Obesity, Health-Care Utilization, and Health-Related Quality of Life After Fracture in Postmenopausal Women: Global Longitudinal Study of Osteoporosis in Women (GLOW)

被引：37

作者：

Compston, Juliet E. ^{[1
]}

Flahive, Julie ^{[2
]}

Hooven, Frederick H. ^{[2
]}

Anderson, Frederick A., Jr. ^{[2
]}

Adachi, Jonathan D. ^{[3
]}

Boonen, Steven ^{[4
]}

Chapurlat, Roland D. ^{[5
]}

Cooper, Cyrus ^{[6
]}

Diez-Perez, Adolfo ^{[7
,8
,9
]}

Greenspan, Susan L. ^{[10
]}

LaCroix, Andrea Z. ^{[11
]}

Lindsay, Robert ^{[12
]}

Netelenbos, J. Coen ^{[13
]}

Pfeilschifter, Johannes ^{[14
]}

Roux, Christian ^{[15
]}

Saag, Kenneth G. ^{[16
]}

Silverman, Stuart ^{[17
]}

Siris, Ethel S. ^{[18
]}

Watts, Nelson B. ^{[19
]}

Gehlbach, Stephen H. ^{[2
]}

机构：

[1] Cambridge Univ Hosp NHS Fdn Trust, Cambridge CB2 0QQ, England

[2] Univ Massachusetts, Sch Med, Ctr Outcomes Res, Worcester, MA USA

[3] McMaster Univ, St Josephs Healthcare, Hamilton, ON, Canada

[4] Katholieke Univ Leuven, Louvain, Belgium

[5] Univ Lyon, Div Rheumatol, Hop E Herriot, INSERM,U1033, Lyon, France

[6] Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton, Hants, England

[7] Autonomous Univ Barcelona, Hosp del Mar, IMIM, Barcelona, Spain

[8] Inst Carlos III, RETICEF, Barcelona, Spain

[9] ISCIII, RETICEF, Madrid, Spain

[10] Univ Pittsburgh, Pittsburgh, PA USA

[11] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

[12] Helen Hayes Hosp, Reg Bone Ctr, W Haverstraw, NY USA

[13] Vrije Univ Amsterdam, Med Ctr, Dept Endocrinol, Amsterdam, Netherlands

[14] Alfried Krupp Hosp, Dept Internal Med 3, Essen, Germany

[15] Paris Descartes Univ, Cochin Hosp, Paris, France

[16] Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA

[17] Cedars Sinai Med Ctr, Dept Rheumatol, Los Angeles, CA 90048 USA

[18] Columbia Univ, Med Ctr, New York, NY USA

[19] Mercy Hlth Osteoporosis & Bone Hlth Serv, Cincinnati, OH USA

来源：

CALCIFIED TISSUE INTERNATIONAL | 2014年 / 94卷 / 02期

关键词：

Fractures; Health-care utilization; Functional status; Quality of life; Obesity; BODY-MASS INDEX; RISK; COMPLICATIONS; PREVALENCE; MEN; HIP;

D O I：

10.1007/s00223-013-9801-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Fractures may be associated with higher morbidity in obese postmenopausal women than in nonobese women. We compared health-care utilization, functional status, and health-related quality of life (HRQL) in obese, nonobese, and underweight women with fractures. Information from the GLOW study, started in 2006, was collected at baseline and at 1, 2, and 3 years. In this subanalysis, self-reported incident clinical fractures, health-care utilization, HRQL, and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged a parts per thousand yen55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 nonobese, and 941 obese women with one or more incident clinical fractures during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities, and fracture type, was significantly greater in obese than nonobese women (6 vs. 5 days, p = 0.017). Physical function and vitality score were significantly worse in obese than in nonobese women, both before and after fracture; but changes after fracture were similar across groups. Use of antiosteoporosis medication was significantly lower in obese than in nonobese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than nonobese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established.

引用

页码：223 / 231

页数：9