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Vertebral fracture assessment in healthy men: prevalence and risk factors
A El Maghraoui1, A Mounach, S Gassim
1Rheumatology and Physical Rehabilitation Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco. abdellahe@menara.ma
Introduction:
Vertebral fracture assessment (VFA) is a technology that can reliably and accurately diagnose vertebral fractures with greater patient convenience, less radiation exposure, and lower cost than standard spine radiography.
Objective:
To study prevalence and risk factors of vertebral fractures using VFA in healthy men.
Methods:
The study cohort consists of a population of 216 healthy men aged between 50 and 79 (mean age, weight and BMI of 63.8 years, 73.3 kg and 25.7 kg/m2, respectively). Lateral VFA images and scans of the lumbar spine and proximal femur were obtained by two technologists using a GE Healthcare Lunar Prodigy densitometer. Vertebral fractures were defined using a combination of Genant semiquantitative (SQ) approach and morphometry.
Results:
Ninety-three percent of vertebrae from T4-L4 and 98% from T8-L4 were adequately visualized on VFA. Vertebral fractures were detected in 29.6% (64/216) of these men: 34/216 (15.7%) had grade 1 and 30/216 (13.8%) had grades 2 or 3. Twenty one of men with VFA-identified fracture (32.8%) had only a single vertebral fracture, while the other 67.2% had two or more. Fractures were most common in the mid-thoracic spine and at the thoraco-lumbar junction. As would be expected, the prevalence of VFA-detected fractures increased with age and as BMD declined. This group of men had a statistically significant lower weight, height, calcium consumption and T-score than those without a VFA-identified vertebral fracture. Regression analysis showed that presence of vertebral fracture was mainly related to the osteoporotic status (OR: 9.0; 95% CI: 3.5-22.8).
Conclusion:
VFA allows evaluation of the majority of vertebral bodies in men. Vertebral fractures are common in healthy men and are related to low BMD.
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