Evaluation of the risk factors of asymptomatic vertebral fractures in postmenopausal women with osteopenia at the femoral neck

• A high incidence of asymptomatic vertebral fracture was found in osteopenic postmenopausal women.
• The number of fractures correlated with a higher risk of estimated major osteoporotic and hip fractures.
• Prior fragility fractures are associated with the presence of asymptomatic vertebral fractures.
• Height loss was a predictor of asymptomatic vertebral fracture in this population, and is easily measured.

ObjectivesTo identify risk factors of asymptomatic vertebral fracture (aVF) in postmenopausal women with osteopenia at the femoral neck and to evaluate the association between the number of aVFs and the risk of major and hip osteoporotic fracture calculated with the FRAX® algorithm.Study designEpidemiological case-series study with data collected transversally.Results728 postmenopausal women with osteopenia were included: 284 (39.0%) had aVF, of whom 200 (70.4%) had prior fragility fractures (FF). The likelihood of having an osteoporotic fracture in the next 10 years increased significantly with the number of aVF. The percentage of women with height loss, which was assessed as the difference between the greatest height reported by participants and that measured at inclusion, was higher in women with an aVF (OR 3.77, 95% CI 2.75–5.16, p < 0.05). Multivariate analysis showed that prior FF, height loss and race were factors associated with the presence of aVF.ConclusionsIn this group of postmenopausal women with osteopenia at the femoral neck, the presence of an aVF correlated with a higher risk of estimated major osteoporotic and hip fractures as calculated using the FRAX® algorithm. Height loss and prior FF were associated with the presence of aVF.