Table 3.
Associations between VF identified using VFA and fracture risk in older women
|
No VF n = 2163 |
Any VF n = 689 |
Grade 1 VF n = 260 |
Grade 2 VF n = 216 |
Grade 3 VF n = 213 |
1 VF n = 481 |
2 VF n = 141 |
≥ 3 VF n = 67 |
|
|---|---|---|---|---|---|---|---|---|
| MOF | ||||||||
| No. (%) | 273 (12.6) | 149 (21.6) | 47 (18.1) | 44 (20.4) | 58 (27.2) | 97 (20.2) | 33 (23.4) | 19 (28.4) |
| Rate per 1000 person-years | 26.7 | 48.1 | 38.9 | 44.7 | 63.7 | 44.3 | 51.7 | 69.2 |
| Time at risk, median (Q3-Q1), years | 4.80 (1.83) | 4.92 (1.79) | 5.10 (1.53) | 4.90 (1.97) | 4.78 (1.89) | 4.93 (1.83) | 4.82 (1.70) | 4.83 (2.42) |
| HR (95% CI) | ||||||||
| Adjusted for age, height, weight | 1 (Reference) | 1.78 (1.46–2.18) | 1.44 (1.05–1.96) | 1.65 (1.20–2.66) | 2.38 (1.79–3.17) | 1.65 (1.31–2.08) | 1.91 (1.33–2.74) | 2.58 (1.62–4.12) |
| + clinical risk factors | 1 (Reference) | 1.65 (1.34–2.02) | 1.40 (1.03–1.91) | 1.54 (1.12–2.13) | 2.03 (1.51–2.73) | 1.56 (1.23–1.97) | 1.75 (1.21–2.52) | 2.09 (1.30–3.37) |
| + FN BMD | 1 (Reference) | 1.52 (1.24–1.87) | 1.33 (0.97–1.81) | 1.41 (1.02–1.94) | 1.82 (1.35–2.44) | 1.46 (1.16–1.85) | 1.58 (1.10–2.28) | 1.79 (1.11–2.90) |
| VF (clinical) | ||||||||
| No. (%) | 83 (3.8) | 77 (11.2) | 18 (6.9) | 25 (11.6) | 34 (16.0) | 47 (9.8) | 14 (9.9) | 16 (23.9) |
| Rate per 1000 person-years | 7.8 | 23.4 | 14.0 | 24.0 | 35.1 | 20.2 | 20.5 | 56.8 |
| Time at risk, median (Q3-Q1), years | 4.96 (1.71) | 5.13 (1.61) | 5.18 (1.22) | 5.15 (1.67) | 4.94 (1.82) | 5.15 (1.59) | 5.14 (1.56) | 4.92 (1.99) |
| HR (95% CI) | ||||||||
| Adjusted for age, height, weight | 1 (Reference) | 2.88 (2.11–3.93) | 1.74 (1.05–2.90) | 2.92 (1.86–4.56) | 4.15 (2.77–6.22) | 2.51 (1.76–3.60) | 2.42 (1.37–4.26) | 6.70 (3.89–11.53) |
| + clinical risk factors | 1 (Reference) | 2.75 (2.01–3.77) | 1.72 (1.03–2.86) | 2.90 (1.84–4.56) | 3.89 (2.55–5.93) | 2.47 (1.72–3.55) | 2.32 (1.30–4.13) | 6.35 (3.60–11.21) |
| + FN BMD | 1 (Reference) | 2.61 (1.90–3.58) | 1.65 (0.99–2.75) | 2.71 (1.72–4.26) | 3.64 (2.38–5.56) | 2.36 (1.64–3.39) | 2.19 (1.23–3.90) | 5.79 (3.26–10.28) |
| Hip | ||||||||
| No. (%) | 81 (3.7) | 43 (6.2) | 12 (4.6) | 9 (4.2) | 22 (10.3) | 25 (5.2) | 13 (9.2) | 5 (7.5) |
| Rate per 1000 person-years | 7.5 | 12.5 | 9.1 | 8.2 | 21.4 | 10.4 | 18.6 | 15.3 |
| Time at risk, median (Q3-Q1), years | 4.99 (1.69) | 5.19 (1.38) | 5.25 (1.17) | 5.27 (1.39) | 5.05 (1.62) | 5.21 (1.36) | 5.14 (1.45) | 5.16 (1.67) |
| HR (95% CI) | ||||||||
| Adjusted for age, height, weight | 1 (Reference) | 1.67 (1.15–2.42) | 1.18 (0.64–2.16) | 1.07 (0.54–2.13) | 3.08 (1.91–4.98) | 1.37 (0.87–2.15) | 2.58 (1.43–4.65) | 2.09 (0.84–5.19) |
| + clinical risk factors | 1 (Reference) | 1.53 (1.05–2.22) | 1.16 (0.63–2.14) | 1.03 (0.51–2.05) | 2.58 (1.57–4.22) | 1.31 (0.83–2.06) | 2.41 (1.33–4.37) | 1.64 (0.65–4.12) |
| + FN BMD | 1 (Reference) | 1.34 (0.92–1.95) | 1.07 (0.58–1.97) | 0.90 (0.45–1.80) | 2.12 (1.29–3.48) | 1.19 (0.76–1.87) | 2.08 (1.15–3.77) | 1.24 (0.49–3.16) |
| Death | ||||||||
| No. (%) | 165 (7.6) | 64 (9.3) | 22 (8.5) | 13 (6.0) | 29 (13.6) | 40 (8.3) | 13 (9.2) | 11 (16.4) |
| Rate per 1000 person-years | 15.1 | 18.1 | 16.4 | 11.6 | 27.1 | 16.1 | 18.0 | 33.1 |
| Time at risk, median (Q3-Q1), years | 5.10 (1.66) | 5.24 (1.29) | 5.26 (1.10) | 5.32 (1.29) | 5.17 (1.52) | 5.26 (1.26) | 5.18 (1.26) | 5.18 (1.36) |
| HR (95% CI) | ||||||||
| Adjusted for age, height, weight | 1 (Reference) | 1.15 (0.86–1.53) | 1.06 (0.68–1.65) | 0.72 (0.41–1.27) | 1.72 (1.15–2.56) | 1.02 (0.72–1.45) | 1.16 (0.66–2.04) | 2.01 (1.09–3.72) |
| + clinical risk factors | 1 (Reference) | 1.21 (0.90–1.62) | 1.10 (0.70–1.71) | 0.77 (0.43–1.35) | 1.88 (1.25–2.84) | 1.09 (0.77–1.55) | 1.27 (0.72–2.24) | 2.09 (1.11–3.91) |
| + FN BMD | 1 (Reference) | 1.16 (0.86–1.55) | 1.07 (0.68–1.67) | 0.73 (0.41–1.28) | 1.78 (1.18–2.70) | 1.05 (0.74–1.49) | 1.21 (0.69–2.15) | 1.91 (1.02–3.60) |
Associations were examined using an extension of the Poisson regression model. Hazard ratios (HR) and 95% confidence intervals (CI) are presented. Model 1: adjusted for age, height and weight. Model 2: adjusted for age, height, weight, and the clinical risk factors used in FRAX (self-reported previous fracture, family history of hip fracture, current smoking, oral glucocorticoid use, rheumatoid arthritis, excessive alcohol intake, secondary osteoporosis) except FN BMD. Model 3: adjusted for the same as model 2 with the addition of FN BMD
VF vertebral fracture, VFA vertebral fracture assessment, FN femoral neck, BMD bone mineral density, MOF major osteoporotic fracture, Q quartile