Department of Rheumatology, Hospital Universitari de Vic. TR2Lab Group, Universitat de Vic-UCC, C/ Francesc Pla el Vigatà, n° 1, 08500, Vic, Spain.
Department of Clinical Epidemiology. Hospital Universitari de Vic. TR2Lab Group, Universitat de Vic-UCC, Barcelona, Spain.
Osteoporos Int. 2019 Oct;30(10):2141-2149. doi: 10.1007/s00198-019-04962-3. Epub 2019 May 23.
The incidence of vertebral fractures (VF) by vertebral fracture assessment (VFA) was 6.6% in postmenopausal women (FRODOS cohort) after 4 years of follow-up, increasing with prevalent VF and minor vertebral deformities, age, lower bone mass, glucocorticoid use, and rheumatoid arthritis. This study supports the usefulness of VFA to identify VF.
Vertebral fracture assessment (VFA) is increasingly used to identify spine fractures, but few cohort studies have used this method in prevalence and incidence assessment. We previously reported the prevalence of vertebral fractures (VF) and minor vertebral deformities (MVD) by morphometric VFA in a population-based cohort of postmenopausal women (FRODOS study). Therefore, the aim of this study was to analyze the incidence of VF, the associated risk factors, and particularly the role of MVD in this cohort of subjects.
We performed a longitudinal analysis of 2510 women aged 59-70 years participating in the FRODOS prevalence study (2006-2009) with evaluable VFA 4 years later. VFA at baseline and in the present study was assessed by quantitative vertebral morphometry and by visual semiquantitative measurement. The multivariate Poisson regression model was performed, and relative risks with confidence interval of 95% were calculated for the incidence of VF. Bone mineral density (BMD) and an osteoporosis questionnaire were collected.
Overall, the incidence of VF was 6.6%, increasing with prevalent VF (24.5%) and in women with prevalent MVD (17.7%). Age and low BMD were also associated risk factors as were the presence of rheumatoid arthritis and exposure to glucocorticoids and bisphosphonates.
The presence of prevalent VF assessed by VFA is associated with further incident spinal fractures in postmenopausal women. In addition, having MVD confers an increased risk of new VF.
在经过 4 年的随访后，绝经后女性（FRODOS 队列）通过椎体骨折评估（VFA）发现椎体骨折的发生率为 6.6%，且该发生率随既往椎体骨折和轻微椎体畸形、年龄、较低的骨密度、糖皮质激素使用和类风湿性关节炎的存在而增加。本研究支持 VFA 用于识别椎体骨折的有效性。
椎体骨折评估（VFA）越来越多地用于识别脊柱骨折，但很少有队列研究使用这种方法进行患病率和发病率评估。我们之前报告了基于人群的绝经后女性队列（FRODOS 研究）中通过定量 VFA 评估的椎体骨折（VF）和轻微椎体畸形（MVD）的患病率。因此，本研究的目的是分析 VF 的发生率、相关危险因素，特别是在该队列中 MVD 的作用。
我们对 2510 名年龄在 59-70 岁之间的女性进行了一项纵向分析，这些女性参加了 FRODOS 患病率研究（2006-2009 年），4 年后可评估 VFA。基线和本次研究的 VFA 通过定量椎体形态计量学和视觉半定量测量进行评估。采用多变量泊松回归模型，计算 VF 发生率的相对风险比和 95%置信区间。收集骨密度（BMD）和骨质疏松问卷。
总体而言，VF 的发生率为 6.6%，随既往 VF（24.5%）和既往 MVD 女性（17.7%）的存在而增加。年龄和低 BMD 也是危险因素，类风湿性关节炎和糖皮质激素及双膦酸盐的使用也是危险因素。
通过 VFA 评估的既往 VF 的存在与绝经后女性进一步发生脊柱骨折相关。此外，存在 MVD 会增加新发 VF 的风险。
