Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass
Abstract
1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Questionnaires
2.3. Physical Function
2.4. Anthropometric, Bone and Blood Biochemistry Parameters
2.5. Accelerometer-Determined Physical Activity
2.6. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Mean ± Standard Deviation or Percentage | |
---|---|
Age (years) | 64.4 ± 7.7 |
Weight (kg) | 61.5 ± 8.5 |
Height (cm) | 161.3 ± 6.5 |
BMI (kg/m2) | 23.6 ± 3.0 |
25(OH)D (nmol/L) | 74.6 ± 25.1 |
aBMD | |
Total hip (g/cm2) Femoral neck (g/cm2) Lumbar spine (g/cm2) | 0.765 ± 0.081 0.636 ± 0.070 0.809 ± 0.112 |
BMC | |
Total hip (g) Femoral neck (g) Lumbar spine (g) | 26.582 ± 3.708 3.207 ± 0.388 43.585 ± 10.916 |
Smoking status | |
Current (%) Former (%) Never (%) | 0 22 78 |
HRQoL and fear of falling | |
EQ-5D score (out of 15) MFES score (out of 140) | 5 (5.0, 6.3) # 140 (134.8, 140) # |
Physical activity | |
Sedentary time physical activity (%) Light-intensity physical activity (%) Moderate-intensity physical activity (%) Vigorous-intensity physical activity (%) Very vigorous-intensity physical activity (%) | 73.3 ± 6.0 21.7 ± 4.7 4.8 ± 2.4 0.2 ± 0.4 0.004 ± 0.01 |
Objective measures of physical function | |
SPPB (out of 12) SCPT (W) | 12 (11, 12) # 277.2 (229.1, 335.5) |
Self-reported comorbidities | |
Hypertension (%) Hypercholesterolemia (%) Thrombosis (%) T2DM (%) Asthma (%) Bronchitis/emphysema (%) Any cancer (%) | 22 28 2 4 14 2 6 |
EQ-5D | Mobility | Usual | Pain | Anxiety | MFES | |
---|---|---|---|---|---|---|
DXA bone parameters | ||||||
Hip BMC (g) | 0.264 | 0.132 | 0.222 | 0.158 | 0.269 | −0.318 * |
Hip aBMD (g/cm2) | 0.002 | −0.021 | 0.066 | −0.109 | 0.031 | −0.196 |
Hip T-score | −0.008 | −0.036 | 0.060 | −0.103 | 0.036 | −0.173 |
Spine BMC (g) | −0.056 | −0.081 | −0.034 | −0.096 | −0.044 | 0.041 |
Spine aBMD (g/cm2) | −0.187 | −0.076 | −0.074 | −0.165 | −0.157 | 0.007 |
Spine T-score | −0.149 | −0.057 | −0.062 | −0.155 | −0.128 | −0.015 |
LS TBS | −0.033 | −0.039 | −0.056 | −0.045 | 0.103 | 0.062 |
FN BMC (g) | 0.064 | 0.049 | 0.026 | 0.000 | 0.056 | 0.015 |
FN aBMD (g/cm2) | −0.066 | −0.025 | −0.078 | −0.118 | −0.053 | 0.095 |
FN T-score | −0.050 | −0.017 | −0.062 | −0.126 | −0.023 | 0.070 |
DXA 3D bone parameters | ||||||
Surface BMD (mg/cm3) | 0.084 | −0.043 | 0.037 | −0.045 | 0.036 | −0.157 |
Trabecular vBMD (mg/cm3) | −0.259 | −0.076 | −0.049 | −0.342 * | −0.149 | −0.022 |
Integral vBMD (mg/cm3) | −0.194 | −0.086 | −0.016 | −0.294 * | −0.149 | −0.078 |
Cortical vBMD (mg/cm3) | −0.049 | −0.095 | 0.058 | −0.142 | −0.069 | −0.198 |
Mean cortical thickness (mm) | 0.149 | −0.010 | 0.033 | 0.013 | 0.119 | −0.087 |
