Osteoporosis International

, Volume 30, Issue 12, pp 2505–2514 | Cite as

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

  • Y.X.J. WángEmail author
  • N. Che-Nordin
  • M. Deng
  • J.F. Griffith
  • J.C.S. Leung
  • A.W.L. Kwok
  • P.C. Leung
  • T.C.Y. Kwok
Original Article



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.


Endplate 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.

Supplementary material

198_2019_5136_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 15 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • Y.X.J. Wáng
    • 1
    Email author
  • N. Che-Nordin
    • 1
  • M. Deng
    • 1
  • J.F. Griffith
    • 1
  • J.C.S. Leung
    • 2
  • A.W.L. Kwok
    • 2
  • P.C. Leung
    • 2
  • T.C.Y. Kwok
    • 2
    • 3
  1. 1.Department of Imaging and Interventional Radiology, Faculty of MedicineThe Chinese University of Hong Kong, Prince of Wales HospitalHong KongChina
  2. 2.JC Centre for Osteoporosis Care and Control, Faculty of MedicineThe Chinese University of Hong Kong, Prince of Wales HospitalHong KongChina
  3. 3.Department of Medicine and Therapeutics, Faculty of MedicineThe Chinese University of Hong Kong, Prince of Wales HospitalHong KongChina

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