Ethnic difference of clinical vertebral fracture risk

Abstract

SummaryVertebral fractures are the most common osteoporotic fractures. Data on the vertebral fracture risk in Asia remain sparse. This study observed that Hong Kong Chinese and Japanese populations have a less dramatic increase in hip fracture rates associated with age than Caucasians, but the vertebral fracture rates were higher, resulting in a high vertebral-to-hip fracture ratio. As a result, estimation of the absolute fracture risk for Asians may need to be readjusted for the higher clinical vertebral fracture rate.IntroductionVertebral fractures are the most common osteoporotic fractures. Data on the vertebral fracture risk in Asia remain sparse. The aim of this study was to report the incidence of clinical vertebral fractures among the Chinese and to compare the vertebral-to-hip fracture risk to other ethnic groups.MethodsFour thousand, three hundred eighty-six community-dwelling Southern Chinese subjects (2,302 women and 1,810 men) aged 50 or above were recruited in the Hong Kong Osteoporosis Study since 1995. Baseline demographic characteristics and medical history were obtained. Subjects were followed annually for fracture outcomes with a structured questionnaire and verified by the computerized patient information system of the Hospital Authority of the Hong Kong Government. Only non-traumatic incident hip fractures and clinical vertebral fractures that received medical attention were included in the analysis. The incidence rates of clinical vertebral fractures and hip fractures were determined and compared to the published data of Swedish Caucasian and Japanese populations.ResultsThe mean age at baseline was 62 ± 8.2 years for women and 68 ± 10.3 years for men. The average duration of follow-up was 4.0 ± 2.8 (range, 1 to 14) years for a total of 14,733 person-years for the whole cohort. The incidence rate for vertebral fracture was 194/100,000 person-years in men and 508/100,000 person-years in women, respectively. For subjects above the age of 65, the clinical vertebral fracture and hip fracture rates were 299/100,000 and 332/100,000 person-years, respectively, in men, and 594/100,000 and 379/100,000 person-years, respectively, in women. Hong Kong Chinese and Japanese populations have a less dramatic increase in hip fracture rates associated with age than Caucasians. At the age of 65 or above, the hip fracture rates for Asian (Hong Kong Chinese and Japanese) men and women were less than half of that in Caucasians, but the vertebral fracture rate was higher in Asians, resulting in a high vertebral-to-hip fracture ratio.ConclusionsThe incidences of vertebral and hip fractures, as well as the vertebral-to-hip fracture ratios vary in Asians and Caucasians. Estimation of the absolute fracture risk for Asians may need to be readjusted for the higher clinical vertebral fracture rate.

Epidemiology of fragility fractures in Sakaiminato, Japan: incidence, secular trends, and prognosis

“…However, the current study was the first to report the gender-and age-specific incidence rates of clinical vertebral fractures in a Japanese population. The incidence rates of clinical vertebral fractures in this study were higher than those in Sweden or Hong Kong [28,29]. We identified clinical vertebral fracture rates of 381 and 1089 in males and females, respectively, while those in other studies ranged from 225 [29] to 260 [28] and 427 [29] to 916 [28], respectively (per 100,000 person-years).…”

The prevalence of osteoporosis in Korean adults aged 50 years or older and the higher diagnosis rates in women who were beneficiaries of a national screening program: The Korea National Health and Nutrition Examination Survey 2008–2009

“…In addition, it has been reported that Asian populations have a less dramatic increase in hip fracture rates associated with age than Caucasians, but the vertebral fracture rates were higher. (23,24) We found that lumbar bone density T-scores tended to be lower than those of the femoral neck or hip, and the prevalence of osteoporosis was higher at the lumbar spine than the femoral neck or total hip. This may explain the ethnic differences between Asians and Caucasians in vertebral and hip fracture incidence.…”

Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus

“…The present study showed that a history of osteoporotic fractures was significantly associated with the risk of falls in patients with T2DM independent of age, duration of T2DM, HbA1c level, and other diabetic complications. Moreover, the presence of vertebral fractures, which are known as an independent predictor of future fractures and frequently occurred in Asians including Japanese compared with other ethics [22], was also significantly associated with the risk of falls in this population. These findings suggest that osteoporotic fractures increase the risk of falls, which in turn leads to an increased incidence of fractures.…”