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

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.