An incident morphometric vertebral fracture was diagnosed by lateral and posterior–anterior chest and spinal X-rays using the semi-quantitative assessment [12], in which a decrease of at least 20% in height of any vertebral body from initial reading to the end of the study was defined as a morphometric vertebral fracture. Since the incidence of clinical vertebral fracture was not known in Japan, the ratio of clinical fracture to morphometric fracture incidence was assumed to be the same

in Japan as it was for Sweden when the Japanese version of FRAX® was developed, i.e. 30% of morphometric vertebral fractures were assumed as clinical fractures [24, 27]. Sweden The incidence rates of hip and clinical vertebral fractures for Swedish Caucasians were also obtained from a previously published study by Kanis et al., in which all incident fractures, including hip fractures (1991) and clinical vertebral fractures (1993 and 1994) were identified from files check details at the Department of Diagnostic Radiology in Malmo, Sweden, for the relevant year. Only vertebral fractures that came to clinical attention were captured, and subjects who previously sustained a fracture of the same type were excluded from analysis. The annual incidences of hip and clinical vertebral fractures were calculated for men and women by age [28]. Statistical analyses Baseline characteristics of the Chinese subjects are expressed in means ± SD for continuous

variables and in percentage for categorical variables. Time to incident hip or vertebral fractures was calculated according to the date of X-ray reports or physician’s consultations when the diagnosis ITF2357 mw was made. The average follow-up period for all subjects was 4.0 ± 2.8 (range, 1 to 14) years, with a total follow-up of 14,733 patient-years. Subjects who had received anti-osteoporosis medication after sustaining a fracture during the follow-up period or those who deceased at the time of analysis were analysed up to their time of treatment initiation or last contact Aspartate time point. Incidence rates were reported as rate per 100,000 person-years. The incidence rates of vertebral and hip fractures were compared to the published data from

Japan and Sweden. Vertebral-to-hip fracture ratios were used to demonstrate the proportion of vertebral fractures in relation to hip fractures in different populations. Results A total of 4,116 Southern Chinese subjects (2,302 women and 1,810 men) aged 50 or above were included in the analysis. The mean age at baseline was 62 ± 8.2 years for women and 68 ± 10.3 years for men. Of the women, 37.2% and 63.4% of men were above the age of 65 years. Baseline demographic information and characteristics are shown in Table 1. Of the men, 55.5% and 72.1% of women reported having difficulty bending forward, kyphosis, low back pain and/or height loss >2 cm since the age of 25. However, only 2.7% of men and 5.5% of women reported a history of past clinical vertebral fracture.