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Calcified Tissue International

, Volume 94, Issue 2, pp 223–231 | Cite as

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

  • Juliet E. Compston
  • Julie Flahive
  • Frederick H. Hooven
  • Frederick A. AndersonJr.
  • Jonathan D. Adachi
  • Steven Boonen
  • Roland D. Chapurlat
  • Cyrus Cooper
  • Adolfo Díez-Perez
  • Susan L. Greenspan
  • Andrea Z. LaCroix
  • Robert Lindsay
  • J. Coen Netelenbos
  • Johannes Pfeilschifter
  • Christian Roux
  • Kenneth G. Saag
  • Stuart Silverman
  • Ethel S. Siris
  • Nelson B. Watts
  • Stephen H. Gehlbach
  • for the GLOW Investigators
Original Research

Abstract

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 ≥55 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.

Keywords

Fractures Health-care utilization Functional status Quality of life Obesity 

Notes

Acknowledgments

Sophie Rushton-Smith, PhD, coordinated revisions and provided editorial assistance, including editing, checking content and language, formatting, and referencing. Financial support for the GLOW study is provided by Warner Chilcott Company and sanofi-aventis to the Center for Outcomes Research, University of Massachusetts Medical School. J. E. C. acknowledges support from the Cambridge Biomedical Research Centre and the National Institute for Health Research (NIHR)

