Differences in prevalence and associated factors between mild and severe vertebral fractures in Japanese men and women: the third survey of the ROAD study


Vertebral fracture (VF) is a common osteoporotic fracture, while its epidemiology varies according to regions and ethnicities, little is known about it in Japan. Using whole-spine radiographs from a population-based cohort study, the Research on Osteoarthritis/Osteoporosis Against Disability study 3rd survey performed in 2012–2013, we estimated the sex- and age-specific prevalence of VF in the Japanese. Genant’s semiquantitative method (SQ) was used to define VF; SQ ≥ 1 as VF, SQ = 1 as mild VF, SQ≥ 2 as severe VF. We also revealed accurate site-specific prevalence, and associated factors with mild and severe VF. The participants were 506 men [mean age 66.3 years, standard deviation (SD):13.0] and 1038 women (mean age 65.3 years, SD: 12.6). The prevalence of VF in participants aged under 40, in their 40s, 50s, 60s, 70s, and ≥ 80 years was 17.4, 7.9, 18.5, 25.6, 26.3, and 41.5%, respectively, in men, and 2.9%, 2.4%, 7,3, 10.3, 27.1, and 53.0%, respectively, in women. Men had a significantly higher prevalence of mild VF (21.2%) than women (10.0%, p < 0.001); whereas, severe VF was significantly more prevalent in women (9.1%) than in men (4.7%, p = 0.003). VF was distributed with 2 peaks regarding site; one large peak at the thoracolumbar region, and another at the middle thoracic lesion. Low back pain and decreased walking ability were independently associated with severe VF, but not with mild VF, after adjustment for participant characteristics. Decreased walking ability was associated with multiple VFs in women, but not in men.

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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 Ms. Kyoko Yoshimura, Mrs. Toki Sakurai, Mrs. Saeko Sahara, and Mr. Noriyuki Oe for their assistance with data reduction and administration.


This work was supported by 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 Scientific Research grants B26293139, B23390172, B20390182, and Challenging Exploratory Research grants 15K15219, 24659317 to Noriko Yoshimura; Scientific Research grants B23390356, 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, C20591737 and Challenging Exploratory Research grants 25670293 to Toru Akune; and by 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), 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), the 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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Horii, C., Asai, Y., Iidaka, T. et al. Differences in prevalence and associated factors between mild and severe vertebral fractures in Japanese men and women: the third survey of the ROAD study. J Bone Miner Metab 37, 844–853 (2019). https://doi.org/10.1007/s00774-018-0981-5

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  • Vertebral fracture
  • Prevalence
  • Low back pain
  • Walking ability
  • ROAD study