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The cumulative incidence of and risk factors for morphometric severe vertebral fractures in Japanese men and women: the ROAD study third and fourth surveys

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Abstract

Summary

This population-based cohort study with a 3-year follow-up revealed that the annual incidence rates of vertebral fracture (VF) and severe VF (sVF) were 5.9%/year and 1.7%/year, respectively. The presence of mild VF at the baseline was a significant risk factor for incident sVF in participants without prevalent sVF.

Introduction

This study aimed to estimate the incidence of morphometric vertebral fracture (VF) and severe VF (sVF) in men and women and clarify whether the presence of a mild VF (mVF) increases the risk of incident sVF.

Methods

Data from the population-based cohort study, entitled the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study, were analyzed. In total, 1190 participants aged ≥ 40 years (mean age, 65.0 ± 11.2) years completed whole-spine lateral radiography both at the third (2012–2013, baseline) and fourth surveys performed 3 years later (2015–2016, follow-up). VF was defined using Genant’s semi-quantitative (SQ) method: VF as SQ ≥ 1, mVF as SQ = 1, and sVF as SQ ≥ 2. Cumulative incidence of VF and sVF was estimated. Multivariate logistic regression analyses were performed to evaluate risk factors for incident sVF.

Results

The baseline prevalence of mVF and sVF were 16.8% and 6.0%, respectively. The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The annual incidence rates of sVF in participants without prevalent VF, with prevalent mVF, and with prevalent sVF were 0.6%/year, 3.8%/year, and 11.7%/year (p < 0.001), respectively. Multivariate logistic regression analyses in participants without prevalent sVF showed that the adjusted odds ratios for incident sVF were 4.12 [95% confident interval 1.85–9.16] and 4.53 [1.49–13.77] if the number of prevalent mVF at the baseline was 1 and ≥ 2, respectively.

Conclusions

The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The presence of prevalent mVF was an independent risk factor for incident sVF.

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Acknowledgements

The authors wish to thank Dr. Naoki Hirabayashi of Kawakami Clinic, Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, Ms. Ikuyo Ueyama, Mrs. Michiko Mori, Mrs. Hisayo Sugimoto, and other members of the public office in Hidakagawa Town; and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji, and other members of the public office in Taiji Town for their assistance in locating and scheduling participants for examinations. We would also like to thank Mrs. Kyoko Hattori, Mrs. Toki Sakurai, Mrs. Saeko Sahara, and Mr. Noriyuki Oe for their assistance with data reduction and administration.

Funding

This work was supported by the Grant-in-Aid funding from the Ministry of Health, Labour and Welfare: H17-Men-eki-009 (Director, Kozo Nakamura), H20-Choujyu-009 (Director, Noriko Yoshimura), H23-Choujyu-002 (Director, Toru Akune), H25-Choujyu-007 (Director, Noriko Yoshimura), and H25-Nanchitou (Men)-005 (Director, Sakae Tanaka). The study was also supported by the Scientific Research grants B26293139, B23390172, and B20390182 and Challenging Exploratory Research grants 15K15219 and 24659317 to Noriko Yoshimura; Scientific Research grants B23390356 and C20591774 and Challenging Exploratory Research grants 23659580 to Shigeyuki Muraki; Challenging Exploratory Research grants 24659666 and 21659349 and Young Scientists A18689031 to Hiroyuki Oka; Scientific Research grants B26293329, B23390357, and C20591737 and Challenging Exploratory Research grants 25670293 to Toru Akune; and by the Collaborating Research with NSF from the Ministry of Education, Culture, Sports, Science and Technology in Japan 08033011–00262 (Director, Noriko Yoshimura). The study was partly supported by grants from the Japan Agency for Medical Research and Development (17gk0210007h0003, Director, Sakae Tanaka). Further, the study was partly supported by grants from the Japan Osteoporosis Society (Noriko Yoshimura, Shigeyuki Muraki, Hiroyuki Oka, and Toru Akune), Japan Osteoporosis Foundation (2015, Noriko Yoshimura, and 2018, Chiaki Horii), The Nakatomi Foundation (2020, Chiaki Horii), research aids from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006–1 and 2010–2, Director, Hiroshi Kawaguchi; and 2014–1, Director, Kozo Nakamura), Japanese Society for Musculoskeletal Medicine (2015, Director, Shigeyuki Muraki; and 2017, Director, Noriko Yoshimura), Mitsui Sumitomo Insurance Welfare Foundation (2016, Director, Noriko Yoshimura), and Japan Dairy Association (2017, Director, Noriko Yoshimura).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    C. Horii, Y. Oshima & S. Tanaka

  2. Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    T. Iidaka, S. Muraki & Noriko Yoshimura

  3. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    H. Oka

  4. Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan

    Y. Asai, S. Tsutsui, H. Hashizume, H. Yamada & M. Yoshida

  5. Department of Orthopaedic Surgery, Tokyo Neurological Center, 4-1-17, Toranomon, Minato-ku, Tokyo, 105-0001, Japan

    H. Kawaguchi

  6. Department of Orthopaedics, Towa Hospital, Towa 4-7-10, Adachi-ku, Tokyo, 120-0003, Japan

    K. Nakamura

  7. Department of Orthopaedics, National Rehabilitation Center for Persons With Disabilities, 4-1 Namiki, Tokorozawa City, Saitama, 359-0042, Japan

    T. Akune

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  1. C. Horii
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  2. T. Iidaka
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  3. S. Muraki
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  8. H. Yamada
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  14. S. Tanaka
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  15. Noriko Yoshimura
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Corresponding author

Correspondence to Noriko Yoshimura.

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The study was approved by the ethics committees of the University of Tokyo (nos. 1264 and 1326) and the Tokyo Metropolitan Institute of Gerontology (no. 5). Written informed consent was provided by all participants.

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Horii, C., Iidaka, T., Muraki, S. et al. The cumulative incidence of and risk factors for morphometric severe vertebral fractures in Japanese men and women: the ROAD study third and fourth surveys. Osteoporos Int 33, 889–899 (2022). https://doi.org/10.1007/s00198-021-06143-7

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