HR-pQCT bone parameters at distal tibia | ||||||
Trabecular area (mm2) | 0.080 | 0.173 | 0.054 | 0.099 | −0.072 | −0.163 |
Trabecular thickness (mm) | 0.061 | 0.113 | 0.112 | −0.081 | 0.045 | 0.014 |
Trabecular separation (mm) | 0.019 | 0.035 | −0.086 | −0.103 | 0.080 | −0.048 |
Trabecular VMS (MPa) | −0.187 | −0.043 | −0.091 | −0.245 | −0.031 | 0.111 |
Cortical Area (mm2) | −0.023 | −0.146 | −0.182 | −0.023 | −0.011 | 0.081 |
Cortical vBMD (mg/cm3) | −0.139 | −0.312 * | −0.104 | −0.073 | −0.011 | 0.133 |
Cortical periosteal perimeter (mm) | 0.022 | 0.148 | 0.110 | 0.042 | −0.180 | −0.142 |
Cortical porosity (%) | −0.013 | 0.092 | −0.092 | −0.020 | −0.005 | 0.044 |
Cortical VMS (MPa) | −0.263 | −0.248 | −0.198 | −0.261 | −0.041 | 0.187 |
Estimated bone failure load (N) | 0.081 | 0.157 | 0.095 | 0.099 | −0.024 | −0.169 |
Bone stiffness (N/mm) | −0.092 | −0.143 | −0.091 | −0.109 | 0.005 | 0.155 |
Gait Speed (m/s) | Stair Climb Power (W) | Chair Stand Time (s) | SPPB | |
---|---|---|---|---|
DXA bone parameters | ||||
Hip BMC (g) Hip aBMD (g/cm2) Hip T-score Spine BMC (g) Spine aBMD (g/cm2) Spine T-score LS TBS FN BMC (g) FN aBMD (g/cm2) FN T-score | 0.272 0.234 0.226 0.236 0.175 0.152 0.159 0.220 0.181 0.168 | 0.390 ** 0.249 0.296 * 0.395 ** 0.317 * 0.271 0.344 * 0.405 ** 0.328 * 0.347 * | −0.043 −0.172 −0.163 −0.191 −0.107 −0.116 −0.262 −0.007 −0.082 −0.089 | 0.106 0.211 0.190 0.026 −0.083 −0.062 0.299 * 0.092 0.002 0.032 |
DXA 3D bone parameters | ||||
Surface BMD (mg/cm3) Trabecular vBMD (mg/cm3) Integral vBMD (mg/cm3) Cortical vBMD (mg/cm3) Mean cortical thickness (mm) | 0.204 0.188 0.200 0.199 0.203 | 0.197 0.111 0.118 0.068 0.279 | −0.064 −0.271 −0.258 −0.136 −0.029 | 0.124 0.245 0.221 0.132 0.139 |
HR-pQCT bone parameters at distal tibia | ||||
Trabecular area (mm2) Trabecular thickness (mm) Trabecular separation (mm) Trabecular VMS (Mpa) Cortical Area (mm2) Cortical vBMD (mg/cm3) Cortical periosteal perimeter (mm) Cortical porosity (%) Cortical VMS (MPa) Estimated bone failure load (N) Bone stiffness (N/mm) | 0.151 −0.413 ** −0.196 −0.213 0.063 0.071 0.091 −0.018 0.118 −0.066 0.042 | 0.342 * −0.314 * −0.220 0.024 0.090 0.146 0.329 * −0.208 −0.036 −0.314 * −0.314 * | 0.153 0.097 0.058 −0.192 −0.341 * −0.186 0.116 −0.093 −0.298 * 0.217 −0.217 | −0.045 −0.109 0.119 0.018 0.087 0.229 −0.069 −0.151 0.331 * −0.106 0.079 |
EQ-5D Score | MFES Score | Gait Speed (m/s) | Stair Climb Power (W) | Chair Stand Time (s) | SPPB | |
---|---|---|---|---|---|---|
DXA bone parameters | ||||||
Hip BMC (g) | 0.218 (−0.072, 0.509) | −0.175 (−0.467, 0.117) | 0.266 (−0.030, 0.562) | 0.485 (0.175, 0.795) | −0.157 (−0.467, 0.153) | 0.016 (−0.344, 0.376) |
