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Review
. 2023 May 24;18(1):123.
doi: 10.1186/s13023-023-02728-z.

Quality of life of pediatric and adult individuals with osteogenesis imperfecta: a meta-analysis

Susanne Wehrli  1   2   3   4 , Marianne Rohrbach  5   6 , Markus Andreas Landolt  7   8   5   9
Affiliations
Review

Quality of life of pediatric and adult individuals with osteogenesis imperfecta: a meta-analysis

Susanne Wehrli et al. Orphanet J Rare Dis. .

Abstract

Background: Osteogenesis imperfecta (OI) is a group of rare inheritable disorders of connective tissue. The cardinal manifestations of OI are low bone mass and reduced bone mineral strength, leading to increased bone fragility and deformity that may lead to significant impairment in daily life. The phenotypic manifestations show a broad range of severity, ranging from mild or moderate to severe and lethal. The here presented meta-analysis aimed to analyze existing findings on quality of life (QoL) in children and adults with OI.

Methods: Nine databases were searched with predefined key words. The selection process was executed by two independent reviewers and was based on predetermined exclusion and inclusion criteria. The quality of each study was assessed using a risk of bias tool. Effect sizes were calculated as standardized mean differences. Between-study heterogeneity was calculated with the I2 statistic.

Results: Among the studies included two featured children and adolescents (N = 189), and four adults (N = 760). Children with OI had significantly lower QoL on the Pediatric quality of life inventory (PedsQL) with regards to the total score, emotional, school, and social functioning compared to controls and norms. The data was not sufficient to calculate differences regarding OI-subtypes. In the adult sample assessed with Short Form Health Survey Questionnaire, 12 (SF-12) and 36 items (SF-36), all OI types showed significantly lower QoL levels across all physical component subscales compared to norms. The same pattern was found for the mental component subscales namely vitality, social functioning, and emotional role functioning. The mental health subscale was significantly lower for OI type I, but not for type III and IV. All of the included studies exhibited a low risk of bias.

Conclusions: QoL was significantly lower in children and adults with OI compared to norms and controls. Studies in adults comparing OI subtypes showed that the clinical severity of the phenotype is not related to worse mental health QoL. Future research is needed to examine QoL in children and adolescents in more sophisticated ways and to better understand the association between clinical severity of an OI-phenotype/severity and mental health in adults.

Keywords: Adult; Mental health; Osteogenesis imperfecta; Pediatrics; PedsQL™; Physical health; Quality of life; Rare disease; SF-12; SF-36.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study selection
Fig. 2
Fig. 2
Forest plot of QoL in children with OI compared to norms. Abbreviations: SMD Standardized mean difference
Fig. 3
Fig. 3
Forest plot of QoL in adults with OI type I compared to norms. Abbreviations: SMD Standardized mean difference
Fig. 4
Fig. 4
Forest plot of QoL in adults with OI type III compared to norms. Abbreviations: SMD Standardized mean difference
Fig. 5
Fig. 5
Forest plot of QoL in adults with OI type IV compared to norms. Abbreviations: SMD Standardized mean difference
Fig. 6
Fig. 6
Forest plot of QoL in adults with OI type I compared to type III. Abbreviations: SMD Standardized mean difference
Fig. 7
Fig. 7
Forest plot of QoL in adults with OI type I compared to type IV. Abbreviations: SMD Standardized mean difference
See this image and copyright information in PMC

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