Osteoporosis and Vertebral Fractures in Men Aged 60-74 Years
Osteoporosis and Vertebral Fractures in Men Aged 60-74 Years
The study population and those not included in the study were comparable with regard to BMI and self-reported chronic illnesses, though smoking and pulmonary disease were observed less frequently among respondents, and a higher proportion of the study population reported that they were living with a partner, participating in sports or had a higher education ( Table 1 ). In all, two participants reported a diagnosis of osteoporosis at inclusion.
BMD was assessed in 585 participants corresponding to 98% of the study population (not technically possible in 15). Using Danish or NHANES III and Hologic (NHANES III for hip BMD, Hologic for the spine) reference values resulted in a prevalence of osteoporosis in the study population of 10.2, and 11.5%, respectively ( Table 2 ). Osteoporosis was more common in the total hip and femoral neck when Danish reference values were used (4.4 versus 0.5% and 5.8 versus 4.1%, both P < 0.01), whereas the Danish reference values resulted in a lower prevalence of osteoporosis in the lumbar spine (4.6 versus 8.0%, P < 0.01) ( Table 2 ).
VFA could be performed in 94% of the participants while evaluation of the remaining scans was impossible due to severe arthritis and scoliosis in 1.2% and poor quality of the scans in the remaining cases. Vertebral bodies were less frequently visible in the upper part of the spine. Thus, T6-L4 and T8-L4 were visible in 48 and 95%, respectively ( Table 3 ). In all, 35 (6.3%) participants had at least one VFx comprising a total of 42 fractures consisting of 26 thoracic and 16 lumbar fractures. One participant had three fractures and five had two fractures. The fractures were most prevalent in the thoracolumbar junction and mid-thoracic spine (see the Supplementary data available in Age and Ageing online, Appendix S1). In all, 14.8–15.7% had osteoporosis and/or VFx depending on reference values used ( Table 2 ).
Participants with osteoporosis as defined by Danish reference values were of similar age as non-osteoporotic ( Table 3 ). In men aged 60–64, 65–69 and 70–74 years, the prevalence of osteoporosis was 6.6, 12.1 and 11.5%, respectively (P = 0.06). BMI was lower in men with osteoporosis, intake of alcohol was lower and smoking more prevalent.
Individuals with VFxs had lower BMD at all sites ( Table 3 ). In men aged 60–64, 65–69 and 70–74 years, the prevalence of VFxs was 2.8, 9.1 and 5.9%, respectively (NS).
The proportion of individuals with a family history of osteoporosis or hip fracture or a sedentary lifestyle was comparable in osteoporotic and non-osteoporotic as well as vertebral and non-VFx participants ( Table 3 ).
Data on VFA and BMD was available in 92% of the participants. Twenty-four per cent of those with a VFx had osteoporosis, whereas 1.5% had osteoporosis and a VFx.
The diagnostic utility of BMD measurements for detection of co-existing VFxs was independent of the reference values used (area under the curve: 0.571 and 0.566, respectively). The sensitivity of DXA using Danish and NHANESIII reference values and a T-score of ≤−2.5 to detect the presence of a concomitant VFx was the same (24%), whereas the specificity was 91 and 90%, respectively. Positive and negative predictive values for BMD using Danish reference values were 14 and 95% and the corresponding results for NHANESIII were 13 and 95%.
Results
The study population and those not included in the study were comparable with regard to BMI and self-reported chronic illnesses, though smoking and pulmonary disease were observed less frequently among respondents, and a higher proportion of the study population reported that they were living with a partner, participating in sports or had a higher education ( Table 1 ). In all, two participants reported a diagnosis of osteoporosis at inclusion.
BMD was assessed in 585 participants corresponding to 98% of the study population (not technically possible in 15). Using Danish or NHANES III and Hologic (NHANES III for hip BMD, Hologic for the spine) reference values resulted in a prevalence of osteoporosis in the study population of 10.2, and 11.5%, respectively ( Table 2 ). Osteoporosis was more common in the total hip and femoral neck when Danish reference values were used (4.4 versus 0.5% and 5.8 versus 4.1%, both P < 0.01), whereas the Danish reference values resulted in a lower prevalence of osteoporosis in the lumbar spine (4.6 versus 8.0%, P < 0.01) ( Table 2 ).
VFA could be performed in 94% of the participants while evaluation of the remaining scans was impossible due to severe arthritis and scoliosis in 1.2% and poor quality of the scans in the remaining cases. Vertebral bodies were less frequently visible in the upper part of the spine. Thus, T6-L4 and T8-L4 were visible in 48 and 95%, respectively ( Table 3 ). In all, 35 (6.3%) participants had at least one VFx comprising a total of 42 fractures consisting of 26 thoracic and 16 lumbar fractures. One participant had three fractures and five had two fractures. The fractures were most prevalent in the thoracolumbar junction and mid-thoracic spine (see the Supplementary data available in Age and Ageing online, Appendix S1). In all, 14.8–15.7% had osteoporosis and/or VFx depending on reference values used ( Table 2 ).
Participants with osteoporosis as defined by Danish reference values were of similar age as non-osteoporotic ( Table 3 ). In men aged 60–64, 65–69 and 70–74 years, the prevalence of osteoporosis was 6.6, 12.1 and 11.5%, respectively (P = 0.06). BMI was lower in men with osteoporosis, intake of alcohol was lower and smoking more prevalent.
Individuals with VFxs had lower BMD at all sites ( Table 3 ). In men aged 60–64, 65–69 and 70–74 years, the prevalence of VFxs was 2.8, 9.1 and 5.9%, respectively (NS).
The proportion of individuals with a family history of osteoporosis or hip fracture or a sedentary lifestyle was comparable in osteoporotic and non-osteoporotic as well as vertebral and non-VFx participants ( Table 3 ).
Data on VFA and BMD was available in 92% of the participants. Twenty-four per cent of those with a VFx had osteoporosis, whereas 1.5% had osteoporosis and a VFx.
The diagnostic utility of BMD measurements for detection of co-existing VFxs was independent of the reference values used (area under the curve: 0.571 and 0.566, respectively). The sensitivity of DXA using Danish and NHANESIII reference values and a T-score of ≤−2.5 to detect the presence of a concomitant VFx was the same (24%), whereas the specificity was 91 and 90%, respectively. Positive and negative predictive values for BMD using Danish reference values were 14 and 95% and the corresponding results for NHANESIII were 13 and 95%.
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