The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS)

Clark, Patricia; Cons-Molina, Fidencio; Delezé, Margarita; Ragi, S.; Haddock, L; Zanchetta, J. R.; Jaller, Juan José; Palermo, Lisa; Talavera, Juan O.; Messina, D.; Morales-Torres, Jorge; Salmerón, Jorge; Navarrete, Amaro; Suárez, Erick; Pérez, Cynthia M.; Cummings, Steven R.

doi:10.1007/s00198-008-0657-4

Cited by 148 publications

(126 citation statements)

References 14 publications

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“…The major finding of this study was that approximately one in four postmenopausal women in apparently good health, but with reduced SI, had sustained at least one vertebral fracture. In accordance with previous surveys, we found that the prevalence and the severity of vertebral fractures in such women increase steadily with age [4,7,10,13,24,27,31,35]. In addition, we found the presence of an undiagnosed osteoporotic vertebral fracture was an independent risk factor for inferior quality-of-life scores using the QUAL-EFFO tool.…”

Section: Discussionsupporting

confidence: 91%

“…In fact, in the European Vertebral Osteoporosis Study (EVOS), the prevalence of fractures in postmenopausal women aged 50 to 79 years, randomly recruited from the general population, varied from 12.0% to 20.2% according to the McCloskey and Eastell method, respectively, and from 11.1% to 20% according to geographic differences [27]. Also, Clark et al [4] in an agestratified random sample of women aged 50 years or older from South America found a prevalence increasing from 6.9% in women aged 50 to 59 years to 27.8% in those aged 80 years or older. This difference may be the result of the fact that the age of our study population was a minimum of 60 years and that the morphometric evaluation was carried out only on those women with a quantitative ultrasound t-score B À2.0 and therefore with a mild increase in fracture risk.…”

Section: Discussionmentioning

confidence: 99%

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Undiagnosed Vertebral Fractures Influence Quality of Life in Postmenopausal Women With Reduced Ultrasound Parameters

Nuti

Caffarelli

Guglielmi

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Osteoporosis, a multifactorial systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to increased bone fragility, is a worldwide public health problem. Vertebral fractures affect approximately 20% of postmenopausal women and are a hallmark of osteoporosis, but they may pass unnoticed, although they may lead to long-term immobility and disability. Questions/purposes The aims of the present study were (1) to determine the prevalence and the severity of vertebral fractures in a large cohort of Italian women aged 60 years or older with reduced values of quantitative ultrasound parameters; and (2) to assess whether vertebral fractures and other variables may be associated with health-related quality of life. Methods A total of 2450 women without back pain aged 60 years or older, after the completion of the Quality of Life Questionnaire of the European Foundation for Osteoporosis QUALEFFO, underwent quantitative ultrasound evaluation of the calcaneus; in those with a stiffness t-score of B À2 (n = 1194), radiographic evaluation of the thoracic and lumbar spine was carried out and then quantitative morphometry was performed by dedicated software (MorphoXpress). The radiographic analysis was carried out on 885 women who presented films of adequate quality. Multivariate regression was used to adjust for confounding variables. Results Of those who underwent radiographic analysis, 681 had no vertebral fractures, and 204 women (23.1%) had one or more previously undiagnosed vertebral fractures. The prevalence of previously undiagnosed vertebral fractures increased with advancing age with more than 30% of women older than 75 years having at least one fracture. Older age, body mass index, and severe vertebral fractures were independently associated with a worse total QUALEFFO score. Conclusions We found that approximately one in four women showed evidence of undiagnosed vertebral fractures, and there was a strong age effect trend. Moreover, the severity grade of vertebral fractures, more than the number of fractures, was associated with a worsening of healthrelated quality of life as assessed by QUALEFFO. These findings confirm the clinical relevance of an early diagnosis of vertebral fractures and seem to support the usefulness of quantitative ultrasound measurements in the stratification of postmenopausal women at increased fracture risk.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Undiagnosed Vertebral Fractures Influence Quality of Life in Postmenopausal Women With Reduced Ultrasound Parameters

Nuti

Caffarelli

Guglielmi

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Assuming that in Brazil 2/3 of this population has low bone mass or osteoporosis (17) and based on our data, a reasonable estimate projects an increase in the number of new vertebral fractures from 60,000 in 2013 to more than 188,000 in 2060.…”

Section: Discussionmentioning

confidence: 70%

Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial

Arantes

Gimeno

Chiang

et al. 2016

Arch. Endocrinol. Metab.

