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Prevalence of Vertebral Fractures and Non-fracture Deformities in Healthy Adult Men: The Importance of Morphologic Criteria

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Abstract

Vertebral fractures (VF) are common in older men but data on VF prevalence in young men is limited. The aim of this study was to describe the prevalence of VF and non-fracture vertebral deformities (VD) in healthy young to middle-aged men, and compare the characteristics of men with normal vertebrae, VF and VD. In this cross-sectional study, vertebral fracture assessment by dual-energy X-ray absorptiometry was performed in 650 men, aged 32 to 60 years (mean 46.2), from the population-based SIBLOS-SIBEX cohort. For VF and VD assessment, both the modified algorithm-based qualitative approach (morphologic criteria) to discriminate VF from VD and the semi-quantitative (morphometric) grading system of Genant (GSQ) were used. We found 48 (0.6%) fractured vertebrae, of which 15 were classified grade 1, 29 grade 2 and 4 grade 3 VF. There were 378 (4.7%) VD, of which 296 were scored grade 1, 82 grade 2 and none grade 3 VD. Twenty-six participants (4%) had VF, 15 had one and 11 had 2 or more VF. Two hundred and twenty-eight (35.1%) men had VD. Femoral neck, total hip and lumbar spine areal bone mineral density (aBMD) were lower in men with VF than in those with normal vertebrae or VD. Men with VD, in turn, had aBMD values similar to men with normal vertebrae. Our results suggest that -even in young healthy men-using the GSQ without taking qualitative aspects into account overestimates VF prevalence, confirming the importance of morphologic criteria to correctly diagnose and distinguish VF from VD.

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Data Availability

The datasets generated and/or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

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Acknowledgements

We would like to thank Kaatje Toye (†), Kathelyne Mertens, Roos Colman and Stefanie De Buyser for administrative, technical and statistical assistance and all the volunteers for participation in the study. Clinical Trial Information: The SIBEX-study was registered on ClinicalTrials.gov (#NVT02997033)

Funding

This study was supported by a grant from the Fund for Scientific Research-Flanders (FWO-Vlaanderen, Grant #G.0876.11).

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Authors and Affiliations

  1. Department of Endocrinology, Ghent University Hospital, Corneel Heymanslaan 10, 9K12E, 9000, Ghent, Belgium

    S. De Smet, T. Banica, H. G. Zmierczak, S. Goemaere, C. Verroken, J. M. Kaufman & B. Lapauw

  2. Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium

    H. G. Zmierczak, S. Goemaere, C. Verroken, J. M. Kaufman & B. Lapauw

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  1. S. De Smet
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  5. C. Verroken
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Contributions

Study design: JMK, BL, SG and HGZ. Data collection: all authors. Data analysis: SDS, TB, HGZ, SG, BL. Data interpretation: all authors. Drafting manuscript: SDS, TB, BL. Take responsibility for the integrity of the data analysis: SDS, TB, HGZ, SG, BL. All authors read and revised the manuscript, and approved the final submitted version.

Corresponding author

Correspondence to B. Lapauw.

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Conflict of interest

Stephanie De Smet, Thiberiu Banica, Hans-Georg Zmierczak, Stefan Goemaere, Charlotte Verroken, Jean-Marc Kaufman, and Bruno Lapauw declare that they have no conflict of interest.

Ethical Approval

The study protocol was in accordance with the standards on human experimentation by the ethical committee of the Ghent University Hospital (Belgium) and is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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De Smet, S., Banica, T., Zmierczak, H.G. et al. Prevalence of Vertebral Fractures and Non-fracture Deformities in Healthy Adult Men: The Importance of Morphologic Criteria. Calcif Tissue Int 112, 24–33 (2023). https://doi.org/10.1007/s00223-022-01029-0

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