Background
Methods
Data source
Study population
Major measurements
HRQoL measurements
HU measurements
Statistical analyses
Non-EU cohort | EU cohort | ||
---|---|---|---|
Baseline characteristic | C | Baseline characteristic | C |
Age (years) | 0.16 | Age | 0.34 |
Alcohol use (Yes) | −0.19 | Alcohol use (Yes) | −1.03 |
Height (cm) | 0.158* | Height (cm) | 0.247 |
Weight (kg) | −0.115* | Weight (kg) | −0.385** |
Country AU vs. US | −4.359* | Country BE vs. UK | −9.088* |
Country CA vs. US | −0.570 | Country NL vs. UK | −2.997 |
Country NZ vs. US | −1.056 | Country SE vs. UK | −3.684 |
Smoke (Yes) | −5.204* | Smoke (Yes) | −8.712** |
Prevalent vertebral fractures | −0.638 | Prevalent vertebral fractures | −2.245** |
Baseline femoral neck BMD (# of SDs < mean for females) | −0.885 | Baseline femoral neck BMD (# of SDs < mean for females) | 2.192 |
Number of preexisting conditions | −0.447*** | Number of preexisting conditions | −1.434*** |
Number of ONF | −0.549 | Number of ONF | 0.751 |
Years postmenopausal | −0.095 | Years postmenopausal | −0.305 |
Family history of osteoporosis (Yes) | −1.004 | Family history of osteoporosis (Yes) | 4.332 |
History of hysterectomy (Yes) | −0.008 | History of hysterectomy (Yes) | −4.723* |
Married (Yes) | −0.118 | Married (Yes) | 0.587 |
Years of education | 0.347* | Years of education | 0.370 |
Baseline LS BMD (# of SDs < mean for females) | 0.472 | Baseline LS BMD (# of SDs < mean for females) | −0.209 |
Variance explained | 0.14 | Variance explained | 0.20 |
Results
Patient characteristics
Baseline characteristic | Non-EU (n = 694) | EU (n = 551) | p-value |
---|---|---|---|
Mean (SD) | Mean (SD) | ||
Age (years) | 68.0 (6.9) | 67.5 (6.2) | 0.1994 |
Height (cm) | 159.7 (6.3) | 160.1 (6.6) | 0.3001 |
Weight (kg) | 65.4 (11.0) | 64.7 (9.9) | 0.2467 |
Body mass index (kg/cm2) | 25.7 (4.2) | 25.2 (3.6) | 0.0370* |
Caucasian (n, %) | 672 (96.8) | 543 (98.5) | 0.0619 |
Smoker (Yes) (n, %) | 617 (88.9) | 421 (76.4) | <0.0001** |
Use of alcohol (Yes) (n, %) | 556 (80.1) | 406 (73.7) | 0.0038* |
Number of prevalent vertebral fractures (≥1) (n, %) | 433 (62.4) | 279 (50.6) | <0.0001** |
Baseline femoral neck BMD (# of SDs < mean for females) | −2.3 (.6) | −2.2 (.6) | 0.0022* |
Number of osteoporotic non-vertebral fractures (≥1) (n, %) | 366 (52.7) | 202 (36.7) | <0.0001** |
Family history of osteoporosis (Yes) (n, %) | 212 (30.5) | 157 (28.5) | 0.0001** |
History of hysterectomy (Yes) (n, %) | 186 (26.8) | 134 (24.3) | 0.3281 |
Married (Yes) (n, %) | 390 (56.2) | 314 (57.0) | 0.7732 |
Number of years postmenopause | 20.3 (8.7) | 19.4 (7.7) | 0.0551 |
Baseline lumbar spine BMD (# of SDs < mean for females) | −2.4 (1.2) | −2.7 (1.1) | 0.0001** |
Number of years of education | 13.6 (3.1) | 10.1 (3.2) | <0.0001** |
Number of self-reported preexisting conditions | 10.9 (5.9) | 5.9 (4.3) | <0.0001** |
Instrument (Cohort) domain | N | Mean | SD | Min | Max |
---|---|---|---|---|---|
OPAQ (Non-EU)
| |||||
Walking/Bending | 693 | 85.42 | 17.08 | 7.14 | 100.00 |
Standing/Sitting | 692 | 80.16 | 20.83 | 0.00 | 100.00 |
Dressing/Reaching | 691 | 93.10 | 14.76 | 0.00 | 100.00 |
Household/Self Care | 692 | 93.16 | 12.60 | 31.25 | 100.00 |
Transfers | 693 | 90.66 | 18.32 | 0.00 | 100.00 |
Usual Work | 692 | 92.02 | 15.87 | 0.00 | 100.00 |
Fear of Falls | 692 | 73.47 | 19.44 | 10.00 | 100.00 |
Level of Tension | 690 | 67.93 | 17.38 | 15.00 | 100.00 |
Body Image | 693 | 67.26 | 24.77 | 0.00 | 100.00 |
Independence | 691 | 83.83 | 17.19 | 0.00 | 100.00 |
Back Pain | 694 | 73.71 | 23.69 | 0.00 | 100.00 |
Fatigue | 693 | 62.52 | 18.75 | 0.00 | 100.00 |
Social Activity | 692 | 40.44 | 19.40 | 0.00 | 100.00 |
Support, Family and Friends | 691 | 85.49 | 20.26 | 0.00 | 100.00 |
NHP (Non-EU)
| |||||
Emotional Reaction | 681 | 5.08 | 12.57 | 0.00 | 100.00 |
Energy | 688 | 11.55 | 23.33 | 0.00 | 100.00 |
Physical Mobility | 686 | 9.54 | 13.42 | 0.00 | 67.16 |
