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The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population

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Abstract

There is little data concerning the morbidity, mortality, and epidemiology of vertebral fracture. The aim of this study was to evaluate the effect of prevalent and incident vertebral fractures as risk factors for further osteoporotic fractures and mortality. The study was performed on a cohort of 316 women and 308 men older than 50 belonging to the EVOS study, randomly selected from our city register. At the beginning of the study and 4 years later, lateral dorsal and lumbar X-rays were performed. In addition, evaluation of the incidence of osteoporotic nonvertebral fractures was performed throughout 8 years. The incidence of all osteoporotic fractures was higher in women than in men (two-fold increase in vertebral fracture incidence and five-fold increase in Colles' and femur incidence). Vertebral fracture was a strong risk factor for a new vertebral fracture [RR=4.7 (1.8–11.9)], hip fracture [RR=6.7 (2.0–22.7)] and Colles' fracture [RR=3.0 (1.1–7.8)]. Prevalent and incident vertebral fractures were associated with a higher risk of having a hip fracture [RR=10.0 (2.0–50.2)] and Colles' fracture [RR=5.5 (1.3–23.4)]. In addition, in women, the vertebral fracture was associated with a higher mortality. By contrast, no association was found in men. These results demonstrate the association between a previous vertebral fracture with increments in the incidence of osteoporotic fractures of any type. In addition, we found a significantly higher mortality rate in women having vertebral fractures. These findings support the necessity of preventing the occurrence of vertebral fractures to limit their strong negative impact on mortality.

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References

  1. Cooper C, Atkinson EJ, O'Fallon WM, Melton LJ III (1992). Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7(2):221–227

    Google Scholar 

  2. O'Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ (1996). The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11(7):1010–1018

    Google Scholar 

  3. Naves Diaz M, Diaz Lopez JB, Gomez Alonso C, Altadill Arregui A, Rodriguez Rebollar A, Cannata Andia JB (2000) [Study of incidence of osteoporotic fractures in a cohort of individuals older than 50 years from Asturias, Spain, after a 6 year follow-up period]. Med Clin (Barc) 115(17):650–653

    Google Scholar 

  4. Melton LJ III, Atkinson EJ, Cooper C, O'Fallon WM, Riggs BL (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10(3):214–221

    Google Scholar 

  5. Lauritzen JB, Lund B (1993) Risk of hip fracture after osteoporosis fractures: 451 women with fracture of lumbar spine, olecranon, knee or ankle. Acta Orthop Scand 64(3):297–300

    Google Scholar 

  6. Kotowicz MA, Melton LJ III, Cooper C, Atkinson EJ, O'Fallon WM, Riggs BL (1994) Risk of hip fracture in women with vertebral fracture. J Bone Miner Res 9(5):599–605

    Google Scholar 

  7. Gunnes M, Mellstrom D, Johnell O (1998) How well can a previous fracture indicate a new fracture? A questionnaire study of 29,802 postmenopausal women. Acta Orthop Scand 69(5):508–512

    Google Scholar 

  8. Naves Diaz M, Diaz Lopez JB, Rodriguez Rebollar A, Gomez Alonso C, Diaz Corte C, Cannata Andia J (2001) [Effect of vertebral fracture on health related quality of life in a Spanish population older than 54 years]. Med Clin (Barc) 116(14):533–535

    Google Scholar 

  9. Ismail AA, O'Neill TW, Cooper C, et al (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8(3):291–297

    Google Scholar 

  10. Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159(11):1215–1220

    Google Scholar 

  11. Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8(9):1137–1148

    Google Scholar 

  12. Diaz Lopez JB, Naves Diaz M, Gomez Alonso C, Fernandez Martin JL, Rodriguez Rebollar A, Cannata Andia JB (2000) [Prevalence of vertebral fracture in population older than 50 years in Asturias (Spain) defined following different radiological criteria]. Med Clin (Barc) 115(9):326–331

    Google Scholar 

  13. Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ III (1991) Classification of vertebral fractures. J Bone Miner Res 6(3):207–215

    Google Scholar 

  14. McCloskey EV, Spector TD, Eyres KS, et al (1993) The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporos Int 3(3):138–147

    Google Scholar 

  15. Black DM, Cummings SR, Stone K, Hudes E, Palermo L, Steiger P (1991) A new approach to defining normal vertebral dimensions. J Bone Miner Res 6(8):883–892

    Google Scholar 

  16. Gardsell P, Johnell O, Nilsson BE, Nilsson JA (1989) The predictive value of fracture, disease, and falling tendency for fragility fractures in women. Calcif Tissue Int 45(6):327–30

    Google Scholar 

  17. Burger H, van Daele PL, Algra D, et al (1994) Vertebral deformities as predictors of non-vertebral fractures. BMJ 309(6960):991–992

    Google Scholar 

  18. Ismail AA, Cockerill W, Cooper C, et al (2001) Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int 12(2):85–90

    Google Scholar 

  19. Black DM, Arden NK, Palermo L, Pearson J, Cummings SR (1999) Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group. J Bone Miner Res 14(5):821–828

    Google Scholar 

  20. O'Neill TW, Cooper C, Finn JD, et al (2001) Incidence of distal forearm fracture in British men and women. Osteoporos Int 12(7):555–558

    Google Scholar 

  21. Ross PD, Davis JW, Epstein RS, Wasnich RD (1991) Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 114(11):919–923

    Google Scholar 

  22. Lindsay R, Silverman SL, Cooper C, et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285(3):320–323

    Google Scholar 

  23. Eastell R (1996) Forearm fracture. Bone 18(3 Suppl):203S–207S

    Google Scholar 

  24. Cuddihy MT, Gabriel SE, Crowson CS, O'Fallon WM, Melton LJ III (1999) Forearm fractures as predictors of subsequent osteoporotic fractures. Osteoporos Int 9(6):469–475

    Google Scholar 

  25. Cooper C, Atkinson EJ, Jacobsen SJ, O'Fallon WM, Melton LJ III (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137(9):1001–1005

    Google Scholar 

  26. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–882

    Google Scholar 

  27. Cummings SR, Nevitt MC, Browner WS, et al (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332(12):767–773

    Google Scholar 

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Acknowledgments

This study has been partly supported by the European Vertebral Osteoporosis Study (EVOS) of the European Community (1991–1993), by the European Prospective Osteoporosis Study (EPOS) of the European Community, BIOMED 1993–1995, BMHI-CT 092-0182 (1993−1997), by Fondo de Investigaciones Sanitarias (FIS 94/1901-E), and by Fundación Renal Iñigo Alvarez de Toledo (Spain). The authors wish to thank Dr J. R. Jiménez Blanco (department of radiology) for technical support.

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Correspondence to J. B. Cannata-Andía.

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Naves, M., Díaz-López, J.B., Gómez, C. et al. The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporos Int 14, 520–524 (2003). https://doi.org/10.1007/s00198-003-1405-4

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  • DOI: https://doi.org/10.1007/s00198-003-1405-4

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