Elderly males with or without existing osteoporotic vertebral fracture have much lower future vertebral fracture risk than elderly females: the MrOS (Hong Kong) year-4 follow-up spine radiograph study
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MrOS (Hong Kong)’s year-4 follow-up shows, for subjects at baseline without vertebral deformity (VD) and endplate or/and cortex fracture (ECF), the VD progression/new VD rate during follow-up in males was half of our paired MsOS (Hong Kong) study’s results. For those with VD or ECF, the VD progression/new VD was less than one sixth of females’ rate.
This study documents MrOS (Hong Kong)’s year-4 follow-up, and the results are compared with the MsOS (Hong Kong) study. Of elderly females with Genant’s grade-0, -1, -2, and -3 VD, at year-4 follow-up, 4.6%, 8%, 10.6%, and 28.9% had at least one VD progression or incident VD, respectively.
Spine radiographs of 1500 Chinese males with baseline (mean age 71.7 years, range 65–91 years) and year-4 follow-up were evaluated according to Genant’s VD criteria and ECF (non-existent, ECF0; or existent, ECF1). Grade-2 VDs were divided into mild (VD2m, 25–34% height loss) and severe (VD2s, 34–40% height loss) subgroups. Study subjects were graded into eight categories: VD0/ECF0, VD1/ECF0, VD2m/ECF0, VD0/ECF1, VD1/ECF1, VD2m/ECF1, VD2s/ECF1, and VD3/ECF1. With an existing VD, a further height loss of ≥ 15% was a VD progression. A new VD incident was a change from grade-0 to grade-2/3, or to grade-1 with ≥ 10% height loss.
Of subjects with Genant’s grade-0, 2.05% (25/1219) developed at least one VD progression or/and new VD, while of subjects with Genant’s grade-1, -2, and -3 VD, only 2% (3/149), 3.1% (3/96), and 2.8% (1/36) developed at least one VD progression/new VD, respectively. Among the three ECF0 groups, there was a significant difference in new ECF incidence, with VD0/ECF0 being the lowest and VD2m/ECF0 being the highest.
VD progression/new VD is much less common in elderly men than in elderly women. Vertebrae with VD had a higher risk of developing ECF.
KeywordsEndplate Incidence Osteoporosis Progression Radiograph Spine Vertebral fracture
This study was partially funded by National Institutes of Health R01 Grant AR049439-01A1 and the Research Grants Council Earmarked Grant CUHK 4101/02M, and a donation from the AME Publishing Company (Hong Kong).
Compliance with ethical standards
Conflicts of interest
Yì Xiáng J. Wáng, Nazmi Che-Nordin, Min Deng, Jason C. S. Leung, Anthony W. L. Kwok, James F. Griffith, Ping Chung Leung, and Timothy C.Y. Kwok declare that they have no conflict of interest.
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