Pain | 678 | 11.88 | 21.37 | 0.00 | 100.00 |
Sleep | 687 | 19.47 | 25.06 | 0.00 | 100.00 |
Social Interaction | 684 | 2.73 | 9.87 | 0.00 | 79.87 |
HUI (Non-EU) Utility Score
| 694 | 0.85 | 0.12 | 0.22 | 1.00 |
QualEFFO (EU)
| |||||
Pain | 541 | 68.77 | 27.20 | 0.00 | 100.00 |
Daily Activity | 550 | 91.20 | 13.83 | 11.11 | 100.00 |
Mobility | 550 | 77.90 | 19.61 | 0.00 | 100.00 |
General Health | 548 | 58.25 | 20.92 | 0.00 | 100.00 |
Mental Health | 549 | 74.95 | 16.84 | 12.50 | 100.00 |
Overall QOL | 524 | 73.42 | 20.13 | 2.00 | 100.00 |
NHP (EU)
| |||||
Emotional Reaction | 525 | 10.07 | 18.58 | 0.00 | 100.00 |
Energy | 547 | 16.64 | 29.62 | 0.00 | 100.00 |
Physical Mobility | 533 | 14.02 | 18.47 | 0.00 | 100.00 |
Pain | 526 | 18.93 | 26.42 | 0.00 | 100.00 |
Sleep | 536 | 24.37 | 28.63 | 0.00 | 100.00 |
Social Interaction | 533 | 5.38 | 14.88 | 0.00 | 100.00 |
EQ-5D (EU) Utility Score
| 551 | 0.78 | 0.23 | −0.59 | 1.00 |
Correlations between HRQoL and HU measures
-
4 from the physical function dimension: walking/bending, standing/sitting, transfers, and usual work;
-
2 from the emotional status dimension: fear of falls and independence; and
-
2 from the symptoms dimension: back pain and fatigue.
Non-EU cohort | EU cohort | ||||||
---|---|---|---|---|---|---|---|
OPAQ vs. HUI | NHP vs. HUI | QualEFFO vs. EQ-5D | NHP vs. EQ-5D | ||||
OPAQ domain | r | NHP Domain | r | QualEFFO domain | r | NHP domain | r |
Walking/Bending | 0.524 | Emotional reaction | −0.393 | Pain | 0.571 | Emotional reaction | −0.561 |
Standing/Sitting | 0.490 | Energy | −0.477 | Daily activity | 0.713 | Energy | −0.593 |
Dressing/Reaching | 0.325 | Physical mobility | −0.506 | Mobility | 0.657 | Physical mobility | −0.596 |
Household/Self care | 0.335 | Pain | −0.578 | General health | 0.558 | Pain | −0.650 |
Transfers | 0.416 | Sleep | −0.386 | Mental health | 0.540 | Sleep | −0.335 |
Usual work | 0.400 | Social interaction | −0.272 | Overall QOL | 0.515 | Social interaction | −0.347 |
Fear of falls | 0.456 | ||||||
Level of tension | 0.342 | ||||||
Body image | 0.265 | ||||||
Independence | 0.405 | ||||||
Back pain | 0.495 | ||||||
Fatigue | 0.444 | ||||||
Social activity | 0.116* | ||||||
Support, family and friends | 0.093* |
Association between baseline patient characteristics and HU
Stepwise regression to identify independent HRQoL predictors of HU
Non-EU Cohort | EU Cohort | ||||||
---|---|---|---|---|---|---|---|
OPAQ vs. HUI | NHP vs. HUI | QualEFFO vs. EQ-5D | NHP vs. EQ-5D | ||||
n = 677 | n = 662 | n = 538 | n = 495 | ||||
OPAQ domain
| C |
NHP domain
| C |
QualEFFO domain
| C |
NHP Domain
| C |
Walking/Bending | 0.184 | Pain | −0.188 | Daily activity | 0.689 | Pain | −0.275 |
Back pain | 0.097 | Emotional reaction | −0.104 | Mental health | 0.327 | Emotional reaction | −0.326 |
Level of tension | 0.084 | Physical mobility | −0.139 | Pain | 0.158 | Physical mobility | −0.274 |
Fear of falls | 0.101 | Sleep | −0.067 | Mobility | 0.132* | Energy | −0.089* |
Fatigue | 0.077* | Energy | −0.055* | ||||
Social interaction | −0.099* | ||||||
Variance explained | 0.41 | Variance explained | 0.44 | Variance explained | 0.61 | Variance Explained | 0.53 |
Determinants of HU, with adjustment for baseline patient characteristics
Non-EU cohort | EU cohort | ||
---|---|---|---|
Dependent Var = HUI; Independent Vars = OPAQ, NHP, BD | Dependent Var = EQ-5D; Independent Vars = QualEFFO, NHP, BD | ||
Domain | C | Domain | C |
OPAQ Walking/Bending | 0.137*** | QualEFFO pain | 0.108** |
OPAQ fear of falls | 0.071** | QualEFFO daily activity | 0.644*** |
OPAQ fatigue | 0.057* | QualEFFO mental health | 0.141* |
NHP emotional reaction | −0.096*** | NHP emotional reaction | −0.299*** |
NHP pain | −0.169*** | NHP pain | −0.154*** |
NHP sleep | −0.056*** | ||
NHP social interaction | −0.109* | ||
Variance explained | 0.48 | Variance explained | 0.64 |