title: Vertebral fracture prevalence among Greek healthy middle-aged postmenopausal women: association with demographics, anthropometric parameters, and bone mineral density.
abstract: BACKGROUND
  The prevalence of skeletal fractures shows a marked geographic variability; however, data regarding the Greek population remain limited.
  
  
  OBJECTIVE
  To evaluate the frequency of asymptomatic vertebral fractures (VFs), and potential risk factors, in a large sample of Greek postmenopausal women.
  
  
  METHODS
  A cross-sectional study at the University Menopause Clinic.
  
  
  METHODS
  Four hundred fifty-four postmenopausal women aged 35 to 80 years, with an average menopausal age of 9.2±7.1 years.
  
  
  METHODS
  They included medical history, anthropometric and biochemical parameters, bone mineral density (BMD) at lumbar spine (LS) and femoral neck (FN), and LS lateral radiographs.
  
  
  METHODS
  Lumbar spine lateral radiographs were evaluated according to quantitative procedures, aiming to identify VFs. Anthropometric and biochemical parameters and values of BMD were compared according to the presence of VFs.
  
  
  RESULTS
  A total of 37 (8.15%) women had at least one VF. Lumbar spine and FN-osteoporosis was identified in up to 23.1% and 40.9% subjects with prevalent VFs, respectively. The prevalence of VFs was largely associated with age, with women aged 60 years or more presenting an up to fourfold risk compared with younger women. Moreover, the presence of VFs was associated with higher menopausal age, advanced age at menarche, a history of early menopause, and prolonged lactation. Lower LS-BMD and, especially, FN-BMD were negatively associated with VF prevalence (prevalent VF vs. no VF: LS-BMD, 0.89±0.16 g/cm(2) vs. 0.98±0.16 g/cm(2), p=.010; FN-BMD, 0.72±0.10 g/cm(2) vs. 0.81±0.12 g/cm(2), p=.008).
  
  
  CONCLUSIONS
  Asymptomatic VFs are common among Greek healthy middle-aged postmenopausal women. More than 50% subjects with prevalent VFs present with normal BMD or osteopenia. Age and bone density classification at the FN presented the strongest association with the prevalence of VFs.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece. Electronic address: ilambrinoudaki@aretaieio.uoa.gr.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Flokatoula
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Pliatsika
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.affiliation: 1st Department of Radiology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Aris
authors.initials: A
authors.lastname: Antoniou
authors.affiliation: 1st Department of Surgery, University of Athens, Laiko Athens General Hospital, 17 Agiou Thoma St, GR-11527 Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Creatsa
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Panoulis
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Dendrinos
authors.affiliation: 1st Department of Radiology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
authors.forename: Xenofon
authors.initials: X
authors.lastname: Papacharalambous
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D017698:Postmenopause; D015995:Prevalence; D016103:Spinal Fractures / Q000453:epidemiology*
keywords: Bone mineral density; Greece; Postmenopausal women; Prevalence; Risk factors; Vertebral fractures