The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS).
In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology.


BACKGROUND
We report the first study of radiographic vertebral fractures in Latin America.


METHODS
An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent.


RESULTS
A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses


CONCLUSIONS
We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.
Clark
P
P
Clinical Epidemiology Unit, CMN Siglo XXI, IMSS Faculty of Medicine UNAM, Lomas de Chapultepec, DF, Mexico City, Mexico. patriciaclark@prodigy.net.mx
Cons-Molina
F
F
Deleze
M
M
Ragi
S
S
Haddock
L
L
Zanchetta
J R
JR
Jaller
J J
JJ
Palermo
L
L
Talavera
J O
JO
Messina
D O
DO
Morales-Torres
J
J
Salmeron
J
J
Navarrete
A
A
Suarez
E
E
Pérez
C M
CM
Cummings
S R
SR
D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D001827:Body Height; D001938:Brazil / Q000453:epidemiology; D003105:Colombia / Q000453:epidemiology; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*