Osteoporosis International

, Volume 16, Issue 4, pp 403–410

Accuracy of height loss during prospective monitoring for detection of incident vertebral fractures

  • K. Siminoski
  • G. Jiang
  • J. D. Adachi
  • D. A. Hanley
  • G. Cline
  • G. Ioannidis
  • A. Hodsman
  • R. G. Josse
  • D. Kendler
  • W. P. Olszynski
  • L.-G. Ste. Marie
  • R. Eastell
Original Article

DOI: 10.1007/s00198-004-1709-z

Cite this article as:
Siminoski, K., Jiang, G., Adachi, J.D. et al. Osteoporos Int (2005) 16: 403. doi:10.1007/s00198-004-1709-z

Abstract

Vertebral fractures are the most common type of osteoporotic fracture, but more than two-thirds remain undetected. We have examined the relationship between height loss and the development of new vertebral fractures to determine whether there is a height loss threshold that has useful clinical accuracy to detect new fractures. We studied 985 postmenopausal women with osteoporosis in the placebo arms of the Vertebral Efficacy with Risedronate Therapy studies. Height was measured annually for 3 years using a wall-mounted stadiometer. New fractures were determined using quantitative and semi-quantitative radiographic morphometry. The relationship between height loss over three years and the number of new vertebral fractures was: height loss (cm)=0.95×number of new vertebral fractures−0.4 cm (r=0.33). The odds ratio for the development of a new fracture increased up to 20.6 (95% confidence interval, 9.3, 45.8) when height loss was greater than 4.0 cm. At a threshold of >2.0 cm height loss over 3 years, sensitivity was 35.5% for detecting new vertebral fractures and specificity was 93.6%. These findings show that there is a strong relationship between the amount of height loss and the risk of a new vertebral fracture. While there is no cut-off that can reliably rule in a new fracture, height loss of ≤2.0 cm over 1–3 years has acceptable accuracy for ruling out an incident fracture.

Keywords

Height loss Osteoporosis Postmenopausal women Stature Vertebral fracture 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • K. Siminoski
    • 1
    • 12
  • G. Jiang
    • 2
  • J. D. Adachi
    • 3
  • D. A. Hanley
    • 4
  • G. Cline
    • 5
  • G. Ioannidis
    • 6
  • A. Hodsman
    • 7
  • R. G. Josse
    • 8
  • D. Kendler
    • 9
  • W. P. Olszynski
    • 10
  • L.-G. Ste. Marie
    • 11
  • R. Eastell
    • 2
  1. 1.Department of Radiology and Diagnostic Imaging and Division of Endocrinology and Metabolism, Department of Internal MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Bone Metabolism Group, Section of Medicine, Division of Clinical Sciences (North)University of SheffieldSheffieldUK
  3. 3.Department of Medicine, St Joseph’s HospitalMcMaster UniversityHamiltonCanada
  4. 4.Department of Medicine, Foothills HospitalUniversity of CalgaryCalgaryCanada
  5. 5.Procter & Gamble PharmaceuticalsMasonUSA
  6. 6.Charlton Medical CentreHamiltonCanada
  7. 7.Department of MedicineUniversity of Western OntarioLondonCanada
  8. 8.Department of MedicineUniversity of TorontoTorontoCanada
  9. 9.Department of MedicineUniversity of British ColumbiaVancouverCanada
  10. 10.Department of MedicineUniversity of SaskatchewanSaskatoonCanada
  11. 11.Department of MedicineUniversity of MontrealMontrealCanada
  12. 12.362 HMRCUniversity of AlbertaEdmontonCanada