Osteoporosis International

, Volume 12, Issue 2, pp 85–90 | Cite as

Prevalent Vertebral Deformity Predicts Incident Hip though not distal Forearm Fracture: Results from the European Prospective Osteoporosis Study

  • A. A. Ismail
  • W. Cockerill
  • C. Cooper
  • J. D. Finn
  • K. Abendroth
  • G. Parisi
  • D. Banzer
  • L. I. Benevolenskaya
  • A. K. Bhalla
  • J. Bruges Armas
  • J. B. Cannata
  • P. D. Delmas
  • J. Dequeker
  • G. Dilsen
  • R. Eastell
  • O. Ershova
  • J. A. Falch
  • B. Felsch
  • S. Havelka
  • K. Hoszowski
  • I. Jajic
  • U. Kragl
  • O. Johnell
  • A. Lopez Vaz
  • R. Lorenc
  • G. Lyritis
  • F. Marchand
  • P. Masaryk
  • C. Matthis
  • T. Miazgowski
  • H. A. P. Pols
  • G. Poor
  • A. Rapado
  • H. H. Raspe
  • D. M. Reid
  • W. Reisinger
  • J. Janott
  • C. Scheidt-Nave
  • J Stepan
  • C. Todd
  • K. Weber
  • A. D.  Woolf
  • G. Ambrecht
  • W. Gowin
  • D. Felsenberg
  • M. Lunt
  • J. A. Kanis
  • J. Reeve
  • A. J.  Silman
  • T. W. O’Neill

Abstract:

The presence of a vertebral deformity increases the risk of subsequent spinal deformities. The aim of this analysis was to determine whether the presence of vertebral deformity predicts incident hip and other limb fractures. Six thousand three hundred and forty-four men and 6788 women aged 50 years and over were recruited from population registers in 31 European centers and followed prospectively for a median of 3 years. All subjects had radiographs performed at baseline and the presence of vertebral deformity was assessed using established morphometric methods. Incident limb fractures which occurred during the follow- up period were ascertained by annual postal questionnaire and confirmed by radiographs, review of medical records and personal interview. During a total of 40 348 person-years of follow-up, 138 men and 391 women sustained a limb fracture. Amongst the women, after adjustment for age, prevalent vertebral deformity was a strong predictor of incident hip fracture, (rate ratio (RR) = 4.5; 95% CI 2.1–9.4) and a weak predictor of ‘other’ limb fractures (RR = 1.6; 95% CI 1.1–2.4), though not distal forearm fracture (RR = 1.0; 95% CI 0.6–1.6). The predictive risk increased with increasing number of prevalent deformities, particularly for subsequent hip fracture: for two or more deformities, RR = 7.2 (95% CI 3.0–17.3). Amongst men, vertebral deformity was not associated with an increased risk of incident limb fracture though there was a nonsignificant trend toward an increased risk of hip fracture with increasing number of deformities. In summary, prevalent radiographic vertebral deformities in women are a strong predictor of hip fracture, and to a lesser extent humerus and ‘other’ limb fractures; however, they do not predict distal forearm fractures.

Key words: Incidence – Limb fracture – Osteoporosis – Vertebral deformity – Vertebral osteoporosis 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2001

