Bone Mineral Density and Health Related Quality of Life: a 3-Year Follow-Up Study of Osteoporotic Postmenopausal Women

Abstract

Objective: 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. Materials and Methods: 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). Result: 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. Conclusion: 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.