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Much lower prevalence and severity of radiographic osteoporotic vertebral fracture in elderly Hong Kong Chinese women than in age-matched Rome Caucasian women: a cross-sectional study

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Abstract

Introduction

Many earlier studies reported that East Asians and Caucasians have similar radiographic osteoporotic vertebral fracture (OVF) prevalence. Since elderly Chinese’s osteoporotic hip fracture prevalence is half (or less than half) of that of their age-match Caucasians, we hypothesize that elderly Chinese’s OVF prevalence could be only half, or even less than half, of that of their age-match Caucasians.

Materials

Age-matched (mean: 74.1 years; range: 65–87 years) elderly women’s radiographs (T4–L5) were from two OVF population-based epidemiological studies conducted in Hong Kong (n = 200) and in Rome (n = 200). All radiographs were double read by one reader in Hong Kong and one reader in Rome. Radiological osteoporotic vertebral deformity (ROVD) classification included no ROVD (grade 0), and ROVDs with < 20%, 20 ~ 25%, ≥ 25% ~ 1/3, ≥ 1/3 ~ 40%, ≥ 40% ~ 2/3, and ≥ 2/3 height loss (grade 1 ~ 6) as well as endplate/cortex fracture (ECF). Spinal deformity index (SDI) was calculated with each vertebra assigned a score of 0, 0.5, 1, 1.5, 2, 2.5, and 3 for no ROVD or ROVDs grade 1 ~ 6.

Results

Seventy-seven (38.5%) Chinese subjects and 123 Italian subjects (61.5%) had ROVD respectively (p < 0.0001). Chinese subjects had ECF in 52 (26%) cases involving 100 vertebrae, while Italian subjects had ECF in 93 (47%) cases involving 230 vertebrae. ROVDs in Italian subjects tended to be more severe (total and mean SDI: 454.5 and 3.71 for Italian, and 212 and 2.72 for Chinese, p < 0.05), more likely to be multiple, more likely to have severe and collapsed grades. The slope of the relationship between age vs. SDI was steeper for the Italian subjects than for the Chinese subjects, suggesting ROVD severity developed faster for aging Italian subjects. A trend suggested earlier onset of ROVD among Italian.

Conclusion

OVFs in Chinese women tend to be less common, less severe, and less likely to have multiple fractures.

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Acknowledgements

Both the Hong Kong team and the Rome team thank their collaborators for the data collection. The Hong Kong team thanks the current and past staffs at JC Centre for Osteoporosis Care and Control of the Chinese University of Hong Kong for their supports and thank Dr Edith M.C. Lau for the pioneering work in Hong Kong.

Funding

This study was partially supported by an Innovation and Technology Fund project of Hong Kong SAR (code: ITS/334/18).

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China

    Yì Xiáng J. Wáng

  2. Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy

    Davide Diacinti

  3. Department of Diagnostic and Molecular Imaging, Radiology and Radiotherapy, University Foundation Hospital Tor Vergata, Rome, Italy

    Davide Diacinti

  4. JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China

    Jason C. S. Leung & Timothy C. Y. Kwok

  5. Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy

    Antonio Iannacone, Endi Kripa & Daniele Diacinti

  6. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China

    Timothy C. Y. Kwok

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  1. Yì Xiáng J. Wáng
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Wáng, Y.X.J., Diacinti, D., Leung, J.C.S. et al. Much lower prevalence and severity of radiographic osteoporotic vertebral fracture in elderly Hong Kong Chinese women than in age-matched Rome Caucasian women: a cross-sectional study. Arch Osteoporos 16, 174 (2021). https://doi.org/10.1007/s11657-021-00987-6

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