Epidemiological Study On Osteoporotic Vertebral Fractures In Shanghai Residents Over 60 Years Old

Backgrounds:As China entering aging society,osteoporosis(OP)and osteoporotic fractures have become one of the major diseases that endanger thousands of the elderly.Among all the osteoporotic fractures,osteoporotic vertebral compression fractures(OVCFs)are the most common type.OVCFs are associated with decreased quality of life,increased risk of future fractures and mortality.Therefore,to study its epidemiology will provide important theoretical basis for prevention and treatment.Purposes:To investigate the epidemiology of osteoporotic vertebral compression fractures(OVCFs)in Shanghai residents,to analyze the risk factors for OVCFs and to evaluate the effectiveness of calcaneus quantitative ultrasound in screening for osteoporosis.Method:The study was a cross-sectional(including retrospective)investigation in Shanghai residents over 60 years old from August 2012 to June 2013.Through multi-stage stratified random sampling,five communities in Yangpu District were randomly selected as sample populations,and a total of 4671 residents over 60 years were recruited.Investigations included questionnaire(including general demographic information,personal habits,the living environment,physical conditions,bony status and fractures,medication history and knowledge of osteoporosis),quantitative ultrasound(QUS),lateral spinal radiographs and blood tests.Result:The standardized prevalence of OVCFs was 4.4%in Shanghai.The standardized prevalence was 2.8%in males and 5.9%in females.The prevalence of OVCFs increased with age.57.4%of vertebral fractures were first diagnosed in this study.The proportion in OVCFs with frequent low back pain,kyphosis and height loss>5 cm was 26.6%,35%,and 23.3%,respectively.The most common fracture sites were T12 and L1.Compared with DXA,the accuracy,sensitivity,and specificity of using QUS bone density T-value ?-2.5 to screen osteoporosis was 0.617,41.7%and 81.6%,respectively.Independent risk factors for OVCFs included:female,aging,QUS bone density T-value ?-2.5,at least one fall in the past year,history of non-vertebral fracture,height loss>5cm,kyphosis,menopause earlier than 45 years and persistent back pain.Good knowledge of osteoporosis was a protective factor.The prevalence of fall in Shanghai elderly residents was 13.8%.Independent risk factors for falls include women,ageing,drinking alcohol,living alone,slippery floor,slippery insoles,having obstacles indoor and outdoor,poor balance,poor hearing,rheumatoid arthritis,kyphosis,frequent hand and foot convulsions and previous non-vertebral fractures.Conclusion:Vertebral fractures were common in the elderly population in Shanghai.The prevalence of OVCFs was higher in women than in men and increased with age.Our results show that OVCFs is a highly silent disease.QUS bone density T-value?-2.5,falls,history of non-vertebral fractures,height loss>5 cm,kyphosis,persistent back pain and early menopause are important risk factors for OVCFs and can be used to screen for high-risk population.A good knowledge of osteoporosis can reduce the risk of OVCFs.Thus,we think screening for high-risk populations of OVCFs,raising people's awareness of osteoporosis and fall-related precautions can help prevent OVCFs.Fall-related precautions include treatment of rheumatoid arthritis,alcohol abstinence and balance training,wearing appropriate and non-slip shoes and insoles,timely clearing obstacles,anti-slip floor and living with children.Calcaneus quantitative ultrasound were effective in screening for osteoporosis.