Prevalence and clinical risk factors for morphometric vertebral fractures in older subjects in KwaZulu-Natal

Abstract

There are limited data on vertebral fractures (VFs) in South Africa (SA). Therefore a study was undertaken to compare the demographic profile, clinical risk factors and bone mineral density (BMD) in subjects aged 60 years and over with and without morphometric VFs. Patients and methods: In a descriptive case-controlled study, demographic data, clinical risk factors (CRF) and BMD were collected. Morphometric VFs were identified using the semi-quantitative Genant method. Descriptive analysis was undertaken using Student's t-test, the Mann-Whitney U-test and the chi-square test. Results: In the 197 subjects enrolled, the median age was 72.0 years (IQR 67.0-78.5 years) and morphometric VFs were identified in 41 subjects (20.8%). The prevalence of VFs increased with age, and while more common in women compared with men (23.8% vs. 13.0%), this was not significant (p 0.095). There was no difference in the prevalence of VFs between African and Indian subjects (23.4% vs. 17.4%; p 0.240), nor CRFs between subjects with and without VFs. Subjects with a VF had a significantly lower BMD at the spine (p = 0.020), but not at the neck of femur and total hip. Conclusion: This study highlights the need for adequate screening and management protocols for osteoporosis in all ethnic groups in SA.

Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes

“…In a study of 197 study volunteers >60 years of age living in Durban, South Africa, 20.8% had morphometric vertebral fractures on thoraco‐lumbar radiographs. There was no statistical difference in fracture prevalence between Black and Indian subjects in that study 85 . In a cohort of 430 postmenopausal women living in Kinshasa, Democratic Republic of Congo, who complained of back pain, vertebral fractures were diagnosed in 11% of the thoraco‐lumbar vertebrae; the prevalence of fractures rose with age 86 .…”

“…There was no statistical difference in fracture prevalence between Black and Indian subjects in that study. 85 In a cohort of 430 postmenopausal women living in Kinshasa, Democratic Republic of Congo, who complained of back pain, vertebral fractures were diagnosed in 11% of the thoraco-lumbar vertebrae; the prevalence of fractures rose with age. 86 In the Gambia, a cross-sectional study of 488 healthy men and women >40 years of age from Kiang West were found to have a prevalence of 9% moderate or severe vertebral fractures on DXA.…”