The Value Of Vertebral Fracture Assessment In The Diagnosis Of Osteoporosis For Postmenopausal Women

Objective To explore influence of the vertebral fracture assessment by dual-energy Xray absorptiometry(DXA)on the diagnosis of vertebral fracture,osteoporosis and severe osteoporosis in postmenopausal women.Method A retrospective study was used to analyze the data of 499 postmenopausal women who is aged ? 50 yrs.The patients took the lateral image of thoracolumbar spine and the bone mineral density(BMD)test by DXA from March,2013 to March 2016 in our hospital.The vertebral fracture assessment was performed for the patients with VFA software.All the results of patients were recorded and analyzed statistically.The influence of vertebral fracture assessment on vertebral fracture rate,osteoporosis diagnostic rate and severe osteoporosis diagnostic rate was studied.The influences of BMD,age,menopausal duration and BMI on osteoporotic fracture were observed.Results The VFA results showed that: BMD combined with VFA improves the diagnosis of vertebral fracture increased by 41.1 percent,the diagnosis of fragility fracture increased by 35.3 percent,the diagnosis of osteoporosis increased by 6.3 percent and severe osteoporosis increased by 29.1 percent.comparing with the vertebral fracture whose mineral density did not reach the osteoporosis threshold value,the vertebral fracture rate increased significantly by 29.2 percent,which met the threshold for diagnosis of osteoporosis.The rates of vertebral fracture and severe osteoporosis in different groups of age and menopausal duration had significant differences.The rates of vertebral fracture and severe osteoporosis increased by 26.6 percent and 31.7 percent respectively in group of age ? 70 yrs,compared with the group of age between 60-69 yrs.The rates of vertebral fracture and severe osteoporosis increased by 15 percent and 19.9 percent respectively in the group of age between 60-69 yrs,compared with the group of age < 60 yrs.The rates of vertebral fracture and severe osteoporosis increased by 41.6 percent and 51.6 percent respectively in the group of age ? 70 yrs,compared with the group of age < 60 yrs.The rates of vertebral fracture and severe osteoporosis increased by 31.1 percent and 36.1 percent respectively in the group of menopausal duration ? 20 yrs,compared with the group of menopausal duration between 10-19 yrs.The rate of severe osteoporosis increased by 17.6 percent in the group of menopausal duration between 10-19 yrs,compared with the group of menopausal duration < 10 yrs.The rates of vertebral fracture and severe osteoporosis increased by 42.1 percent and 53.7 percent in the group of menopausal duration ? 20 yrs,compared with the group of menopausal duration < 10 yrs.The change of BMD and the osteoporosis morbidity in different groups of age and menopausal duration had statistical significance.BMD reduced along with the growing age,the prolonged menopausal duration and the reducing BMI.The osteoporosis rate increased by 16 percent in the group of age ? 70 yrs,compared with the group of age between 60-69 yrs.The osteoporotic morbidity increased by 17.1 percent in the group of age between 60-69 yrs,compared with the group of age < 60 yrs.The osteoporotic morbidity increased by 33.1 percent in the group of age ? 70 yrs,compared with the group of age < 60 yrs.The osteoporotic morbidity increased by 11.8% in the group of menopausal duration ? 20 yrs,compared with the group of menopausal duration between10-19 yrs.The osteoporotic morbidity increased by 23.4 percent in the group of menopausal duration between 10-19 yrs,compared with the group of menopausal duration < 10 yrs.The osteoporotic morbidity increased by 35.2 percent in the group of menopausal duration ? 20 yrs,compared with the group of menopausal duration < 10 yrs.The osteoporotic morbidity decreased by 13.5 percent in the group of BMI ? 24,compared with group of 18.5?BMI<24.The osteoporosis rate decreased by 21.9 percent in the group of BMI ? 24,compared with group of BMI < 18.5.Conclusion The BMD measurement combined with VFA for postmenopausal women at same time could significantly improve the diagnosis of vertebral fracture,osteoporosis and severe osteoporosis.The risks of fragility fractures increase with a lower BMD,a growing age,a longer menopausal duration.increasing osteoporotic morbidity and reducing BMD were positively related to age and menopausal duration.