Risk Factors for Osteoporotic Vertebral Fractures in Postmenopausal Women: A Cross-Sectional Study

Underdiagnosed osteoporotic vertebral fractures are a major cause of morbidity in postmenopausal women. For prompt intervention and prevention, early detection of clinical, metabolic, and densitometric risk factors is essential. The purpose of this study was to ascertain the frequency of vertebral fractures and the risk factors that are linked to them in a group of postmenopausal women.

220 postmenopausal women participated in a cross-sectional study conducted in a hospital. We gathered information on body mass index (BMI), previous fragility fractures, lifestyle factors, demographics, reproductive history, and serum vitamin D levels. Dual-energy X-ray absorptiometry was used to measure the bone mineral density (BMD) at the femoral neck and lumbar spine. Lateral thoracolumbar radiographs were used to assess vertebral fractures, which were then graded using a standardized semiquantitative method. Women with and without vertebral fractures were compared, and independent predictors were found using multivariate logistic regression.

The participants' average age was 61.8 ± 8.4 years. 76 women (34.5%) had vertebral fractures, which were classified as mild in 15.5%, moderate in 11.8%, and severe in 7.3%. 44.5% had osteoporosis of the lumbar spine. Significantly older, longer postmenopausal duration, lower BMI, lower lumbar spine T-scores, higher rates of vitamin D deficiency, increased physical inactivity, and more frequent fragility fractures were all present in women with vertebral fractures (all P < 0.01). Age ≥65 years, time since menopause ≥15 years, BMI <20 kg/m2, lumbar spine osteoporosis, vitamin D deficiency, and previous fragility fractures were found to be independent predictors of vertebral fractures by multivariate analysis.

Osteoporotic vertebral fractures are common in postmenopausal women and are closely associated with advanced age, prolonged menopause, low BMI, decreased lumbar spine BMD, vitamin D deficiency, and prior fragility fractures. A thorough evaluation of risk factors beyond BMD is necessary for early detection and preventive measures.