Top

Published in:

01-05-2017 | Review

Worldwide prevalence and incidence of osteoporotic vertebral fractures

Authors: G. Ballane, J. A. Cauley, M. M. Luckey, G. El-Hajj Fuleihan

Published in: Osteoporosis International | Issue 5/2017

Abstract

We investigated the prevalence and incidence of vertebral fractures worldwide. We used a systematic Medline search current to 2015 and updated as per authors’ libraries. A total of 62 articles of fair to good quality and comparable methods for vertebral fracture identification were considered. The prevalence of morphometric vertebral fractures in European women is highest in Scandinavia (26%) and lowest in Eastern Europe (18%). Prevalence rates in North America (NA) for White women ≥50 are 20–24%, with a White/Black ratio of 1.6. Rates in women ≥50 years in Latin America are overall lower than Europe and NA (11–19%). In Asia, rates in women above ≥65 are highest in Japan (24%), lowest in Indonesia (9%), and in the Middle East, Lebanon, rates are 20%. The highest–lowest ratio between countries, within and across continents, varied from 1.4–2.6. Incidence data is less abundant and more heterogeneous. Age-standardized rates in studies combining hospitalized and ambulatory vertebral fractures are highest in South Korea, USA, and Hong Kong and lowest in the UK. Neither a North-South gradient nor a relation to urbanization is evident. Conversely, the incidence of hospitalized vertebral fractures in European patients ≥50 shows a North-South gradient with 3–3.7-fold variability. In the USA, rates in Whites are approximately 4-fold higher than in Blacks. Vertebral fractures variation worldwide is lower than observed with hip fractures, and some of highest rates are unexpectedly from Asia. Better quality representative studies are needed. We investigate the occurrence of vertebral fractures, worldwide, using published data current until the present. Worldwide, the variation in vertebral fractures is lower than observed for hip fractures. Some of the highest rates are from North America and unexpectedly Asia. The highest–lowest ratio between countries, within and across continents, varied from 1.4–2.6. Better quality representative data is needed.

Available only for authorised users

Bouxsein M, Genant H (2010) International Osteoporosis Foundation Vertebral Fracture Audit. wwwiofbonehealthorg

Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int

Fink HA, Milavetz DL, Palermo L et al (2005) What proportion of incident radiographic vertebral deformities is clinically diagnosed and vice versa? J Bone Miner Res 20(7):1216–1222CrossRefPubMed

Gehlbach SH, Bigelow C, Heimisdottir M, May S, Walker M, Kirkwood JR (2000) Recognition of vertebral fracture in a clinical setting. Osteoporos Int 11:577–582CrossRefPubMed

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

O’Neill TW, Felsenberg D, Varlow J et al (1996) The prevalence of vertebral deformity in European men and women: the European vertebral osteoporosis study. J Bone Miner Res 11(7):1010–1018CrossRefPubMed

Cauley JA, El-Hajj Fuleihan G, Luckey MM (2011) FRAX(R) international task force of the 2010 joint International Society for Clinical Densitometry & international osteoporosis foundation position development conference. J Clin Densitom 14(3):237–239CrossRefPubMed

Melton LJ, Kan SH, Frye KM, Wahner HW, O’Fallon WM, Riggs B (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011CrossRefPubMed

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):883–892CrossRefPubMed

10.

Jackson SA, Tenenhouse A, Robertson L (2000) Vertebral fracture definition from population-based data: preliminary results from the Canadian multicenter osteoporosis study (CaMos). Osteoporos Int 11(8):680–687CrossRefPubMed

11.

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 3:138–147CrossRefPubMed

12.

Davies KM, Recker RR, Heaney RP (1989) Normal vertebral dimensions and normal variation in serial measurements of vertebrae. J Bone Miner Res 4(3):341–349CrossRefPubMed

13.

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

14.

Ling X, Cummings SR, Mingwei Q et al (2000) Vertebral fractures in Beijing, China: the Beijing osteoporosis project. J Bone Miner Res 15(10):2019–2025CrossRefPubMed

15.

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):1215–1220CrossRefPubMed

16.

