Prevalence of asymptomatic radiographic vertebral fracture in postmenopausal Thai women
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ORIGINAL ARTICLE
Prevalence of asymptomatic radiographic vertebral fracture in postmenopausal Thai women Chatlert Pongchaiyakul 1 & Suranut Charoensri 1 & Taninnit Leerapun 2 & Sunton Wongsiri 3 & Thawee Songpatanasilp 4 & Nimit Taechakraichana 5 Received: 16 January 2020 / Accepted: 18 May 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary We aim to investigate the nationwide prevalence of asymptomatic radiographic vertebral fracture in Thailand. We found 29% of postmenopausal women had at least one radiographic vertebral fracture. The prevalence was significantly higher among women with osteoporosis at the total hip (TH) region which implies that TH bone mineral density is a determinant of vertebral fracture risk. Introduction Radiographic vertebral fracture is associated with an increased risk of osteoporotic fracture and mortality in postmenopausal women. We designed a study to determine the prevalence of asymptomatic vertebral fractures in postmenopausal Thai women. Methods The study was designed as a cross-sectional investigation at five university hospitals so as to achieve representation of the four main regions of Thailand. Radiographs were taken from 1062 postmenopausal women averaging 60 years of age. The presence of vertebral fracture was assessed by the Genant’s semiquantitative method with three independent radiologists. Respective bone mineral density was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine (LS), femoral neck (FN), and total hip (TH). Results Among the 1062 women, 311 were found to have at least one radiographic vertebral fracture—yielding a prevalence of 29% (95% CI 23.6–32.0%)—and 90 (8.5%, 95% CI 6.8–10.2%) had at least two fractures. The prevalence of vertebral fracture increased with advancing age. Most fractures occurred at one vertebra (71%) and only 29% at multiple vertebrae. The prevalence of vertebral fracture was significantly higher among women with osteoporosis compared with non-osteoporosis at the TH region. There was no significant difference in the prevalence among women with or without osteoporosis at the LS or FN. Conclusions Radiographic vertebral fractures were common among Thai postmenopausal women (~ 29%). These findings suggest that approximately one in three postmenopausal women has undiagnosed vertebral fracture. Radiographic diagnosis should therefore be an essential investigation for identifying and confirming the presence of vertebral fractures. Keywords Epidemiology . Osteoporosis . Vertebral fracture
* Chatlert Pongchaiyakul [email protected] 1
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
2
Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
3
Department of Orthopaedics and Physical Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
4
Department of Orthopaedics, Phramongkutklao College of Medicine, Phramongkutklao Hosp
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