Zvekic-Svorcan Jelena, Aleksic Jelena, Jankovic Tanja, Filipovic Karmela, Cvetkovic Milan, Vuksanovic Miljanka, Filipov Predrag
University of Novi Sad, Faculty of Medicine Novi Sad, Serbia.
Special Hospital for Rheumatic Diseases Novi Sad, Serbia.
J Back Musculoskelet Rehabil. 2019;32(2):269-276. doi: 10.3233/BMR-170898.
Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women.
Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Further analyses were performed on 217 osteoporotic women identified from those records, whereby those in the experimental group (n= 110) had a vertebral fracture, while those assigned to the control group (n= 107) did not. The two groups were comparable in terms of age (t= 0.450; p> 0.01). Risk factors that could serve as the best predictors of vertebral fracture occurrence were investigated. Multivariate logistic regression analysis was used for testing effect of several factors on vertebral fracture occurrence as the dependent variable.
Patients that have never suffered a vertebral fracture had a significantly higher bone mineral density (t= 8.161; p< 0.01) in comparison to those with a verified vertebral fracture. Factors that significantly contributed to the risk of vertebral fracture were presence of kyphosis (OR 708.338; 95% CI 19.238-26.081.950), use of glucocorticoids (OR 87.618; 95% CI 9.175-836.707), and presence of comorbidities (OR 7.327; 95% CI 1.500-35.793). Moreover, a unit increase in body mass index (BMI) was found to lower the probability of vertebral fracture by a factor of 0.846. Women that entered menopause later have lower chance of suffering a vertebral fracture (OR = 0.539; 95% CI 0.400-0.726).
Lower body mass index, presence of kyphosis, use of glucocorticoids, early menopause onset, and presence of comorbidities are the factors that contribute the most to vertebral osteoporotic fracture occurrence.
椎体骨折是因骨矿物质密度低以及其他风险因素而发生的最常见的骨质疏松性骨折。本文旨在研究绝经后女性发生椎体骨质疏松性骨折的风险因素。
对从塞尔维亚国家骨质疏松症登记处获得的651名绝经后女性的数据进行回顾性分析。对从这些记录中识别出的217名骨质疏松女性进行了进一步分析，其中实验组（n = 110）有椎体骨折，而分配到对照组（n = 107）的女性没有。两组在年龄方面具有可比性（t = 0.450；p>0.01）。研究了可作为椎体骨折发生最佳预测指标的风险因素。多因素逻辑回归分析用于测试几个因素对作为因变量的椎体骨折发生的影响。
与经证实有椎体骨折的患者相比，从未发生过椎体骨折的患者骨矿物质密度显著更高（t = 8.161；p<0.01）。对椎体骨折风险有显著影响的因素包括驼背的存在（比值比708.338；95%置信区间19.238 - 26081.950）、糖皮质激素的使用（比值比87.618；95%置信区间9.175 - 836.707）以及合并症的存在（比值比7.327；95%置信区间1.500 - 35.793）。此外，发现体重指数（BMI）每增加一个单位，椎体骨折的概率降低0.846倍。绝经较晚的女性发生椎体骨折的几率较低（比值比 = 0.539；95%置信区间0.400 - 0.726）。
较低的体重指数、驼背的存在、糖皮质激素的使用、绝经早以及合并症的存在是导致椎体骨质疏松性骨折发生的最主要因素。