Melton LJ 3rd, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3(3):113–119CrossRefPubMed

17.

Cauley JA, Palermo L, Vogt M et al (2008) Prevalent vertebral fractures in black women and white women. J Bone Miner Res 23(9):1458–1467CrossRefPubMedPubMedCentral

18.

Clark P, Cons-Molina F, Deleze M et al (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American vertebral osteoporosis study (LAVOS). Osteoporos Int 20(2):275–282CrossRefPubMed

19.

Clark P, Cons-Molina F, Deleze M, Talavera JO, Palermo L, Cummings SO (2010) The prevalence of radiographic vertebral fractures in Mexican men. Osteoporos Int 21(9):1523–1528CrossRefPubMed

20.

Ho-Pham LT, Mai LD, Pham HN, Nguyen ND, Nguyen TV (2012) Reference ranges for vertebral heights and prevalence of asymptomatic (undiagnosed) vertebral fracture in Vietnamese men and women. Arch Osteoporos 7:257–266CrossRefPubMed

21.

Kwok AW, Leung JC, Chan AY et al (2012) Prevalence of vertebral fracture in Asian men and women: comparison between Hong Kong, Thailand, Indonesia and Japan. Public Health 126(6):523–531CrossRefPubMed

22.

Lau EM, Chan HH, Woo J et al (1996) Normal ranges for vertebral height ratios and prevalence of vertebral fracture in Hong Kong Chinese: a comparison with American Caucasians. J Bone Miner Res 11(9):1364–1368CrossRefPubMed

23.

Tsang SW, Bow CH, Chu EY, Yeung SC, Soong CC, Kung AW (2011) Clinical risk factor assessment had better discriminative ability than bone mineral density in identifying subjects with vertebral fracture. Osteoporos Int 22(2):667–674CrossRefPubMed

24.

Jitapunkul S, Thamarpirat J, Chaiwanichsiri D, Boonhong J (2008) Incidence of vertebral fractures in Thai women and men: a prospective population-based study. Geriatr Gerontol Int 8(4):251–258CrossRefPubMed

25.

Tsai K, Twu S, Chieng P, Yang R, Lee T (1996) Prevalence of vertebral fractures in chinese men and women in urban Taiwanese communities. Calcif Tissue Int 59(4):249–253CrossRefPubMed

26.

Shin CS, Kim MJ, Shim SM et al (2012) The prevalence and risk factors of vertebral fractures in Korea. J Bone Miner Metab 30(2):183–192CrossRefPubMed

27.

Van der Klift M, De Laet CE, McCloskey EV, Hofman A, Pols HA (2002) The incidence of vertebral fractures in men and women: the Rotterdam study. J Bone Miner Res 17(6):1051–1056CrossRefPubMed

28.

Spector TD, McCloskey EV, Doyle DV, Kanis JA (1993) Prevalence of vertebral fracture in women and the relationship with bone density and symptoms: the Chingford study. J Bone Miner Res 8(7):817–822CrossRefPubMed

29.

Ballane G, Cauley JA, Arabi A, El-Hajj Fuleihan G (2013) Geographic variability in hip and vertebral fractures. In: Marcus R, Feldman D, Dempster DW, Luckey M, Cauley CE (eds) Osteoporosis, 4th edn, pp 623–644CrossRef

30.

Grados F, Marcelli C, Dargent-Molina P et al (2004) Prevalence of vertebral fractures in French women older than 75 years from the EPIDOS study. Bone 34(2):362–367CrossRefPubMed

31.

Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P (2000) Consequences of vertebral deformities in older men and women. J Bone Miner Res 15(8):1564–1572CrossRefPubMed

32.

Waterloo S, Nguyen T, Ahmed LA et al (2012) Important risk factors and attributable risk of vertebral fractures in the population-based Tromso study. BMC Musculoskelet Disord 13:163CrossRefPubMedPubMedCentral

33.

Sanfelix-Genoves J, Reig-Molla B, Sanfelix-Gimeno G et al (2010) The population-based prevalence of osteoporotic vertebral fracture and densitometric osteoporosis in postmenopausal women over 50 in Valencia, Spain (the FRAVO study). Bone 47(3):610–616CrossRefPubMed

34.