Authors and Affiliations

  • A. A. Ismail
    • 1
  • W. Cockerill
    • 1
  • C. Cooper
    • 2
  • J. D. Finn
    • 1
  • K. Abendroth
    • 3
  • G. Parisi
    • 4
  • D. Banzer
    • 5
  • L. I. Benevolenskaya
    • 6
  • A. K. Bhalla
    • 7
  • J. Bruges Armas
    • 8
  • J. B. Cannata
    • 9
  • P. D. Delmas
    • 10
  • J. Dequeker
    • 11
  • G. Dilsen
    • 12
  • R. Eastell
    • 13
  • O. Ershova
    • 14
  • J. A. Falch
    • 15
  • B. Felsch
    • 3
  • S. Havelka
    • 16
  • K. Hoszowski
    • 17
  • I. Jajic
    • 18
  • U. Kragl
    • 19
  • O. Johnell
    • 20
  • A. Lopez Vaz
    • 21
  • R. Lorenc
    • 17
  • G. Lyritis
    • 22
  • F. Marchand
    • 23
  • P. Masaryk
    • 24
  • C. Matthis
    • 25
  • T. Miazgowski
    • 26
  • H. A. P. Pols
    • 27
  • G. Poor
    • 28
  • A. Rapado
    • 29
  • H. H. Raspe
    • 25
  • D. M. Reid
    • 30
  • W. Reisinger
    • 31
  • J. Janott
    • 32
  • C. Scheidt-Nave
    • 33
  • J Stepan
    • 34
  • C. Todd
    • 35
  • K. Weber
    • 36
  • A. D.  Woolf
    • 37
  • G. Ambrecht
    • 38
  • W. Gowin
    • 38
  • D. Felsenberg
    • 38
  • M. Lunt
    • 1
  • J. A. Kanis
    • 39
  • J. Reeve
    • 35
  • A. J.  Silman
    • 1
  • T. W. O’Neill
    • 1
  1. 1.ARC Epidemiology Unit, University of Manchester, Manchester, UKGB
  2. 2.University of Southampton, Southampton General Hospital, Southampton, UKGB
  3. 3.Clinic for Internal Medicine, Jena, GermanyDE
  4. 4.Institute of Clinical Medicine, University of Siena, Siena, ItalyIT
  5. 5.Behring Hospital, Berlin, GermanyDE
  6. 6.Institute of Rheumatology, Moscow, RussiaRU
  7. 7.Royal National Hospital for Rheumatic Diseases, Bath, UKGB
  8. 8.Hospital de Angra do Heroismo, Azores, PortugalPT
  9. 9.Asturia General Hospital, Oviedo, SpainES
  10. 10.Ho^pital Edouard Herriot, Lyon, FranceFR
  11. 11.Rheumatology Unit, University Hospital, Leuven, BelgiumBE
  12. 12.Medical Faculty, University of Istanbul, Istanbul, TurkeyTR
  13. 13.Bone Metabolism Group, Northern General Hospital, Sheffield, UKGB
  14. 14.Medical Institute, Yaroslavl, RussiaRU
  15. 15.Aker Hospital, Oslo, NorwayNO
  16. 16.Institute of Rheumatology, Prague, Czech RepublicCS
  17. 17.PKP Hospital, Warsaw, PolandPL
  18. 18.Clinical Hospital, Zagreb, CroatiaYU
  19. 19.Medical Academy, Erfurt, GermanyDE
  20. 20.Malmo¨ University Hospital, Malmo¨, SwedenSE
  21. 21.Hospital de San Joao, Oporto, PortugalPT
  22. 22.Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, GreeceGR
  23. 23.Centre de Medecine Specialise´e, Montceau-les-Mines, FranceFR
  24. 24.Institute of Rheumatic Diseases, Piestany, SlovakiaYU
  25. 25.Institute of Social Medicine, Lubeck, GermanyDE
  26. 26.Academy of Medicine, Szczecin, PolandPL
  27. 27.Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, NetherlandsNL
  28. 28.National Institute of Rheumatology and Physiotherapy, Budapest, HungaryHU
  29. 29.Faculty of Medicine, University of Madrid, Madrid, SpainES
  30. 30.Department of Medicine and Therapeutics, University of Aberdeen, UKUK
  31. 31.Institute for Diagnostic Radiology, Humboldt University, Berlin, GermanyDE
  32. 32.Department of Clinical Medicine, Ruhr University, Bochum, GermanyDE
  33. 33.Department of Endocrinology, University of Heidelberg, Heidelberg, GermanyDE
  34. 34.Department of Internal Medicine, Charles University, Prague, Czech RepublicCZ
  35. 35.Institute of Public Health, Cambridge, UKGB
  36. 36.Department of Medicine, University Hospital, Graz, AustriaAT
  37. 37.Royal Cornwall Hospital, Truro, UKGB
  38. 38.Department of Radiology and Nuclear Medicine, Free University, Berlin, GermanyDE
  39. 39.Centre for Metabolic Bone Disease, Sheffield, UKGB

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