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The prevalence of and risk factors for radiographic vertebral fractures in older Indian women and men: Delhi Vertebral Osteoporosis Study (DeVOS)

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Abstract

Summary

High prevalence of vertebral fractures (17.9 % over all; 18.8 % male and 17.1 % female) was observed in 808 free-living residents of Delhi, India, aged more than 50 years. The prevalence rates were comparable to that reported in Caucasian populations. While there was an increase in fracture prevalence with age in females, the same was not observed in males.

Introduction

The aim of this paper is to study the prevalence of and risk factors for morphometric vertebral fractures in elderly Indian men and women over 50 years of age.

Methods

We recruited 808 healthy subjects aged 50 years or more, residing in three residential colonies in Delhi, India who voluntarily agreed to participate in this study. All subjects underwent lateral X-rays of the lumbar and thoracic spine according to a standardized protocol. All X-rays were blindly evaluated by a single trained person using an advanced semi-automated software (Optasia Medical) based on Genant’s semiquantitative method. Recruited subjects underwent anthropometric, biochemical, and hormonal evaluation.

Results

With a mean age of 64.9 (±6.7) years, 345 males and 415 females were evaluated. Vertebral fractures were present in 17.9 % (95 % CI 15.2, 20.6) subjects [males, 18.8 % (95 % CI 14.6, 23), females 17.1 % (95 % CI 13.5, 20.8)]. Prevalence of vertebral fractures increased with age in females from 14.7 % in 50–59 years age group to 22.4 % in those ≥70 years, but not in men. Overweight subjects had significantly lower risk [OR, 0.63 (95 % CI 0.41, 0.97), p = 0.035] of vertebral fractures. Serum 25 hydroxyvitamin D levels, intake of calcium and vitamin D, or history of previous fractures were not statistically different between patients with or without prevalent vertebral fractures.

Conclusions

The prevalence of vertebral fractures among older Indians was comparable to that reported in Caucasian populations. Prevalence of vertebral fractures increased with age in females, but not in males. Overweight individuals were protected against vertebral fractures.

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Acknowledgments

The study was supported in part by research grants from the Institute of Nuclear Medicine and Allied Sciences (INMAS), New Delhi. We also acknowledge the valuable assistance provided by Brig. Satish Kukreja (Retd), Honorary CEO, Indian Society for Bone and Mineral Research in executing the study. We would like to acknowledge the assistance provided by the following research staff: Madan Prasad, Abhishek Kaushik, and Meeta Rautela. Finally, we would like to thank the office bearers of the participating Residence Welfare Associations and the volunteers.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, 110054, India

    Raman K. Marwaha & Kuntal Bhadra

  2. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India

    Nikhil Tandon & Yashdeep Gupta

  3. Dr B.R. Sur Homoeopathic Medical College Hospital& Research Centre, Moti Bagh, New Delhi, 110021, India

    Archana Narang

  4. Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India

    Kalaivani Mani

  5. Division of Endocrinology and Diabetes, Medanta Medicity, Gurgaon, Delhi NCR, India

    Ambrish Mithal

  6. Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Illinois, Chicago, IL, USA

    Subhash Kukreja

Authors
  1. Raman K. Marwaha
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  2. Nikhil Tandon
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  3. Yashdeep Gupta
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  4. Kuntal Bhadra
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  5. Archana Narang
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  6. Kalaivani Mani
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  7. Ambrish Mithal
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  8. Subhash Kukreja
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Corresponding author

Correspondence to Subhash Kukreja.

Additional information

Raman K. Marwaha and Nikhil Tandon contributed equally to this paper.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM Table 1

Risk factors for vertebral fracture (males; doc 50 kb)

ESM Table 2

Risk factors for vertebral fracture (females; doc 50 kb)

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Marwaha, R.K., Tandon, N., Gupta, Y. et al. The prevalence of and risk factors for radiographic vertebral fractures in older Indian women and men: Delhi Vertebral Osteoporosis Study (DeVOS). Arch Osteoporos 7, 201–207 (2012). https://doi.org/10.1007/s11657-012-0098-8

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  • DOI: https://doi.org/10.1007/s11657-012-0098-8

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