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Objective: Vertebral fracture is the most common osteoporotic fracture, affecting quality of life and increasing mortality. Epidemiological data on incidence of vertebral fracture are scarce in Brazil and throughout Latin America. Our aim was to determine vertebral fracture incidence and risk factors in a female Brazilian population. Subjects and methods: Postmenopausal women with low bone mass were studied from the Brazilian placebo group of Arzoxifene Generations Trial (n = 974), followed for up to 5 years. The primary endpoint was new vertebral fractures, detected by X-Ray. Experimental design defined two strata: A. Osteoporosis or previous vertebral fracture with osteopenia; B. Osteopenia without previous fracture. Previous fracture, T-score, ionized calcium, alkaline phosphatase, creatinine and glucose were analyzed at baseline. Crude and adjusted incidence rates of vertebral fractures were estimated and Poisson regression model was used. Results: Incidence rate was 7.7 (95% CI of 5.4 to 10.9) per 1,000 person-years (PY), increasing as a function of age. Women with new vertebral fractures had higher prevalence of previous nonvertebral fracture after menopause, were older and had lower lumbar spine (LS) T-score. Fracture risk increased by 46% for each unit reduction in LS T-score. Variables correlated with new vertebral fracture were age (p = 0.034), LS T-score, stratum A (p = 0.001 for both) and previous nonvertebral fracture after menopause (p = 0.019). In the final model, LS T-score was the strongest predictor. Conclusions: Incidence rate of vertebral fracture of 7.7 per 1,000 PY. Age and previous fractures were associated with new vertebral fracture, but LS T-score was the most important predictor. Arch Endocrinol Metab. 2016;60(1):54-9

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“…The Latin American Vertebral Osteoporosis Study (LAVOS) evaluated a randomized sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico (22). The preva lence of vertebral fractures as assessed by lateral Xrays of the lumbar and thoracic spine was 11.18%, and was similar in the five countries.…”

Section: Prevalence Of Osteoporosis In Brazilmentioning

confidence: 99%

The burden of osteoporosis in Brazil

Marinho

Guerra

Drummond³

et al. 2014

Arq Bras Endocrinol Metab

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Osteoporotic fractures impose severe physical, psychosocial, and financial burden both to the patient and the society. Studies on the prevalence of osteoporosis and fragility fractures in Brazil show a wide variation, due to differences in sample size, the population studied, and methodologies. Few studies have been conducted in Brazil about the cost-effectiveness analyses of different intervention options aimed at the diagnosis and treatment of osteoporosis. Investigation and treatment strategies based on cost-effectiveness and scientific evidence are essential in the preparation of public health policies with the ultimate goal of reducing the incidence of fractures and, consequently, the direct and indirect costs associated with them. This article reviews the Brazilian burden of osteoporosis in terms of the prevalence and fractures attributable to the disease, the costs related to the investigation and management, as well as the impact of osteoporosis on the population as a whole and on affected individuals. Arq Bras Endocrinol Metab. 2014;58(5):434-43Keywords Expenses; osteoporosis; Brazil RESUMOFraturas osteoporóticas impõem graves entraves físicos, psicossociais e financeiros, tanto para o paciente quanto para a sociedade. Estudos sobre a prevalência de osteoporose e fraturas por fragilidade no Brasil mostram uma grande variação, em decorrência das diferenças no tamanho das amostras, da população estudada e da metodologia empregada. Poucos estudos têm sido realizados no Brasil sobre a análise de custo-efetividade das diferentes opções de intervenção que visam ao diagnóstico e ao tratamento da osteoporose. Estratégias de investigação e de tratamento com base na relação custo-eficácia e evidências científicas são essenciais para a elaboração de políticas de saúde pública, com o objetivo final de reduzir a incidência de fraturas e, consequentemente, os custos diretos e indiretos associados a elas. Este artigo faz uma revisão sobre o ônus da osteoporose no Brasil em termos de prevalência e fraturas atribuí-veis à doença, de custos relacionados com a investigação, tratamento da osteoporose, bem como seu impacto na população como um todo e em indivíduos afetados. Arq Bras Endocrinol Metab.

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The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS)

Abstract: We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.

Cited by 148 publications

References 14 publications

Undiagnosed Vertebral Fractures Influence Quality of Life in Postmenopausal Women With Reduced Ultrasound Parameters

Undiagnosed Vertebral Fractures Influence Quality of Life in Postmenopausal Women With Reduced Ultrasound Parameters

Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial

The burden of osteoporosis in Brazil

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