Ballane G, Cauley J A, Luckey M M, El-Hajj Fuleihan G
Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Bliss Street, Beirut, 113-6044, Lebanon.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Osteoporos Int. 2017 May;28(5):1531-1542. doi: 10.1007/s00198-017-3909-3. Epub 2017 Feb 6.
We investigated the prevalence and incidence of vertebral fractures worldwide. We used a systematic Medline search current to 2015 and updated as per authors' libraries. A total of 62 articles of fair to good quality and comparable methods for vertebral fracture identification were considered. The prevalence of morphometric vertebral fractures in European women is highest in Scandinavia (26%) and lowest in Eastern Europe (18%). Prevalence rates in North America (NA) for White women ≥50 are 20-24%, with a White/Black ratio of 1.6. Rates in women ≥50 years in Latin America are overall lower than Europe and NA (11-19%). In Asia, rates in women above ≥65 are highest in Japan (24%), lowest in Indonesia (9%), and in the Middle East, Lebanon, rates are 20%. The highest-lowest ratio between countries, within and across continents, varied from 1.4-2.6. Incidence data is less abundant and more heterogeneous. Age-standardized rates in studies combining hospitalized and ambulatory vertebral fractures are highest in South Korea, USA, and Hong Kong and lowest in the UK. Neither a North-South gradient nor a relation to urbanization is evident. Conversely, the incidence of hospitalized vertebral fractures in European patients ≥50 shows a North-South gradient with 3-3.7-fold variability. In the USA, rates in Whites are approximately 4-fold higher than in Blacks. Vertebral fractures variation worldwide is lower than observed with hip fractures, and some of highest rates are unexpectedly from Asia. Better quality representative studies are needed. We investigate the occurrence of vertebral fractures, worldwide, using published data current until the present. Worldwide, the variation in vertebral fractures is lower than observed for hip fractures. Some of the highest rates are from North America and unexpectedly Asia. The highest-lowest ratio between countries, within and across continents, varied from 1.4-2.6. Better quality representative data is needed.
我们调查了全球范围内椎体骨折的患病率和发病率。我们利用截至2015年的系统医学文献数据库检索，并根据作者的文献库进行更新。总共纳入了62篇质量中等至良好且用于椎体骨折识别方法具有可比性的文章。欧洲女性形态计量学椎体骨折的患病率在斯堪的纳维亚最高（26%），在东欧最低（18%）。北美50岁及以上白人女性的患病率为20%-24%，白人与黑人的比例为1.6。拉丁美洲50岁及以上女性的患病率总体低于欧洲和北美（11%-19%）。在亚洲，65岁及以上女性的患病率在日本最高（24%），在印度尼西亚最低（9%），在中东的黎巴嫩为20%。各国家之间、各洲内部以及跨洲的最高与最低比例在1.4至2.6之间。发病率数据较少且更具异质性。在综合住院和门诊椎体骨折的研究中，年龄标准化发病率在韩国、美国和香港最高，在英国最低。南北梯度和城市化之间的关系均不明显。相反，欧洲50岁及以上患者住院椎体骨折的发病率呈现南北梯度，变化幅度为3至3.7倍。在美国，白人的发病率比黑人高约4倍。全球椎体骨折的变异性低于髋部骨折，一些最高发病率出乎意料地来自亚洲。需要开展质量更高的代表性研究。我们利用直至目前的已发表数据调查全球范围内椎体骨折的发生情况。在全球范围内，椎体骨折的变异性低于髋部骨折。一些最高发病率来自北美，出乎意料的是还有亚洲。各国家之间、各洲内部以及跨洲的最高与最低比例在1.4至2.6之间。需要质量更高的代表性数据。
