Hiroaki Ohta1, Yukari Uemura2, Toshitaka Nakamura3, Masao Fukunaga4, Yasuo Ohashi2, Takayuki Hosoi5, Satoshi Mori6, Toshitsugu Sugimoto7, Eiji Itoi8, Hajime Orimo9, Masataka Shiraki10. 1. Department of Clinical Medical Research Center, International University of Health and Welfare, Women's Medical Center of Sanno Medical Center, Tokyo, Japan. 2. Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan. 3. National Center for Global Health and Medicine, Tokyo, Japan. 4. Kawasaki Medical School, Okayama, Japan. 5. Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, Aichi, Japan. 6. Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan. 7. Internal Medicine 1, Shimane University Faculty of Medicine, Shimane, Japan. 8. Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi, Japan. 9. Japan Osteoporosis Foundation, Tokyo, Japan. 10. Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, Nagano, Japan. Electronic address: ripid@fc4.so-net.ne.jp.
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.
BACKGROUND: Deteriorated quality of life (QOL) is a major problem in osteoporoticwomen. 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 osteoporoticwomen 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 osteoporoticwomen 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 osteoporoticwomen, 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.