Vokes TJ, Gillen DL, Pham AT, Lovett JM (2007) Risk factors for prevalent vertebral fractures in black and white female densitometry patients. J Clin Densitom 10(1):1–9CrossRefPubMed

35.

Yakemchuk V, Beaumont LF, Webber CE, Gulenchyn KY, Jager PL (2012) Vertebral fracture prevalence in a referral population of 750 Canadian men and women. Clin Radiol 67(11):1061–1068CrossRefPubMed

36.

Lopes JB, Danilevicius CF, Takayama L et al (2011) Prevalence and risk factors of radiographic vertebral fracture in Brazilian community-dwelling elderly. Osteoporos Int 22(2):711–719CrossRefPubMed

37.

Kwok AW, Gong JS, Wang YX et al (2013) Prevalence and risk factors of radiographic vertebral fractures in elderly Chinese men and women: results of Mr. OS (Hong Kong) and Ms. OS (Hong Kong) studies. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 24(3):877–885CrossRef

38.

Ho-Pham LT, Nguyen ND, Vu BQ, Pham HN, Nguyen TV (2009) Prevalence and risk factors of radiographic vertebral fracture in postmenopausal Vietnamese women. Bone 45(2):213–217CrossRefPubMed

39.

Marwaha RK, Tandon N, Gupta Y et al (2012) The prevalence of and risk factors for radiographic vertebral fractures in older Indian women and men: Delhi vertebral osteoporosis study (DeVOS). Arch Osteoporos 7:201–207CrossRefPubMed

40.

Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M (2003) Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res 18(8):1547–1553CrossRefPubMed

41.

Kitazawa A, Kushida K, Yamazaki K, Inoue T (2001) Prevalence of vertebral fractures in a population-based sample in Japan. J Bone Miner Metab 19(2):115–118CrossRefPubMed

42.

Rostom S, Allali F, Bennani L, Abouqal R, Hajjaj-Hassouni N (2012) The prevalence of vertebral fractures and health-related quality of life in postmenopausal women. Rheumatol Int 32(4):971–980CrossRefPubMed

43.

El Maghraoui A, Mounach A, Rezqi A, Achemlal L, Bezza A, Ghozlani I (2012) Vertebral fracture assessment in asymptomatic men and its impact on management. Bone 50(4):853–857CrossRefPubMed

44.

Baddoura R, Arabi A, Haddad-Zebouni S et al (2007) Vertebral fracture risk and impact of database selection on identifying elderly Lebanese with osteoporosis. Bone 40(4):1066–1072CrossRefPubMed

45.

Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674CrossRefPubMed

46.

Sanders KM, Seeman E, Ugoni AM et al (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10(3):240–247CrossRefPubMed

47.

Oinuma T, Sakuma M, Endo N (2010) Secular change of the incidence of four fracture types associated with senile osteoporosis in Sado, Japan: the results of a 3-year survey. J Bone Miner Metab 28(1):55–59CrossRefPubMed

48.

Bow CH, Cheung E, Cheung CL et al (2012) Ethnic difference of clinical vertebral fracture risk. Osteoporos Int 23(3):879–885CrossRefPubMed

49.

van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29(6):517–522CrossRefPubMed

50.

Bassgen K, Westphal T, Haar P, Kundt G, Mittlmeier T, Schober HC (2013) Population-based prospective study on the incidence of osteoporosis-associated fractures in a German population of 200,413 inhabitants. Journal of public health 35(2):255–261CrossRefPubMed

51.

Piscitelli P, Tarantino U, Chitano G et al (2011) Updated incidence rates of fragility fractures in Italy: extension study 2002-2008. Clinical cases in mineral and bone metabolism: the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases 8(3):54–61

52.

Lippuner K, Johansson H, Kanis JA, Rizzoli R (2009) Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. Osteoporos Int 20(7):1131–1140CrossRefPubMed

53.

Siggeirsdottir K, Aspelund T, Jonsson BY et al Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989-2008. Osteoporos Int:2013

54.

