Osteoporosis International

, Volume 14, Issue 1, pp 19–26

Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS)

  • D.K. Roy
  • T.W. O'Neill
  • J.D. Finn
  • M. Lunt
  • A.J. Silman
  • D. Felsenberg
  • G. Armbrecht
  • D. Banzer
  • L.I. Benevolenskaya
  • A. Bhalla
  • J. Bruges Armas
  • J.B. Cannata
  • C. Cooper
  • J. Dequeker
  • M.N. Diaz
  • R. Eastell
  • O.B. Yershova
  • B. Felsch
  • W. Gowin
  • S. Havelka
  • K. Hoszowski
  • A.A. Ismail
  • I. Jajic
  • I. Janott
  • O. Johnell
  • J.A. Kanis
  • G. Kragl
  • A. Lopez Vaz
  • R. Lorenc
  • G. Lyritis
  • P. Masaryk
  • C. Matthis
  • T. Miazgowski
  • C. Gennari
  • H.A.P. Pols
  • G. Poor
  • H.H. Raspe
  • D.M. Reid
  • W. Reisinger
  • C. Scheidt-Nave
  • J.J. Stepan
  • C.J. Todd
  • K. Weber
  • A.D. Woolf
  • J. Reeve
ORIGINAL ARTICLE

DOI: 10.1007/s00198-002-1317-8

Cite this article as:
Roy, D., O'Neill, T., Finn, J. et al. Osteoporos Int (2003) 14: 19. doi:10.1007/s00198-002-1317-8

Abstract

 The aim of this analysis was to determine the influence of lifestyle, anthropometric and reproductive factors on the subsequent risk of incident vertebral fracture in men and women aged 50–79 years. Subjects were recruited from population registers from 28 centers across Europe. At baseline, they completed an interviewer-administered questionnaire and had lateral thoraco-lumbar spine radiographs performed. Repeat spinal radiographs were performed a mean of 3.8 years later. Incident vertebral fractures were defined morphometrically and also qualitatively by an experienced radiologist. Poisson regression was used to determine the influence of the baseline risk factor variables on the occurrence of incident vertebral fracture. A total of 3173 men (mean age 63.1 years) and 3402 women (mean age 62.2 years) contributed data to the analysis. In total there were 193 incident morphometric and 224 qualitative fractures. In women, an age at menarche 16 years or older was associated with an increased risk of vertebral fracture (RR=1.80; 95%CI 1.24, 2.63), whilst use of hormonal replacement was protective (RR=0.58; 95%CI 0.34, 0.99). None of the lifestyle factors studied including smoking, alcohol intake, physical activity or milk consumption showed any consistent associations with incident vertebral fracture. In men and women, increasing body weight and body mass index were associated with a reduced risk of vertebral fracture though, apart from body mass index in men, the confidence intervals embraced unity. For most variables the strengths of the associations observed were similar using the qualitative and morphometric approaches to fracture definition. In conclusion our data suggest that modification of other lifestyle risk factors is unlikely to have a major impact on the population occurrence of vertebral fractures. The important biological mechanisms underlying vertebral fracture risk need to be explored using new investigational strategies.