Hip aBMD (g/cm2) | −0.012 (−0.327, 0.303) | 0.032 (−0.282, 0.346) | 0.265 (−0.050, 0.580) | 0.263 (−0.093, 0.618) | −0.271 (−0.592, 0.051) | 0.243 (−0.130, 0.616) |
Hip T-score | −0.026 (−0.339, 0.288) | 0.038 (−0.274, 0.351) | 0.254 (−0.061, 0.569) | 0.239 (−0.112, 0.591) | −0.251 (−0.568, 0.066) | 0.212 (−0.161, 0.586) |
Spine BMC (g) | −0.106 (−0.410, 0.198) | 0.119 (−0.184, 0.421) | 0.219 (−0.089, 0.527) | 0.288 (−0.055, 0.630) | −0.162 (−0.480, 0.156) | −0.107 (−0.475, 0.261) |
Spine aBMD (g/cm2) | −0.263 (−0.566, 0.040) | 0.204 (−0.102, 0.510) | 0.145 (−0.177, 0.466) | 0.220 (−0.137, 0.576) | −0.136 (−0.464, 0.191) | −0.100 (−0.478, 0.277) |
Spine T-score | −0.252 (−0.562, 0.058) | 0.211 (−0.101, 0.523) | 0.134 (−0.195, 0.463) | 0.224 (−0.135, 0.583) | −0.165 (−0.494, 0.164) | −0.063 (−0.450, 0.324) |
LS TBS | −0.020 (−0.290, 0.249) | 0.098 (−0.169, 0.364) | −0.047 (−0.326, 0.231) | 0.034 (−0.278, 0.346) | −0.046 (−0.329, 0.238) | 0.052 (−0.274, 0.377) |
FN BMC (g) | −0.018 (−0.322, 0.286) | 0.175 (−0.123, 0.473) | 0.294 (−0.006, 0.594) | 0.458 (0.136, 0.780) | −0.165 (−0.481, 0.151) | 0.268 (−0.090, 0.625) |
FN aBMD (g/cm2) | −0.126 (−0.434, 0.182) | 0.250 (−0.050, 0.550) | 0.198 (−0.117, 0.513) | 0.353 (0.010, 0.696) | −0.205 (−0.526, 0.116) | 0.292 (−0.071, 0.656) |
FN T-score | −0.121 (−0.431, 0.190) | 0.245 (−0.057, 0.547) | 0.188 (−0.131, 0.506) | 0.351 (0.011, 0.692) | −0.206 (−0.525, 0.113) | 0.306 (−0.059, 0.671) |
DXA 3D bone parameters | ||||||
Surface BMD (mg/cm3) | −0.007 (−0.328, 0.313) | 0.001 (−0.308, 0.309) | 0.211 (−0.102, 0.524) | 0.191 (−0.163, 0.544) | −0.122 (−0.445, 0.202) | 0.121 (−0.251, 0.492) |
Trabecular vBMD (mg/cm3) | −0.246 (−0.561, 0.070) | 0.148 (−0.161, 0.457) | 0.145 (−0.176, 0.466) | 0.075 (−0.287, 0.437) | −0.252 (−0.573, 0.068) | 0.315 (−0.051, 0.680) |
Integral vBMD (mg/cm3) | −0.200 (−0.520, 0.121) | 0.095 (−0.218, 0.408) | 0.151 (−0.171, 0.474) | 0.054 (−0.311, 0.419) | −0.235 (−0.559, 0.089) | 0.238 (−0.136, 0.611) |
Cortical vBMD (mg/cm3) | −0.086 (−0.416, 0.243) | −0.053 (−0.375, 0.268) | 0.210 (−0.118, 0.538) | 0.068 (−0.301, 0.437) | −0.170 (−0.502, 0.162) | 0.072 (−0.318, 0.463) |
Mean cortical thickness (mm) | 0.077 (−0.236, 0.389) | 0.041 (−0.264, 0.347) | 0.191 (−0.121, 0.502) | 0.243 (−0.100, 0.585) | −0.069 (−0.388, 0.249) | 0.153 (−0.215, 0.521) |
HR-pQCT bone parameters at distal tibia | ||||||
Trabecular area (mm2) | 0.161 (−0.150, 0.472) | −0.215 (−0.521, 0.092) | 0.180 (−0.141, 0.501) | 0.444 (0.106, 0.781) | 0.155 (−0.173, 0.484) | −0.044 (−0.425, 0.336) |
Trabecular thickness (mm) | 0.076 (−0.249, 0.402) | −0.052 (−0.376, 0.273) | −0.439 (−0.745, −0.132) | −0.387 (−0.745, −0.029) | 0.089 (−0.254, 0.431) | 0.002 (−0.393, 0.396) |