Disclosures

J. E. C. has previously consulted for Servier, Shire, Nycomed, Novartis, Amgen, Procter & Gamble, Wyeth, Pfizer, The Alliance for Better Bone Health, Roche, and GlaxoSmithKline; has received lecture fees, travel, and accommodation from Servier, Procter & Gamble, and Lilly; and has received grant support from Servier R&D (2007–2009), Procter & Gamble (2007–2009), Nycomed (2009–2012), and Acuitas (2009–2011). J. F., F. H. H., F. A. A., and S. H. G. have received funding from The Alliance for Better Bone Health (sanofi-aventis and Warner Chilcott). J. D. A. has previously consulted for and/or received lecture fees from Amgen, Lilly, GlaxoSmithKline, Merck, Novartis, Nycomed, Pfizer, Procter & Gamble, Roche, sanofi-aventis, Servier, Warner Chilcott, and Wyeth and has conducted clinical trials for Amgen, Lilly, GlaxoSmithKline, Merck, Novartis, Pfizer, Procter & Gamble, Roche, sanofi-aventis, Warner Chilcott, Wyeth, and Bristol-Myers Squibb. S. B. has received grant support from Amgen, Lilly, Novartis, Pfizer, Procter & Gamble, sanofi-aventis, Roche, and GlaxoSmithKline and has received honoraria from, served on speakers’ bureaus for, and consulted/acted as an advisory board member for Amgen, Lilly, Merck, Novartis, Procter & Gamble, sanofi-aventis, and Servier. R. D. C. has received funding from the French Ministry of Health, Merck, Servier, Lilly, and Procter & Gamble; has received honoraria from Amgen, Servier, Novartis, Lilly, Roche, and sanofi-aventis; and has consulted/acted as an advisory board member for Amgen, Merck, Servier, Nycomed, and Novartis. C. C. has consulted for and/or received lecture fees from Amgen, The Alliance for Better Bone Health (sanofi-aventis and Warner Chilcott), Lilly, Merck, Servier, Novartis, and Roche-GSK. A. D.-P. has received consulting fees and lectured for Eli Lilly, Amgen, Procter & Gamble, Servier, and Daiichi-Sankyo; has been an expert witness for Merck; consults for and/or is an advisory board member for Novartis, Eli Lilly, Amgen, and Procter & Gamble; and has received honoraria from Novartis, Lilly, Amgen, Procter & Gamble, and Roche. S. L. G. has previously consulted and/or been an advisory board member for Amgen, Lilly, and Merck and has received grant support from The Alliance for Better Bone Health (sanofi-aventis and Proctor & Gamble) and Lilly. A. Z. L. has received funding from The Alliance for Better Bone Health (sanofi-aventis and Warner Chilcott) and is an advisory board member for Amgen. R. L. has received funding from The Alliance for Better Bone Health (sanofi-aventis and Warner Chilcott) and is a speaker and consultant for Eli Lilly and Amgen. J. C. N. has previously consulted for Roche Diagnostics, Daiichi-Sankyo, Proctor & Gamble, and Nycomed; has received lecture fees, travel, and accommodation from Roche Diagnostics, Novartis, Daiichi-Sankyo, and Procter & Gamble; and has received grant support from The Alliance for Better Bone Health and Amgen. J. P. has received grant support from Amgen, Kyphon, Novartis, and Roche; has received grant support for equipment from GE Lunar; has served on speakers’ bureaus for Amgen, sanofi-aventis, GlaxoSmithKline, Roche, Lilly Deutschland, Orion Pharma, Merck, Merckle, Nycomed, and Procter & Gamble; and has acted as an advisory board member for Novartis, Roche, Procter & Gamble, and Teva. C. R. has received honoraria from and consults and/or acts as an advisory board member for Alliance, Amgen, Lilly, Merck, Novartis, Nycomed, Roche, GlaxoSmithKline, Servier, and Wyeth. K. G. S. has consulted for or received other remuneration from Eli Lilly, Merck, Novartis, and Amgen and has conducted paid research for Eli Lilly, Merck, Novartis, and Amgen. S. S. has received grant support from Wyeth, Lilly, Novartis, and Alliance; has served on speakers’ bureaus for Lilly, Novartis, Pfizer, and Procter & Gamble; has received honoraria from Procter & Gamble; and has consulted and/or acted as an advisory board member for Lilly, Argen, Wyeth, Merck, Roche, and Novartis. E. S. S. has consulted for Amgen, Lilly, Novartis, and The Alliance for Better Bone Health and has served on speakers’ bureaus for Amgen and Lilly. N. B. W. has received honoraria for lectures in the past year from Amgen, Lilly, Novartis, and Warner Chilcott; has received consulting fees during the past year from Abbott, Amgen, Bristol-Myers Squibb, Endo, Imagepace, Johnson & Johnson, Lilly, Medpace, Merck, Nitto Denko, Noven, Novo Nordisk, Pfizer/Wyeth, and Quark; has received research support (through his health system) from Merck and NPS; and cofounded, has stock options in, and is a director of OsteoDynamics.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Juliet E. Compston
    • 1
  • Julie Flahive
    • 2
  • Frederick H. Hooven
    • 2
  • Frederick A. AndersonJr.
    • 2
  • Jonathan D. Adachi
    • 3
  • Steven Boonen
    • 4
  • Roland D. Chapurlat
    • 5
  • Cyrus Cooper
    • 6
  • Adolfo Díez-Perez
    • 7
    • 8
    • 9
  • Susan L. Greenspan
    • 10
  • Andrea Z. LaCroix
    • 11
  • Robert Lindsay
    • 12
  • J. Coen Netelenbos
    • 13
  • Johannes Pfeilschifter
    • 14
  • Christian Roux
    • 15
  • Kenneth G. Saag
    • 16
  • Stuart Silverman
    • 17
  • Ethel S. Siris
    • 18
  • Nelson B. Watts
    • 19
  • Stephen H. Gehlbach
    • 2
  • for the GLOW Investigators
  1. 1.Cambridge University Hospitals NHS Foundation TrustCambridgeUK
  2. 2.Center for Outcomes ResearchUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.St. Joseph’s HealthcareMcMaster UniversityHamiltonCanada
  4. 4.Katholieke Universiteit LeuvenLeuvenBelgium
  5. 5.Division of Rheumatology, INSERM U1033, Hôpital E. HerriotUniversité de LyonLyonFrance
  6. 6.MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
  7. 7.Hospital del Mar-IMIM-Autonomous University of BarcelonaBarcelonaSpain
  8. 8.RETICEFInstituto Carlos IIIBarcelonaSpain
  9. 9.RETICEFISCIIIMadridSpain
  10. 10.University of PittsburghPittsburghUSA
  11. 11.Fred Hutchinson Cancer Research CenterSeattleUSA
  12. 12.Regional Bone CenterHelen Hayes HospitalWest HaverstrawUSA
  13. 13.Department of EndocrinologyVU University Medical CenterAmsterdamThe Netherlands
  14. 14.Department of Internal Medicine IIIAlfried Krupp KrankenhausEssenGermany
  15. 15.Cochin HospitalParis Descartes UniversityParisFrance
  16. 16.Division of Clinical Immunology and RheumatologyUniversity of Alabama at BirminghamBirminghamUSA
  17. 17.Department of RheumatologyCedars-Sinai Medical CenterLos AngelesUSA
  18. 18.Columbia University Medical CenterNew YorkUSA
  19. 19.Mercy Health Osteoporosis and Bone Health ServicesCincinnatiUSA

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