Relationship of health related quality of life to prevalent and new or worsening back pain in postmenopausal women with osteoporosis.
Relationship of health related quality of life to prevalent and new or worsening back pain in postmenopausal women with osteoporosis.
复制标题
健康相关的生活质量与患有骨质疏松症的绝经后妇女中流行的、新发的或恶化的背痛的关系。
作者：
S. Silverman;V. Piziak;Peiqi Chen;D. Misurski;R. Wagman
目的
探讨绝经后骨质疏松妇女背痛与健康相关生活质量（HRQOL）之间的关系。
方法
骨折预防试验是一项前瞻性、双盲、安慰剂对照研究，旨在比较接受特立哌酮治疗的女性发生新发骨折的比例与接受安慰剂治疗的女性发生新发骨折的比例。受试者是患有骨质疏松症和既往椎体骨折的绝经后非卧床女性。作为这项试验的一部分，来自加拿大、新西兰、澳大利亚和美国的讲英语的妇女参加了使用骨质疏松评估问卷（OPAQ）的HRQOL亚组研究。在基线、12个月和研究终止时（中位治疗持续时间19个月）进行OPAQ。作为试验期间不良事件监测的一部分，收集背痛数据。认为发生背痛的受试者自发报告了该事件，未进行具体询问。在控制脊柱畸形指数评分后，我们研究了普遍背痛对HRQOL的影响，以及在控制偶发性椎骨骨折后，新发或加重背痛对HRQOL的影响。
结果
在基线完成OPAQ的471名女性中，172名报告背痛，与所有OPAQ维度评分的平均下降相关（p < 0.05）。在所有时间点完成OPAQ的429名女性中，88名经历了新的或恶化的背痛，这与身体功能，情绪状态和症状评分的平均下降有关（p < 0.01）。在65名经历中度至重度背痛的女性中，所有OPAQ维度均显著降低（p < 0.05）。
结论
普遍的背痛和新发或恶化的背痛对HRQOL都有负面影响。预防绝经后妇女背痛的骨质疏松治疗也可预防HRQOL下降。
OBJECTIVE
To examine the association between back pain and health related quality of life (HRQOL) in postmenopausal women with osteoporosis.
METHODS
The Fracture Prevention Trial was a prospective double blinded, placebo controlled study designed to compare the proportion of women receiving teriparatide who experienced a new fracture to the proportion of women receiving placebo who experienced a new fracture. Subjects were ambulatory postmenopausal women with osteoporosis and prior vertebral fracture. As part of this trial, English-speaking women from Canada, New Zealand, Australia, and the United States participated in a HRQOL substudy using the Osteoporosis Assessment Questionnaire (OPAQ). OPAQ was administered at baseline, 12 months, and at study termination (median treatment duration 19 mo). Back pain data were collected as part of the adverse event monitoring during the trial. Subjects considered to have experienced back pain reported this event spontaneously and were not queried specifically. We examined the influence of prevalent back pain on HRQOL after controlling for spine deformity index score, and the influence of new or worsening back pain on HRQOL after controlling for incident vertebral fracture.
RESULTS
Of 471 women who completed OPAQ at baseline, 172 reported back pain that was associated with a mean decrease in all OPAQ dimension scores (p < 0.05). Of 429 women who completed OPAQ at all timepoints, 88 experienced new or worsening back pain that was associated with a mean decrease in physical function, emotional status, and symptoms scores (p < 0.01 for each). In a subset of 65 women who experienced moderate to severe back pain, all OPAQ dimensions were significantly reduced (p < 0.05).
CONCLUSION
Both prevalent back pain and new or worsening back pain affected HRQOL negatively. Osteoporosis therapies that prevent the development of back pain in postmenopausal women may also prevent decreases in HRQOL.