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

• Published in: Osteoporosis international Vol. 30; no. 12; pp. 2505 - 2514
• Main Authors: Wáng, Y.X.J., Che-Nordin, N., Deng, M., Griffith, J.F., Leung, J.C.S., Kwok, A.W.L., Leung, P.C., Kwok, T.C.Y.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.12.2019; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Bone Density - physiology; Disease Progression; Endocrinology; Female; Females; Follow-Up Studies; Geriatrics; Health risk assessment; Hong Kong - epidemiology; Humans; Male; Males; Medicine; Medicine & Public Health; Older people; Original Article; Orthopedics; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - physiopathology; Prospective Studies; Radiography; Recurrence; Rheumatology; Risk Factors; Severity of Illness Index; Sex Factors; Spinal Curvatures - diagnostic imaging; Spinal Curvatures - epidemiology; Spinal Curvatures - physiopathology; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - physiopathology; Spine; Vertebrae; Hong Kong; Hong Kong China; Progression; Osteoporosis; Radiograph; Spine; Vertebral fracture; Endplate; Incidence
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-019-05136-x

Summary 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. Introduction 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. Methods 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. Results 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. Conclusion 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.