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Prevalence of vertebral fractures and minor vertebral deformities evaluated by DXA-assisted vertebral fracture assessment (VFA) in a population-based study of postmenopausal women: the FRODOS study

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Abstract

Summary

Population-based studies performed with vertebral fracture assessment (VFA) morphometric technology are lacking in postmenopausal osteoporosis. In this study, we show a lower than expected prevalence of vertebral fractures, a high prevalence of minor vertebral deformities, and a clear association with clinical and densitometric parameters indicating the usefulness of this approach.

Introduction

Adequate epidemiological data on the prevalence of vertebral fractures (VF) is essential in studies of postmenopausal osteoporosis. Routine DXA-assisted VFA may be useful to determine the presence of VF. However, population-based studies performed with this technology are lacking. We aimed to assess the prevalence of VF and minor deformities in 2,968 postmenopausal women aged 59–70 years from a population-based cohort.

Methods

VFA and bone mineral density (BMD) measurements were conducted, and McCloskey criteria (vertebral heights under 3 SD from reference values) confirmed with the Genant method were used to define VF. Additionally, minor vertebral deformities (vertebral heights between −2 and −2.99 SD) were evaluated.

Results

The prevalence of VF was 4.3 %, and 17 % of the participants had minor vertebral deformities. Low BMD was frequently observed in women with VF, with 48 %, and 42 % of participants showing osteoporosis and osteopenia. Minor vertebral deformities were observed in nearly 40 % of women with VF. Multivariate logistic regression analysis showed that age, history of previous fracture, osteoporotic BMD, receiving anti-osteoporotic treatment, and current use of glucocorticoids were significantly associated with VF.

Conclusions

Although the VFA approach showed a lower than expected prevalence of VF in our cohort, its association with clinical and densitometric parameters may be useful to identify women at risk for developing fragility fractures and may therefore justify its use in longitudinal studies. The high prevalence of minor vertebral deformities detected in patients with VF indicates the need to evaluate this type of deformity as a risk factor for further skeletal fractures.

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Grant support

This study was supported by grants (PI05/1430-PI10/0034) from the Spanish Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Rheumatology Unit, Hospital General de Vic, C/ Francesc Pla, 1, 08500, Vic, Barcelona, Spain

    E. Kanterewicz

  2. Epidemiology Unit, Hospital General de Vic, Vic, Spain

    E. Puigoriol

  3. Radiology Unit, Hospital General de Vic, Vic, Spain

    J. García-Barrionuevo

  4. Densitometry Unit, CETIR Centre Mèdic, Barcelona, Spain

    L. del Rio

  5. Orthopedic Surgery Service, Hospital General de Vic, Vic, Spain

    M. Casellas

  6. Rheumatology Service, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain

    P. Peris

Authors
  1. E. Kanterewicz
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  2. E. Puigoriol
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  4. L. del Rio
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  5. M. Casellas
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  6. P. Peris
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Consortia

Frodos Research Group

Corresponding author

Correspondence to E. Kanterewicz.

Additional information

The members of the FRODOS Research Group are listed in the Appendix

Appendix

Appendix

Frodos Research Group

Dr Toni Iruela (EAP Centelles), Dr Xavier Farrés (EAP Vic Sud), Dra Sara Martínez (CAP Osona), Dra Maria Vilamú (CAP Manlleu), Dra Consol Sánchez (CAP Torelló), Dra Núria de la Iglesia (Consultori Local St Vicenç de Torelló), Dr Josep Fontarnau (Consultori Local St Pere de Torelló), Dr Vicenç Canal (CAP Roda de Ter), Dr Xavier Costa (CAP Tona), Dr Vicenç Coma (Consultori Local Seva), Dra Assumpta Farràs (Consultori Local St Miquel de Balenyà), Dra Lourdes Piñol (CAP St Hipolit de Voltregà), Dra Rosa Maria Salla (CAP Sta Eugenia de Berga), Dra Anna Puente (Consultori Local Taradell), Dra Marta Cantero (Consultori Local St Julià de Vilatorta), Dr Carles Blay (Consultori Local Calldetenes), Dra Anna Ribas (Consultori Local Folgueroles), Dr Jordi Espinàs (Consultori Local Viladrau), Jordi Oliva (CAP Sta Eugenia de Berga), Dr Tomàs Morelló (CAP St Quirze de Besora), Dra Anna Ramos (CAP St Quirze de Besora), Dr Pere Munt (Consultori de Montesquiu), Dr Dani Montanyà (Consultori St Boi de Lluçanès), Dr Josep Ma Garcia Talavera (CAP Prats de Lluçanès), Dr Raimon Codina (CAP Prats de Lluçanès), Dr Francesc Olivé (Consultori d’Olost), Dr Miquel Casadevall (Consultori St Bartomeu del Grau.

EK and EP take responsibility for the integrity of the data analysis.

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Kanterewicz, E., Puigoriol, E., García-Barrionuevo, J. et al. Prevalence of vertebral fractures and minor vertebral deformities evaluated by DXA-assisted vertebral fracture assessment (VFA) in a population-based study of postmenopausal women: the FRODOS study. Osteoporos Int 25, 1455–1464 (2014). https://doi.org/10.1007/s00198-014-2628-2

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