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Worldwide prevalence and incidence of osteoporotic vertebral fractures

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Abstract

We investigated the prevalence and incidence of vertebral fractures worldwide. We used a systematic Medline search current to 2015 and updated as per authors’ libraries. A total of 62 articles of fair to good quality and comparable methods for vertebral fracture identification were considered. The prevalence of morphometric vertebral fractures in European women is highest in Scandinavia (26%) and lowest in Eastern Europe (18%). Prevalence rates in North America (NA) for White women ≥50 are 20–24%, with a White/Black ratio of 1.6. Rates in women ≥50 years in Latin America are overall lower than Europe and NA (11–19%). In Asia, rates in women above ≥65 are highest in Japan (24%), lowest in Indonesia (9%), and in the Middle East, Lebanon, rates are 20%. The highest–lowest ratio between countries, within and across continents, varied from 1.4–2.6. Incidence data is less abundant and more heterogeneous. Age-standardized rates in studies combining hospitalized and ambulatory vertebral fractures are highest in South Korea, USA, and Hong Kong and lowest in the UK. Neither a North-South gradient nor a relation to urbanization is evident. Conversely, the incidence of hospitalized vertebral fractures in European patients ≥50 shows a North-South gradient with 3–3.7-fold variability. In the USA, rates in Whites are approximately 4-fold higher than in Blacks. Vertebral fractures variation worldwide is lower than observed with hip fractures, and some of highest rates are unexpectedly from Asia. Better quality representative studies are needed. We investigate the occurrence of vertebral fractures, worldwide, using published data current until the present. Worldwide, the variation in vertebral fractures is lower than observed for hip fractures. Some of the highest rates are from North America and unexpectedly Asia. The highest–lowest ratio between countries, within and across continents, varied from 1.4–2.6. Better quality representative data is needed.

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Acknowledgments

Special thanks to Ms. Aida Farha, Medical Information Specialist, Saab Medical Library, American University of Beirut, for her advice and assistance in designing comprehensive and complex searches of the various medical literature resources, and provision of selected articles. The authors also thank Mr. Ali Hammoudi for his help with the tables and figures.

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Authors and Affiliations

  1. Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Bliss Street, Beirut, 113-6044, Lebanon

    G. Ballane & G. El-Hajj Fuleihan

  2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    J. A. Cauley

  3. Barnabas Health Osteoporosis Center, Livingston, NJ, USA

    M. M. Luckey

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  1. G. Ballane
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  2. J. A. Cauley
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Correspondence to G. El-Hajj Fuleihan.

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Appendix 4

Fig. Age-specific incidence rates for vertebral fractures in men and women worldwide. (JPEG 608 kb)

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Ballane, G., Cauley, J.A., Luckey, M.M. et al. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 28, 1531–1542 (2017). https://doi.org/10.1007/s00198-017-3909-3

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