The objective of this study was to evaluate the relationship between change in bone mineral density (BMD) and change in health related quality of life (HRQoL) over a 3-year period, in patients without incident of osteoporotic fracture.
Prior to the present study, two randomized controlled trials had been carried out to assess the efficacy of a new anti-osteoporotic drug. From the placebo group of those two trials, we selected for the present study 1838 osteoporotic postmenopausal women aged over 50 years, and followed their progress for a period of 3 years. BMD was measured at the lumbar spine and the proximal femur by dual-energy X-ray absorptiometry. Each patient received calcium and vitamin D supplements. HRQoL was assessed using 2 questionnaires: the generic tool Short Form 36 items (SF-36; including mental and physical components) and the specific Quality of Life Questionnaire in Osteoporosis (QUALIOST).
At baseline, after adjustment for body mass index (BMI), age, number of vertebral fractures and number of peripheral fractures, multivariate regression analysis showed a significant association between the lumbar BMD and the mental component of the SF-36 (p< 0.001). However, the relationship was not significant with the global score of the QUALIOST (p=0.098) and the physical component of the SF-36 (p=0.051). Multivariate regressions did not show a significant relationship between HRQoL and proximal femur BMD at baseline. After 3 years of follow-up, multivariate regression analysis showed no significant association between change in lumbar BMD and the main HRQoL items (global score of the QUALIOST, physical and mental components of the SF-36; p between 0.437 and 0.942). No significant relationships were found between change in femoral BMD and change in the global score of the QUALIOST (p=0.088) or change in the mental component of the SF-36 (p=0.222). However, a significant positive association (p=0.031) appeared between change in the physical component of the SF-36 and femoral BMD change.
In osteoporotic postmenopausal women receiving calcium and vitamin D, few relationships were found between BMD and HRQoL. However, these results were not strong enough to indicate a real clinically interesting relationship between HRQoL and BMD. Other studies would need to be performed to verify these results.
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