Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Prevalence of Osteoporosis and Osteoporotic Fractures: A Population Based Survey Including Vertebral Fracture Assessment by Morphometry (VFA).

Euller-Ziegler1,  Liana E., Roux1,  Christian H., Breuil1,  Veronique, Dasilva1,  Virginie, Albert-Sabonnadiere1,  Christine, Grisot1,  Christian, Flory1,  Philippe

L'Archet Hospital, University of Nice, Nice, France
Labstic Santé, University of Nice, Nice, France

Prevalence studies on osteoporosis (OP) in the general population are scarce; vertebral fractures (VF) are frequently underdiagnosed.

Objectives:

To estimate the prevalence of low bone mineral density (BMD), osteoporotic fractures and risk factors in women aged 50 to 85 years.

Methods:

After random selection in the national insurance system regional database (French Alpes Maritimes area), a sample of women aged 50 to 85 years, representative of the general population, was evaluated: medical and risk factors questionnaires, bone densitometry (DXA / hip, femoral neck, spine), screening for vertebral fractures (VF) by high density morphometry (VFA, Hologic QDR4500, Genant scoring by 2 independent MD). Statistical analysis was performed using c2, ANOVA or Kruskall-Wallis test when appropriated.

Study granted by Ministry of Health and promoted by CHU of Nice (Academic Hospital of Nice, France).

Results:

519 women were evaluated, mean age 63.4± 8.8 years, BMI 25,4± 4,9 kg/m2, hip fracture in 1st degree relatives (15%), long term steroid treatment (9.4%), alcohol >= 3 units (3.7%), current smoking (2.7%), RA (0.8%), early menopause (14.6%), personal history of low energy clinical fracture after 50 years (15%), including non vertebral fractures 13.5%.

DXA demonstrated OP in 13.7% of the women (mean age 68 ± 9.4 years), osteopenia in 59% (63.8± 8.4 years).

The prevalence of VF by VFA was 29.7% (presence of >=1 VF Genant stage >=1), (18.1% with >=1 VF Genant stage >=2). The VF were scored Genant stage 1 (55.1%), stage 2 (39.3 %), stage 3 (5%), with a median number of 2 VF by woman (1 – 8). VF scored Genant stage >=1 were present in women classified by DXA as having osteoporosis (24%), but also osteopenia (61%), even normal BMD (15%) (and VF scored Genant stage >= 2 in respectively 27.7%, 58.5%, 13.8% of the women); conversely, 52% of women classified by DXA as having osteoporosis, 30.7% osteopenia and 16.2% normal BMD had VF Genant stage >=1 (and 36.6%, 18% & 9.1% had VF Genant stage >= 2).

The overall prevalence of osteoporotic fractures was 37.4% (VF and/or non vertebral fracture), mean age 67.3 ± 8.9 years, classified by DXA as osteoporosis (20.6%), osteopenia (61.3%), normal (18%).

Correlations: T-score decrease (global status and at each site) was linked with age (p=0.001) and BMI (p=0.001); the presence of fracture was linked with age (p<0.001), T-score (p<0.001) (globally and for VF), BMI (globally). Fractures were more frequent in subjects with a personal history of prior fracture (p<0.001, globally and for VF), without significant link with other risk factors.

Discussion:

Methological issues of prevalence studies on OP are well known. The partnership with the national insurance system allowed us to analyse a representative sample of the general population. VFA, delivering a lower dose of radiation than XRays and well accepted by our subjects, allowed easier VF detection (according to Genant stages >=1 & >=2) and therefore VF prevalence analysis.

Conclusion:

This study brings new data emphasizing the public health dimension of osteoporosis and the high frequency of undiagnosed vertebral fractures in the general population, even in women with osteopenia or normal BMD.

To cite this abstract, please use the following information:
Euller-Ziegler, Liana E., Roux, Christian H., Breuil, Veronique, Dasilva, Virginie, Albert-Sabonnadiere, Christine, Grisot, Christian, et al; Prevalence of Osteoporosis and Osteoporotic Fractures: A Population Based Survey Including Vertebral Fracture Assessment by Morphometry (VFA). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :976
DOI: 10.1002/art.28743

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