Lalita Wattanachanya1,2, Chatlert Pongchaiyakul3. 1. Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 2. Excellence Center for Diabetes, Hormone, and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 3. Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Abstract
OBJECTIVE: To determine the prevalence of and risk factors for morphometric vertebral fracture (VF) in apparently healthy postmenopausal women with osteopenia. METHODS: This cross-sectional study included 490 postmenopausal Thai women with osteopenia. All had no known history of low-trauma fracture, no underlying diseases, or history of taking medications that affect bone metabolism. Morphometric VFs were assessed by thoracolumbar spine x-rays, using the Genant semiquantitative method, and interpreted independently by three radiologists. RESULTS: Mean age of participants was 59.9 ± 7.8 years and mean body mass index was 24.3 ± 3.4 kg/m2. Morphometric VFs were present in 29% (142/490) of women (grade 1: 62.0%, grade 2: 19.3%, and grade 3: 18.7%). Of these, 4.9% were aged 50 years or less, 40.1% were aged 50-59 years, 38% were aged 60-69 years, and 16.9% were aged over 70 years. Age and the Fracture Risk Assessment Tool (FRAX) scores for hip and major osteoporotic fracture, with or without bone mineral density, were positively correlated with VF. No differences in fracture prevalence among those with various degrees of osteopenia. Applying the current guidelines for VF screening results in discoveries of less than a half of osteopenic women who have had morphometric VF. CONCLUSIONS: Almost one third of apparently healthy postmenopausal women with osteopenia had morphometric VF. Advancing age and greater FRAX scores were associated with higher prevalence of morphometric VF.
OBJECTIVE: To determine the prevalence of and risk factors for morphometric vertebral fracture (VF) in apparently healthy postmenopausal women with osteopenia. METHODS: This cross-sectional study included 490 postmenopausal Thai women with osteopenia. All had no known history of low-trauma fracture, no underlying diseases, or history of taking medications that affect bone metabolism. Morphometric VFs were assessed by thoracolumbar spine x-rays, using the Genant semiquantitative method, and interpreted independently by three radiologists. RESULTS: Mean age of participants was 59.9 ± 7.8 years and mean body mass index was 24.3 ± 3.4 kg/m2. Morphometric VFs were present in 29% (142/490) of women (grade 1: 62.0%, grade 2: 19.3%, and grade 3: 18.7%). Of these, 4.9% were aged 50 years or less, 40.1% were aged 50-59 years, 38% were aged 60-69 years, and 16.9% were aged over 70 years. Age and the Fracture Risk Assessment Tool (FRAX) scores for hip and major osteoporotic fracture, with or without bone mineral density, were positively correlated with VF. No differences in fracture prevalence among those with various degrees of osteopenia. Applying the current guidelines for VF screening results in discoveries of less than a half of osteopenicwomen who have had morphometric VF. CONCLUSIONS: Almost one third of apparently healthy postmenopausal women with osteopenia had morphometric VF. Advancing age and greater FRAX scores were associated with higher prevalence of morphometric VF.