We examined anthropometric indicators to improve predictive ability of asymptomatic vertebral fracture screening models.
Study design and setting
Data were obtained from the 1996 Japanese Population-based Osteoporosis (JPOS) Study. McCloskey–Kanis criteria diagnosed vertebral deformities on X-ray absorptiometric images in 693 women aged ≥50.The multiple logistic regression model included age, height, weight, postmenopausal status, total hip BMD, and arm span (AS) or sitting height as explanatory variables. Akaike's information criterion (AIC) evaluated model goodness-of-fit.
Age-adjusted AS and sitting height in subjects with and without vertebral deformities were 147.2 ± 0.6 cm and 148.5 ± 0.2 cm (P = 0.055), 78.5 ± 0.5 cm and 79.9 ± 0.2 cm (P = 0.007), respectively. Every 5-cm increase in AS indicated 1.5-fold increased risk of prevalent vertebral deformity in the model including age, height, weight, postmenopausal status, and BMD. Including the explanatory variable AS in models yielded better predictive accuracy than excluding AS (AIC, 441.7 vs 446.6, respectively). Sitting height did not significantly influence model predictive ability.
Predictive accuracy of model for vertebral fracture including age, height, weight, postmenopausal status, and BMD improved when AS was added as an explanatory variable. Models to screen for asymptomatic vertebral fractures should include AS.
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- Vertebral fracture assessment: the 2007 ISCD Official Positions.J Clin Densitom. 2008; 11: 92-108
- Epidemiology and outcomes of osteoporotic fractures.Lancet. 2002; 359: 1761-1767
- Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989.J Bone Miner Res. 1992; 7: 221-227
- Contributions of vertebral fractures to stature loss among elderly Japanese-American women in Hawaii.J Bone Miner Res. 1996; 11: 408-411
- Vertebral fractures in Beijing, China: the Beijing Osteoporosis Project.J Bone Miner Res. 2000; 15: 2019-2025
- When should the doctor order a spine X-ray? Identifying vertebral fractures for osteoporosis care: results from the European Prospective Osteoporosis Study (EPOS).J Bone Miner Res. 2004; 19: 1982-1993
- Use of clinical risk factors to identify postmenopausal women with vertebral fractures.Osteoporos Int. 2007; 18: 35-43
- The relationship between anthropometric measurements and fractures in women.Bone. 1996; 19: 407-413
- Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS).Osteoporos Int. 1998; 8: 291-297
- The accuracy of historical height loss for the detection of vertebral fractures in postmenopausal women.Osteoporos Int. 2006; 17: 290-296
- Arm-span, height, and age in black and white women.Ann Hum Biol. 1990; 17: 37-41
- Components of adult height and height loss. Secular trend and effects of aging in women in the DOM project.Ann Epidemiol. 1992; 2: 611-615
- Predicting height from arm measurements.J Pediatr Orthop. 1993; 13: 761-765
- Interpreting spirometric data: impact of substitution of arm span for standing height in adults from North India.Chest. 1999; 115: 557-562
- The use of arm span as a predictor of height: a study of South Indian women.J Orthop Surg. 2001; 9: 19-23
- The value of span measurements in osteoporosis.Br J Clin Pract. 1990; 44: 154
- Are arm span measurements useful in the prediction of osteoporosis in postmenopausal women?.Osteoporos Int. 1998; 8: 174-176
- Usefulness of armspan and height comparison in detecting vertebral deformities in women.Osteoporos Int. 1999; 9: 129-133
- Body segment lengths and arm span in healthy men and women and patients with vertebral fractures.Osteoporos Int. 2004; 15: 43-48
- Arm span-height difference is not an indicator of osteoporosis or associated vertebral deformity in postmenopausal women.Int J Clin Pract. 2007; 62: 157-159
- Fukui Osteoporosis Cohort. Use of anthropometric indicators in screening for undiagnosed vertebral fractures: a cross-sectional analysis of the Fukui Osteoporosis Cohort (FOC) Study.BMC Musculoskelet Disord. 2008; 9: 157
- Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population. Japanese Population-Based Osteoporosis (JPOS) Study.Osteoporos Int. 2001; 12: 529-537
- The assessment of vertebral deformity: a method for use in population studies and clinical trials.Osteoporos Int. 1993; 3: 138-147
- Information theory and an extension of the maximum likelihood principle.in: Petrov B.N. Csaki F. Proceedings of the second international symposium on information theory. Akademiai Kiado, Budapest1973: 267-281
- Predictive equations for estimation of stature in Malaysian elderly people.Asia Pac J Clin Nutr. 2003; 12: 80-84
- Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US.Int J Epidemiol. 1995; 24: 1171-1177
- Historical height loss, vertebral deformity, and health-related quality of life in Hiroshima cohort study.Osteoporos Int. 2007; 18: 1493-1499
- Comparison of four morphometric definitions and a semiquantitative consensus reading for assessing prevalent vertebral fractures.Osteoporos Int. 2001; 12: 716-722
Published online: September 18, 2009
Accepted: September 3, 2009
Received: July 22, 2009
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.