Keywords Incident vertebral fractureOsteoporosisProspective studyRisk factors

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • D.K. Roy
    • 2
  • T.W. O'Neill
    • 2
  • J.D. Finn
    • 2
  • M. Lunt
    • 2
  • A.J. Silman
    • 2
  • D. Felsenberg
    • 3
  • G. Armbrecht
    • 3
  • D. Banzer
    • 4
  • L.I. Benevolenskaya
    • 5
  • A. Bhalla
    • 6
  • J. Bruges Armas
    • 7
  • J.B. Cannata
    • 8
  • C. Cooper
    • 9
  • J. Dequeker
    • 10
  • M.N. Diaz
    • 8
  • R. Eastell
    • 11
  • O.B. Yershova
    • 12
  • B. Felsch
    • 13
  • W. Gowin
    • 3
  • S. Havelka
    • 14
  • K. Hoszowski
    • 15
  • A.A. Ismail
    • 2
  • I. Jajic
    • 16
  • I. Janott
    • 17
  • O. Johnell
    • 18
  • J.A. Kanis
    • 19
  • G. Kragl
    • 20
  • A. Lopez Vaz
    • 21
  • R. Lorenc
    • 22
  • G. Lyritis
    • 23
  • P. Masaryk
    • 24
  • C. Matthis
    • 25
  • T. Miazgowski
    • 26
  • C. Gennari
    • 27
  • H.A.P. Pols
    • 28
  • G. Poor
    • 29
  • H.H. Raspe
    • 25
  • D.M. Reid
    • 30
  • W. Reisinger
    • 31
  • C. Scheidt-Nave
    • 32
  • J.J. Stepan
    • 14
  • C.J. Todd
    • 33
  • K. Weber
    • 34
  • A.D. Woolf
    • 35
  • J. Reeve
    • 36
  1. 1.ARC Epidemiology Unit, Stopford Building, University of Manchester, Manchester, M13 9PT, UK Tel: +44 (0)161 2755040 Fax: +44 (0)161 2755043 e-mail: Terry@fs1.ser.man.ac.ukGB
  2. 2.ARC Epidemiology Unit, University of Manchester, Manchester, UKGB
  3. 3.Department of Radiology and Nuclear Medicine, Free University, Berlin, GermanyDE
  4. 4.Behring Hospital, Berlin, GermanyDE
  5. 5.Institute of Rheumatology, Moscow, RussiaRU
  6. 6.Royal National Hospital for Rheumatic Diseases, Bath, UKGB
  7. 7.Hospital de Angra do Herismo, Azores, PortugalPT
  8. 8.Asturia General Hospital, Oviedo, SpainES
  9. 9.University of Southampton, Southampton General Hospital, Southampton, UKGB
  10. 10.University Hospital, Leuven, BelgiumBE
  11. 11.Bone Metabolism Group, Northern General Hospital, Sheffield, UKGB
  12. 12.Medical Institute, Yaroslavl, RussiaRU
  13. 13.Clinic for Internal Medicine, Jena, GermanyDE
  14. 14.Department of Internal Medicine, Charles University, Prague, Czech RepublicCZ
  15. 15.Medical Centre, Wilenska 18, Warsaw, PolandPL
  16. 16.Clinical Hospital, Zagreb, CroatiaHR
  17. 17.Ruhr University, Bochum, GermanyDE
  18. 18.Lund University, Malmö, SwedenSE
  19. 19.Centre for Metabolic Bone Disease, University of Sheffield, UKGB
  20. 20.Medical Academy, Erfurt, GermanyDE
  21. 21.Hospital de San Joao, Oporto, PortugalPT
  22. 22.The Children's Memorial Health Institute, Warsaw PolandPL
  23. 23.Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, GreeceGR
  24. 24.Institute of Rheumatic Diseases, Piestany, SlovakiaSK
  25. 25.Institute of Social Medicine, Lubeck, GermanyDE
  26. 26.Academy of Medicine, Szczecin, PolandPL
  27. 27.Institute of Clinical Medicine, University of Siena, Siena, ItalyIT
  28. 28.Department of Epidemiology and Internal Medicine, Erasmus University, Rotterdam, The NetherlandsNL
  29. 29.National Institute of Rheumatology and Physiotherapy, Budapest, HungaryHU
  30. 30.Department of Medicine and Therapeutics, University of Aberdeen, UKGB
  31. 31.Institute for Diagnostic Radiology, Humboldt University, Berlin, GermanyDE
  32. 32.Department of General Practice, University of Goettingen, GermanyDE
  33. 33.School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UKGB
  34. 34.Department of Medicine, University Hospital, Graz, AustriaAT
  35. 35.Royal Cornwall Hospital, Truro, UKGB
  36. 36.Institute of Public Health, Cambridge, UKGB