European Vertebral Osteoporosis Study Research Articles

Height and body mass index in oslo, norway, compared to other regions of europe: do they explain differences in the incidence of hip fracture?

Lean body stature and tallness have both been identified as risk factors for hip fracture. In this study, height and weight data from a multinational multicenter study were used' to compare Oslo, which has some of the highest incidence rates of hip fracture ever reported, to other regions of Europe, with respect to height and body mass index. More than 17,000 subjects in six age strata (50–54, 55–59, 60–64, 65–69, 70–74, 75+ years) from 36 centers in 19 European countries were enrolled in the European Vertebral Osteoporosis Study (EVOS), which included standardized height and weight measurements. We found that men in Oslo were 4.3 cm taller than men in western Europe, 5.0 cm taller than men in eastern Europe, and 8.6 cm taller than men in southern Europe. Oslo women were also taller, by 2.2 cm compared to women in western Europe, 2.7 cm compared to women in eastern Europe, and 5.2 cm compared to women in southern Europe. In all age groups, except women aged 55–59 years, mean body mass index (BMI) was lowest in Oslo. Nearly twice as many had a BMI less than 22.0 kg/m2 in Oslo compared to the other regions combined (11.1% vs. 6.6% in men and 19.2% vs. 9.9% in women). This study indicates that the people of Oslo are taller and leaner than people in other regions of Europe. This may in part explain the higher incidence of hip fracture in the population of Oslo.

Current musculoskeletal symptoms in peri and postmenopausal women: results of a multicenter population epidemiological study. The EVOS Study Group

Within the European vertebral osteoporosis study four stratified systematic samples of German residents aged 50-79 in Lübeck, Heidelberg, Jena and East Berlin have been drawn. Overall 4628 subjects were included, of whom 4385 were contactable and 3106 (71%) responded to the postal questionnaire enquiring about rheumatic complaints "today". 2348 (54%) followed an invitation to a medical examination in which a specific gynaecological history was taken. The prevalence of current back-, neck- and joint-pain is consistently higher in females than in males in all age groups. Females show a peak prevalence in the age group 55-64. 104/1134 women were pre- or perimenopausal. 1030 women had not had their period for at least 13 months and were classified as "postmenopausal". Neither the menopausal status nor the duration of the postmenopause were statistically significantly associated with the frequency of the three rheumatic complaints.

Reproducibility of a questionnaire on risk factors for osteoporosis in a multicentre prevalence survey: the European Vertebral Osteoporosis Study.

The European Vertebral Osteoporosis Study Group (EVOS) developed a questionnaire, back translated into 14 different European languages, for use in a multinational epidemiological study of vertebral osteoporosis. We investigated the reproducibility of this questionnaire in four of the participating study centres. In all 151 men and women, aged 50-85 years, from Lubeck (Germany), Malmo (Sweden), Warsaw (Poland) and Oviedo (Northern Spain), were retested with the questionnaire on two occasions using a different observer within a 28-day period. Questions relating to personal or medical history were more reproducible than questions concerning subjective symptoms or aspects of lifestyle. The level of agreement for the non-ordinal categorical variables, as estimated by kappa, varied from 0.38 to 1.00 across the four centres. Agreement for the multicategory ordinal, mainly lifestyle, questions was in general poorer though improved when a weighted analysis was performed. For continuous data the 95% limits of agreement were narrow, and there was no evidence of bias between interviewers. There were no important differences in reproducibility across the four centres for either categorical or continuous data. The study indicates that the questionnaire may produce useful and comparable information concerning risk factors for osteoporosis across different countries and in different languages. It also highlights that questionnaire instruments designed for use in multinational population-based studies may provide data of comparable quality across a range of settings.

The epidemiology of vertebral fractures

Vertebral fractures are recognised as a hallmark of osteoporosis, yet little is known of their epidemiology. This deficiency limits accurate characterisation of the public health importance of osteoporosis. Assessment of the impact of vertebral fractures has been hampered by the absence of formal criteria for identifying fractures on a thoracolumbar radiograph. Initial methods relying upon subjective radiological assessments have given way to morphometric measurements of vertebral heights, with deformities defined according to various algorithms. These methods have been used in a series of studies performed in Rochester, MN, to determine the incidence, outcome, and time trends of vertebral deformities. The results suggest a prevalence rate of vertebral deformity of 25.3 per-100 Rochester women aged 50 years and over (95% CI, 22.3–28.2), with an estimated incidence of 17.8 per 1,000 person-years. The incidence of clinically diagnosed vertebral fractures among women in the same population was 5.3 per 1,000 person-years, suggesting that around 30% of such deformities in women receive clinical attention. Morphometric measurement on the radiographs of women with clinically diagnosed fractures revealed that 80% had grade 2 (>4 SD) deformities. Comparable data on the occurrence and health impact of vertebral deformities throughout Europe are urgently required. The European Vertebral Osteoporosis Study (EVOS) is a multicentre epidemiological study that aims to address this issue. It is designed as a radiographic prevalence study in 34 European centres. Age-stratified samples of 300 men and 300 women aged 50 years and over are selected from population registers in each centre, and undergo standardised thoracolumbar radiography, anthropometry, and a structured interview on current and past risk factors for osteoporosis. Data on the design of the study, und preliminary results on the prevalence of vertebral deformities and individual risk factors in selected centres will be presented elsewhere.