Cross-sectional associations between prevalent vertebral fracture and pulmonary function. The sixth Tromso Study

Persons with vertebral fracture may have reduced pulmonary function, but this association has not been much studied. The aim of this cross-sectional study was therefore to examine the relationship between vertebral fracture and pulmonary function in a general, elderly population. Vertebral morphometry was used for vertebral fracture assessment in 2132 elderly men (n = 892) and women (n = 1240) aged 55 to 87 years in the population-based Tromsø Study 2007–08. Pulmonary function was examined by spirometry. Pulmonary function was expressed as FVC% predicted, FEV1% predicted, and FEV1/FVC% predicted values, adjusted FVC, FEV1, and FEV1/FVC, and obstructive and restrictive ventilatory impairment. Vertebral fracture was classified according to appearance, number, severity, and location of fractures. Associations were analyzed using general linear and logistic models. FVC% predicted and FEV1% predicted values were not associated with vertebral fracture (P > 0.05), whereas FEV1/FVC% predicted ratio was associated with both prevalent fracture, number of fractures, severity of fractures, and fracture site in men (P < 0.05), but not in women. When FVC, FEV1, and FEV1/FVC values were adjusted for multiple covariates, we found no significant association with vertebral fracture. Obstructive and restrictive ventilatory impairment was not associated with prevalent vertebral fracture. In conclusion, this study did not confirm any clinically relevant associations between prevalent vertebral fracture and ventilatory impairment in elderly individuals

Vertebral fractures: Prevalence, risk factors, and health-related quality of life. A cross-sectional study The Tromsø study 2007/2008

Summary Background: Osteoporotic fractures constitute a major health burden in western societies. Forearm, vertebral-, and hip fractures are the most common types. Norway has the highest reported prevalence of forearm- and hip fractures. Little data has been available concerning vertebral fractures, although these, together with the hip fractures, are associated with increased morbidity and mortality. The aim of this thesis was to describe the prevalence of vertebral fractures in a general population, and to study important, associated risk factors and health-related quality of life. Material and method: Information on prevalent vertebral fractures was ascertained by a vertebral fracture assessment (VFA) method (dual-energy X-ray absorptiometry (DXA), GE Lunar Prodigy) in 2887 women and men, mean age 65.4, in the population-based Tromsø Study 2007-08. Bone mineral density (BMD; g/cm²) was measured at the hip by DXA. Demographic factors, lifestyle, and health-related quality of life information was collected by questionnaires. To explore associations, we used logistic and multiple regression analyses. Results: Vertebral fractures were found with an equal distribution of 12 % in women and 14 % in men, most common between 1st lumbar and 6th thoracic vertebra. In both sexes, the number of vertebral fractures increased with increasing age and declining BMD. Population attributable risk fraction for these two factors was 46% in women and 33% in men. Self-reported health-related quality of life was reduced in women with vertebral fractures compared to those without. In men there was no difference, indicating that prevalent vertebral fractures does not necessarily have an impact on men’s self-perceived health. Conclusions: The prevalence of vertebral fractures in this population was lower than expected. Men had similar fracture rates as women, but less bothered. These findings deserve a longitudinal follow-up

Vertebral fractures and self-perceived health in elderly women and men in a population-based cross-sectional study: the Tromsø Study 2007-08

Health-related quality of life (HRQL) may be associated with increased mortality in the elderly. The effect of prevalent vertebral fractures on HRQL in elderly women and men is not well described. The purpose of this study was to examine the association between prevalent vertebral fractures and back pain, neck pain, and HRQL in elderly women and men, and to study possible gender differences in the reported pain and HRQL. Information on prevalent vertebral fractures was ascertained by a vertebral fracture assessment (VFA) method (dual-energy X-ray absorptiometry (DXA), GE Lunar Prodigy) in 2887 women and men, mean age 65.4 (SD 9.4) who participated in the population-based Tromsø Study which was conducted in 2007–08. Bone mineral density (BMD; g/cm2) was measured by DXA at the femoral sites. Self-reported HRQL was assessed using the standardized measures EQ-5D-3 L and EQ VAS from the EuroQol Group. Lifestyle information was collected by questionnaires. The association between vertebral fractures and pain was analyzed using logistic regression, between vertebral fractures and EQ-5D-3 L and EQ VAS scores by multiple regression analyses. In women, presence of vertebral fractures was associated with an increased risk of back pain with an OR of 1.76 (95% CI: 1.24 – 2.50) after adjustments for age, height, weight, and BMD. Women with vertebral fractures had lower EQ-5D-3 L scores (p < 0.001) than women without vertebral fractures, also after adjustments. These associations were not present in men. Type of fracture was not associated with EQ-5D-3 L scores, but increasing numbers (p < 0.001) and severity of fractures (p < 0.002) were associated with decreasing EQ-5D-3 L score in women. Prevalent vertebral fractures are associated with increased risk of back pain and reduced HRQL in postmenopausal women, but not in men