Asymptomatic morphometric vertebral fractures and its associated factors: A cross-sectional study among adults in a selected urban area in Selangor, Malaysia

PLoS One. 2021 Jul 22;16(7):e0255069. doi: 10.1371/journal.pone.0255069. eCollection 2021.

Abstract

Objective: This study aimed to determine the prevalence of vertebral fractures (VF) in a selected urban population in Malaysia and to explore possible variables associated with VF in the study population.

Methods: A cross-sectional study involving community-living, healthy subjects aged between 45-90 years from the state of Selangor, Malaysia, were invited to attend a bone health check-up. Subjects with diseases known to affect bone metabolism or were on treatment for osteoporosis (OP) were excluded. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Lateral and antero-posterior view lumbar spine x-rays were performed and VF was determined by the semi-quantitative Genant method.

Results: A total of 386 subjects were studied. Asymptomatic morphometric VF were found in 44 (11.4%) subjects. T12 was the most common vertebrae to be fractured. The prevalence of VF was significantly higher in menopausal women (12.4%) compared to non-menopausal women, in those above the age of 60 (18.5%), in those of Chinese ethnicity (16.5%), in those with a low body fat percentage (17.1%) and among those with OP (27.0%). The mean (standard deviation) 25-hydroxyvitamin D [25(OH)D] levels were significantly higher in those with VF compared to those without VF, 67.64 (23.50) and 57.47 (21.71) nmol/L, respectively. However, after multiple regression analysis, age over 60 years and OP on DXA BMD measurement were the only significant associated factors for VF.

Conclusion: Overall, 11.4% of a selected Malaysian urban population had asymptomatic morphometric VF. Age over 60 years and OP on DXA BMD measurement, but not 25(OH)D levels, were associated with VF.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Density*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Malaysia / epidemiology
  • Male
  • Middle Aged
  • Osteoporosis* / diagnostic imaging
  • Osteoporosis* / epidemiology
  • Osteoporosis* / metabolism
  • Osteoporotic Fractures* / diagnostic imaging
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / metabolism
  • Prevalence
  • Risk Factors
  • Spinal Fractures* / diagnostic imaging
  • Spinal Fractures* / epidemiology
  • Spinal Fractures* / metabolism

Grants and funding

This project was funded by a grant from the Ministry of Education, Malaysia (FRGS/1/2015/SKK03/UPM/02/1) awarded to SCT. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.