Serum 25-hydroxyvitamin D level as an independent determinant of quality of life in osteoporosis with a high risk for fracture.
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.
Department of Clinical Medical Research Center, International University of Health and Welfare, Women's Medical Center of Sanno Medical Center, Tokyo, Japan.
Hiroaki
H
Ohta
Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan.
Yukari
Y
Uemura
National Center for Global Health and Medicine, Tokyo, Japan.
Toshitaka
T
Nakamura
Kawasaki Medical School, Okayama, Japan.
Masao
M
Fukunaga
Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan.
Yasuo
Y
Ohashi
Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, Aichi, Japan.
Takayuki
T
Hosoi
Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
Satoshi
S
Mori
Internal Medicine 1, Shimane University Faculty of Medicine, Shimane, Japan.
Toshitsugu
T
Sugimoto
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi, Japan.
Eiji
E
Itoi
Japan Osteoporosis Foundation, Tokyo, Japan.
Hajime
H
Orimo
Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, Nagano, Japan. Electronic address: ripid@fc4.so-net.ne.jp.
Masataka
M
Shiraki
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications*; D011788:Quality of Life; D016103:Spinal Fractures / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D016387:Women's Health
D014807:Vitamin D; C104450:25-hydroxyvitamin D
25(OH)D; QOL; fall; fracture; osteoporosis