Trabecular separation (mm) | 0.311 (−0.002, 0.624) | −0.052 (−0.376, 0.273) | −0.115 (−0.452, 0.222) | −0.286 (−0.654, 0.082) | 0.002 (−0.342, 0.347) | 0.336 (−0.044, 0.717) |
Trabecular VMS (MPa) | −0.221 (−0.539, 0.097) | 0.078 (−0.245, 0.401) | −0.322 (−0.643, −0.002) | −0.200 (−0.567, 0.166) | −0.175 (−0.509, 0.158) | 0.028 (−0.366, 0.421) |
Cortical Area (mm2) | −0.081 (−0.400, 0.241) | 0.218 (−0.097, 0.534) | 0.043 (−0.290, 0.375) | 0.033 (−0.340, 0.405) | −0.279 (−0.606, 0.049) | −0.071 (−0.459, 0.317) |
Cortical vBMD (mg/cm3) | −0.219 (−0.533, 0.094) | 0.339 (0.037, 0.641 | 0.051 (−0.281, 0.382) | 0.062 (−0.308, 0.433) | −0.168 (−0.501, 0.166) | 0.111 (−0.274, 0.497) |
Cortical periosteal perimeter (mm) | 0.112 (−0.196, 0.419) | −0.212 (−0.514, 0.090) | 0.085 (−0.234, 0.405) | 0.447 (0.116, 0.777) | 0.081 (−0.244, 0.407) | −0.114 (−0.486, 0.259) |
Cortical porosity (%) | 0.162 (−0.150, 0.475) | −0.192 (−0.502, 0.118) | −0.164 (−0.488, 0.160) | −0.257 (−0.616, 0.101) | −0.109 (−0.441, 0.223) | −0.208 (−0.585, 0.169) |
Cortical VMS (MPa) | −0.237 (−0.537, 0.063) | 0.344 (0.055, 0.633) | −0.006 (−0.327, 0.315) | −0.188 (−0.537, 0.161) | −0.254 (−0.566, 0.058) | 0.411 (0.061, 0.760) |
Estimated bone failure load (N) | 0.125 (−0.174, 424) | −0.074 (−0.374, 0.226) | 0.034 (−0.279, 0.347) | −0.147 (−0.490, 0.195) | 0.212 (−0.095, 0.519) | 0.025 (−0.341, 0.390) |
Bone stiffness (N/mm) | −0.138 (−0.438, 0.163) | 0.067 (−0.235, 0.369) | −0.063 (−0.378, 0.251) | 0.123 (−0.223, 0.468) | −0.203 (−0.513, 0.106) | −0.061 (−0.428, 0.306) |
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Gandham, A.; McMillan, L.B.; Ng, C.-A.; Humbert, L.; Bonham, M.P.; Zengin, A.; Ebeling, P.R.; Scott, D. Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass. J. Clin. Med. 2019, 8, 1370. https://doi.org/10.3390/jcm8091370
Gandham A, McMillan LB, Ng C-A, Humbert L, Bonham MP, Zengin A, Ebeling PR, Scott D. Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass. Journal of Clinical Medicine. 2019; 8(9):1370. https://doi.org/10.3390/jcm8091370
Chicago/Turabian StyleGandham, Anoohya, Lachlan B. McMillan, Carrie-Anne Ng, Ludovic Humbert, Maxine P. Bonham, Ayse Zengin, Peter R. Ebeling, and David Scott. 2019. "Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass" Journal of Clinical Medicine 8, no. 9: 1370. https://doi.org/10.3390/jcm8091370
APA StyleGandham, A., McMillan, L. B., Ng, C.-A., Humbert, L., Bonham, M. P., Zengin, A., Ebeling, P. R., & Scott, D. (2019). Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass. Journal of Clinical Medicine, 8(9), 1370. https://doi.org/10.3390/jcm8091370