Dzajkovska B, Wertheimer AI, Mrhar A (2007) The burden-of-illness study on osteoporosis in the Slovenian female population. Pharm World Sci 29(4):404–411CrossRefPubMed

55.

Hu R, Mustard CA, Burns C (1996) Epidemiology of incident spinal fracture in a complete population. Spine (Phila Pa 1976) 21(4):492–499CrossRef

56.

Melton LJ 3rd, Crowson CS, O’Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9(1):29–37CrossRefPubMed

57.

Amin S, Achenbach SJ, Atkinson EJ, Khosla S, Melton LJ 3rd (2013) Trends in fracture incidence: a population-based study over 20 years. J Bone Miner Res

58.

Lee YK, Jang S, Jang S et al (2012) Mortality after vertebral fracture in Korea: analysis of the National Claim Registry. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 23(7):1859–1865CrossRef

59.

Johnell O, Gullberg B, Kanis JA (1997) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7(2):138–144CrossRefPubMed

60.

Jansson KA, Blomqvist P, Svedmark P et al (2010) Thoracolumbar vertebral fractures in Sweden: an analysis of 13,496 patients admitted to hospital. Eur J Epidemiol 25(6):431–437CrossRefPubMedPubMedCentral

61.

Bouza C, Lopez T, Palma M, Amate JM (2007) Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 18(5):649–657CrossRefPubMed

62.

Jacobsen SJ, Cooper C, Gottlieb MS, Goldberg J, Yahnke DP, Melton LJ 3rd (1992) Hospitalization with vertebral fracture among the aged: a national population-based study, 1986-1989. Epidemiology 3(6):515–518CrossRefPubMed

63.

Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRefPubMed

64.

Cooper C, Cole ZA, Holroyd CR et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288CrossRefPubMedPubMedCentral

65.

Parisien M, Cosman F, Morgan D et al (1997) Histomorphometric assessment of bone mass, structure, and remodeling: a comparison between healthy black and white premenopausal women. J Bone Miner Res Off J Am Soc Bone Miner Res 12(6):948–957CrossRef

66.

Qiu S, Rao DS, Palnitkar S, Parfitt AM (2006) Differences in osteocyte and lacunar density between black and white American women. Bone 38(1):130–135CrossRefPubMed

67.

Schousboe JT (2015) Epidemiology of Vertebral Fractures. Journal of clinical densitometry: the official journal of the International Society for Clinical Densitometry

68.

Cauley JA, Chalhoub D, Kassem AM, Fuleihan Gel H (2014) Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol 10(6):338–351CrossRefPubMed

69.

Cooper C, Atkinson EJ, Kotowicz M, O’Fallon WM, Melton LJ 3rd (1992) Secular trends in the incidence of postmenopausal vertebral fractures. Calcif Tissue Int 51(2):100–104CrossRefPubMed

70.

Leslie WD, Sadatsafavi M, Lix LM et al (2011) Secular decreases in fracture rates 1986-2006 for Manitoba, Canada: a population-based analysis. Osteoporos Int 22(7):2137–2143CrossRefPubMed

Title: Worldwide prevalence and incidence of osteoporotic vertebral fractures
Authors: G. Ballane
J. A. Cauley
M. M. Luckey
G. El-Hajj Fuleihan
Publication date: 01-05-2017
Publisher: Springer London
Published in: Osteoporosis International / Issue 5/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-017-3909-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Worldwide prevalence and incidence of osteoporotic vertebral fractures

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2017

Biopsy vs. peripheral computed tomography to assess bone disease in CKD patients on dialysis: differences and similarities

A role for thiazide diuretic therapy in preventing bone loss, fracture, and nephrolithiasis in individuals with thalassemia and hypercalciuria?

Significant improvement of bone mineral density and bone turnover markers by denosumab therapy in bisphosphonate-unresponsive patients: response to comments

Conclusions stand firm with additional data

Post-fracture care: do we need to educate patients rather than doctors? The PREVOST randomized controlled trial

Increased risk of incident osteoporosis and osteoporotic fracture in tuberculosis patients: a population-based study in a tuberculosis-endemic area