Prevalence and incidence of osteoporotic vertebral fractures in community-dwelling European older adults: an observational analysis of the DO-HEALTH trial.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Osteoporosis International Pub Date : 2025-06-01 Epub Date: 2025-04-25 DOI:10.1007/s00198-025-07489-y

Andreas P Albrecht, Melanie Kistler-Fischbacher, Caroline De Godoi Rezende Costa Molino, Gabriele Armbrecht, Gregor Freystaetter, Robert Theiler, Reto W Kressig, Jose A P Da Silva, René Rizzoli, Guido A Wanner, Andreas Egli, Bess Dawson-Hughes, Heike A Bischoff-Ferrari

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引用次数: 0

Abstract

We examined vertebral fracture (VF) prevalence, incidence, and treatment among 1488 older adults. VF prevalence and incidence were higher in women, older participants, and those with low bone density. In addition to VFs being underdiagnosed (only 20.7% of VFs clinically recognized), treatment rates were low, underscoring the need for improved screening and management.

Purpose: To estimate prevalence and incidence of osteoporotic VFs and VF progressions overall and by sex, age, and bone status and to describe the proportion of participants with VFs in reporting osteoporosis (OP) medication use.

Methods: This observational analysis of the DO-HEALTH trial, a three-year, randomized, controlled trial among community-dwelling adults age ≥ 70 years, includes a subsample of participants recruited at four study sites equipped with DXA machines. Prevalence and incidence rates (IR) of VFs and VF progressions were described overall and by subgroups of sex, age, and bone status. Incidence of VFs which were clinically recognized was also estimated. Further, we estimated the proportion of participants on OP medication.

Results: A total of 1488 participants were included (mean age 74.9 years, 63.1% women, 77.0% had osteopenia or osteoporosis). One hundred forty-four (9.7%) participants had at least one radiographic VF at baseline and of those 19.4% participants reported OP medication use. Over the three-year follow-up, 50 participants sustained 58 new radiographic VFs (IR 1.4, 95% CI 1.1, 1.9). Of the 58 radiographic VFs, only 12 (20.7%) were clinically recognized. Furthermore, 31 participants sustained 35 VF progressions (N = 157; IR 7.7, 95% CI 5.5, 10.7). Prevalence and incidence were significantly higher in women, in older participants and those with osteopenia or osteoporosis compared to those with normal bone density.

Conclusions: This study suggests a high prevalence and incidence of VFs in community-dwelling European older adults. Underdiagnosis may be even more prevalent than previously observed, and treatment rates were low.

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欧洲社区老年人骨质疏松性椎体骨折的患病率和发病率：DO-HEALTH试验的观察性分析

我们调查了1488名老年人椎体骨折（VF）的患病率、发病率和治疗情况。VF的患病率和发病率在女性、老年人和骨密度低的人群中较高。除了VFs未被充分诊断（只有20.7%的VFs被临床识别），治疗率也很低，强调了改进筛查和管理的必要性。目的：估计骨质疏松性室性房颤的患病率和发病率以及总体、性别、年龄和骨骼状况的室性房颤进展情况，并描述报告骨质疏松症（OP）药物使用的室性房颤参与者的比例。方法：对DO-HEALTH试验进行观察性分析，这是一项为期三年的随机对照试验，在社区居住的年龄≥70岁的成年人中进行，包括在四个配备DXA机器的研究地点招募的参与者的子样本。VFs的患病率和发病率（IR）以及VF的进展情况进行了总体描述，并按性别、年龄和骨骼状况进行了亚组描述。并对临床确认的室性心动过速发生率进行了估计。进一步，我们估计了OP药物治疗参与者的比例。结果：共纳入1488名参与者（平均年龄74.9岁，63.1%为女性，77.0%为骨质减少或骨质疏松症）。144名（9.7%）参与者在基线时至少有一次影像学VF，其中19.4%的参与者报告使用了OP药物。在三年的随访中，50名参与者出现了58个新的影像学VFs （IR 1.4, 95% CI 1.1, 1.9）。在58个影像学VFs中，只有12个（20.7%）被临床识别。此外，31名参与者持续35次VF进展(N = 157；Ir 7.7, 95% ci 5.5, 10.7)。与骨密度正常的人相比，女性、老年参与者和骨质疏松症患者的患病率和发病率明显更高。结论：这项研究表明，在欧洲社区居住的老年人中，室性室性疾病的患病率和发病率很高。诊断不足可能比以前观察到的更为普遍，而且治疗率很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.