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Prevalent Vertebral Deformity Predicts Incident Hip though not distal Forearm Fracture: Results from the European Prospective Osteoporosis Study |
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| Authors: | A A Ismail W Cockerill C Cooper J D Finn K Abendroth G Parisi D Banzer L I Benevolenskaya A K Bhalla J Bruges Armas J B Cannata P D Delmas J Dequeker G Dilsen R Eastell O Ershova J A Falch B Felsch S Havelka K Hoszowski I Jajic U Kragl O Johnell A Lopez Vaz R Lorenc G Lyritis F Marchand P Masaryk C Matthis T Miazgowski H A P Pols G Poor A Rapado H H Raspe D M Reid W Reisinger J Janott C Scheidt-Nave J Stepan C Todd K Weber A D Woolf G Ambrecht W Gowin D Felsenberg M Lunt J A Kanis J Reeve A J Silman T W O’Neill |
| Institution: | ARC Epidemiology Unit, University of Manchester, Manchester, UK, GB University of Southampton, Southampton General Hospital, Southampton, UK, GB Clinic for Internal Medicine, Jena, Germany, DE Institute of Clinical Medicine, University of Siena, Siena, Italy, IT Behring Hospital, Berlin, Germany, DE Institute of Rheumatology, Moscow, Russia, RU Royal National Hospital for Rheumatic Diseases, Bath, UK, GB Hospital de Angra do Heroismo, Azores, Portugal, PT Asturia General Hospital, Oviedo, Spain, ES Ho^pital Edouard Herriot, Lyon, France, FR Rheumatology Unit, University Hospital, Leuven, Belgium, BE Medical Faculty, University of Istanbul, Istanbul, Turkey, TR Bone Metabolism Group, Northern General Hospital, Sheffield, UK, GB Medical Institute, Yaroslavl, Russia, RU Aker Hospital, Oslo, Norway, NO Institute of Rheumatology, Prague, Czech Republic, CS PKP Hospital, Warsaw, Poland, PL Clinical Hospital, Zagreb, Croatia, YU Medical Academy, Erfurt, Germany, DE Malmo¨ University Hospital, Malmo¨, Sweden, SE Hospital de San Joao, Oporto, Portugal, PT Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece, GR Centre de Medecine Specialise′e, Montceau-les-Mines, France, FR Institute of Rheumatic Diseases, Piestany, Slovakia, YU Institute of Social Medicine, Lubeck, Germany, DE Academy of Medicine, Szczecin, Poland, PL Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands, NL National Institute of Rheumatology and Physiotherapy, Budapest, Hungary, HU Faculty of Medicine, University of Madrid, Madrid, Spain, ES Department of Medicine and Therapeutics, University of Aberdeen, UK, UK Institute for Diagnostic Radiology, Humboldt University, Berlin, Germany, DE Department of Clinical Medicine, Ruhr University, Bochum, Germany, DE Department of Endocrinology, University of Heidelberg, Heidelberg, Germany, DE Department of Internal Medicine, Charles University, Prague, Czech Republic, CZ Institute of Public Health, Cambridge, UK, GB Department of Medicine, University Hospital, Graz, Austria, AT Royal Cornwall Hospital, Truro, UK, GB Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany, DE Centre for Metabolic Bone Disease, Sheffield, UK, GB |
| Abstract: | The presence of a vertebral deformity increases the risk of subsequent spinal deformities. The aim of this analysis was to determine whether the presence of vertebral deformity predicts incident hip and other limb fractures. Six thousand three hundred and forty-four men and 6788 women aged 50 years and over were recruited from population registers in 31 European centers and followed prospectively for a median of 3 years. All subjects had radiographs performed at baseline and the presence of vertebral deformity was assessed using established morphometric methods. Incident limb fractures which occurred during the follow- up period were ascertained by annual postal questionnaire and confirmed by radiographs, review of medical records and personal interview. During a total of 40 348 person-years of follow-up, 138 men and 391 women sustained a limb fracture. Amongst the women, after adjustment for age, prevalent vertebral deformity was a strong predictor of incident hip fracture, (rate ratio (RR) = 4.5; 95% CI 2.1–9.4) and a weak predictor of ‘other’ limb fractures (RR = 1.6; 95% CI 1.1–2.4), though not distal forearm fracture (RR = 1.0; 95% CI 0.6–1.6). The predictive risk increased with increasing number of prevalent deformities, particularly for subsequent hip fracture: for two or more deformities, RR = 7.2 (95% CI 3.0–17.3). Amongst men, vertebral deformity was not associated with an increased risk of incident limb fracture though there was a nonsignificant trend toward an increased risk of hip fracture with increasing number of deformities. In summary, prevalent radiographic vertebral deformities in women are a strong predictor of hip fracture, and to a lesser extent humerus and ‘other’ limb fractures; however, they do not predict distal forearm fractures. Received: 23 February 2000 / Accepted: 11 August 2000 |
| Keywords: | : Incidence – Limb fracture – Osteoporosis – Vertebral deformity – Vertebral osteoporosis |
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