Relationship between historical height loss and vertebral fractures in postmenopausal women.
The aim of this study was to evaluate the relationship between historical height loss (HHL) and prevalent vertebral fractures (VF) in postmenopausal Moroccan women and to estimate its accuracy as a clinical test for detecting VF. Two hundred eighty-eight postmenopausal women were studied. All subjects had bone density measurements and spinal radiographs. Vertebral bodies (T4-L4) were graded using the semi-quantitative method of Genant. HHL was calculated as the difference between a patient's tallest recalled height and the current measured height. The mean age was 58.4 +/- 7.8 years. Thirty-one percent of patients were osteoporotic, and 46.5% had VF. Patients with VF had lost more height than those without VF (median, 2.0 cm (0.26-3.3) vs 0.96 cm (0.33-2.4), p < 0.05). In univariate analysis, HHL was positively correlated to both number and grade of prevalent VF (p < 0.05). The area under the receiver operating characteristics curve for the ability of HHL to detect VF was 0.60 (95% confidence interval (CI), 0.52, 0.69). Our HHL threshold for detecting VF was >1.5 cm, its sensitivity was 58%, and its specificity was 61%. The positive predictive value was 53%, and the negative predictive value was 65%. With HHL >1.5 cm, positive likelihood ratio was 1.49 with 95% CI, 1.07, 2.06. Our results demonstrate significant positive associations between HHL, VF, number of VF, and grade of VF. However, this relationship is not clinically pertinent. Consequently, HHL cannot be used as a reliable clinical test for detecting VF in postmenopausal Moroccan women.
Bennani
Loubna
L
Laboratory of Information and Research on Bone Diseases, Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Rabat, Morocco. loubnabennani29@yahoo.fr
Allali
Fadoua
F
Rostom
Samira
S
Hmamouchi
Ihsane
I
Khazzani
Hamza
H
El Mansouri
Laila
L
Ichchou
Linda
L
Abourazzak
Fatima Zohra
FZ
Abouqal
Redouane
R
Hajjaj-Hassouni
Najia
N
D000328:Adult; D001827:Body Height; D015519:Bone Density; D002136:Calcium, Dietary; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017698:Postmenopause / Q000502:physiology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D011859:Radiography; D015203:Reproducibility of Results; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries
D002136:Calcium, Dietary
Br J Nutr. 1999 Sep;82(3):165-77
10655963
Bone. 1996 Oct;19(4):407-13
8894148
Osteoporos Int. 1999;9(3):206-13
10450408
J Bone Miner Res. 1993 Sep;8(9):1137-48
8237484
Osteoporos Int. 2006 Feb;17(2):290-6
16143833
Osteoporos Int. 2004 Jan;15(1):43-8
14504695
Hum Biol. 1977 Dec;49(4):541-58
590953
Osteoporos Int. 2005 Apr;16(4):403-10
15309381
CMAJ. 2002 Nov 12;167(10 Suppl):S1-34
12427685
Am J Clin Nutr. 1980 Jan;33(1):155-62
7355777
J Bone Miner Res. 1993 Jul;8(7):817-22
8352064
J Obstet Gynaecol Res. 2001 Dec;27(6):325-7
11794818
J Bone Miner Res. 1992 Apr;7(4):449-56
1535172
Ann Rheum Dis. 2007 Jan;66(1):81-5
16793842
Rheumatol Int. 2008 Jun;28(8):737-41
18172652
Osteoporos Int. 2001;12(9):716-22
11605736
Nutrition. 2003 Jun;19(6):481-6
12781845
J Bone Miner Res. 2004 Dec;19(12):1982-93
15537441
J Bone Miner Res. 1992 Feb;7(2):221-7
1570766
Endocr Pract. 2003 Nov-Dec;9(6):544-64
14715483
Osteoporos Int. 2008 Jan;19(1):21-8
17962917
Maturitas. 2007 Aug 20;57(4):392-8
17561361
BMC Public Health. 2006 May 19;6:135
16712731
Osteoporos Int. 1999;9(2):129-33
10367039
J Bone Miner Res. 1991 Oct;6(10):1115-20
1796758
Semin Arthritis Rheum. 2009 Jun;38(6):444-51
18336870
J Bone Miner Res. 1996 Mar;11(3):408-11
8852952
Rev Prat. 2006 Mar 31;56(6):673-7
16705929
Bone. 2003 Oct;33(4):522-32
14555255
Ann Hum Biol. 1991 Sep-Oct;18(5):433-40
1952801