and types of physical activity.
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Affiliation(s)
- Xinhua Qu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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