Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730, China.
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730, China.
Osteoporos Int. 2017 Sep;28(9):2583-2590. doi: 10.1007/s00198-017-4085-1. Epub 2017 May 30.
In a random sample of postmenopausal Chinese women, the prevalence of radiographic vertebral fractures increased from 13% between ages 50 and 59 to over 50% after age 80 years. A model with seven clinical risk factors predicted the probability of vertebral fractures as well with as without BMD and better than a model with only three risk factors. More than half an hour of outdoor activity per day might correlate with lower risk of vertebral fracture in this population.
We aimed to describe the prevalence and develop a model for prediction of radiographic vertebral fractures in a large random sample of postmenopausal Chinese women.
We enrolled 1760 women from an age-stratified random sample of postmenopausal women in Beijing, China. The presence of vertebral fracture was assessed by semi-quantitative grading of lateral thoracolumbar radiographs, risk factors by interview, bone mineral density (BMD) of the proximal femur and lumbar spine by dual x-ray absorptiometry (DXA), and markers of bone turnover from a fasting blood sample. Associations of these factors were analyzed in logistic models and discrimination by areas of receiver operating characteristics curves (AUC).
The prevalence of vertebral fracture, ranged from 13.4% ages 50 to 59 years old to 58.1% at age 80 years or older. Older age, a history of non-vertebral fracture, lower femoral neck BMD T-score, body mass index (BMI), height loss, housework, and less than half an hour of outdoor activity were significantly associated with increased probability of having a vertebral fracture. A model with those seven factors had a similar AUC with or without BMD and performed better than a simple model with three factors.
This study is from a true random sample of postmenopausal women in urban China with high response rate. The prevalence of vertebral fractures in postmenopausal women in Beijing increases from 13% under age 60 to over 50% by age 80 years. A model with seven clinical risk factors with or without BMD is better than simple models and may guide the use of spine x-rays to identify women with vertebral fractures. More than half an hour of outdoor activity might correlate with lower risk of vertebral fracture in this population.
在一项随机抽取的绝经后中国女性样本中，影像学椎体骨折的患病率从 50-59 岁时的 13%上升到 80 岁以后的 50%以上。一个包含 7 个临床危险因素的模型能够很好地预测椎体骨折的概率，且与包含或不包含骨密度（BMD）的模型一样准确，优于仅包含 3 个危险因素的模型。每天户外活动 30 分钟以上可能与该人群椎体骨折风险降低相关。
本研究旨在描述大样本随机抽取的绝经后中国女性椎体骨折的患病率，并建立预测模型。
我们从中国北京分层随机抽取的绝经后女性中招募了 1760 名女性。通过对侧胸腰椎 X 线片进行半定量分级评估椎体骨折的存在，通过访谈评估危险因素，通过双能 X 线吸收法（DXA）评估股骨近端和腰椎的骨密度（BMD），并通过空腹血样检测骨转换标志物。使用逻辑回归模型分析这些因素之间的相关性，并通过受试者工作特征曲线（ROC）下面积（AUC）评估其区分度。
椎体骨折的患病率从 50-59 岁的 13.4%到 80 岁或以上的 58.1%不等。年龄较大、非椎体骨折史、股骨颈 BMD T 评分较低、体重指数（BMI）、身高损失、家务劳动、户外活动时间少于半小时与椎体骨折发生概率增加显著相关。包含这 7 个因素的模型与包含或不包含 BMD 的模型具有相似的 AUC，且表现优于包含 3 个因素的简单模型。
本研究来自于中国城市绝经后女性的真实随机样本，应答率较高。北京地区绝经后女性的椎体骨折患病率从 60 岁以下的 13%增加到 80 岁以上的 50%以上。一个包含 7 个临床危险因素的模型，无论是否包含 BMD，都优于简单模型，可能有助于指导使用脊柱 X 线片来识别患有椎体骨折的女性。在该人群中，每天户外活动 30 分钟以上可能与椎体骨折风险降低相关。
