Skeletal Radiology · Nov 17, 2025

Relevance of vertebral fractural deformity for hip fracture prediction: a community-based study of older Chinese women and men

By Wáng YXJ, Leung JCS, Kwok TCY

OBJECTIVE: To estimate hip fracture (Fx) risk if one or more vertebral fractures are detected in an otherwise healthy older woman or man. MATERIALS AND METHODS: The study was conducted among older Chinese community subjects. 2000 women were enrolled; 1951 were followed for five years. 2000 men were enrolled; 1882 cases were followed for five years. With thoracolumbar spine radiographs, for each vertebra, a score of 0, -0.5, -1, -1.5, -2, -2.5, and -3 was assigned for no osteoporotic-like vertebral fractural deformity (OLVF) or OLVF of < 20%, ≥ 20 ~ 25%, ≥ 25% ~ 33%, ≥ 33% ~ 40%, ≥ 40% ~ 66%, and ≥ 66% vertebral height loss, respectively. OLVFss was the summed score of vertebrae T3 to L5. The femoral neck (FN) cutpoint T-score was ≤ -2.7 for osteoporosis in women and ≤ -2.1 for osteofrailia in men. OLVFss ≤ - 1.5 suggests osteoporosis in women, and OLVFss ≤ - 2.5 suggests osteofrailia in men. RESULTS: For women, 26 cases developed hip Fx (mean age: 80 years). Baseline FN T-score ≤ -2.7 and OLVFss ≤ -1.5 had a positive predictive value of 5.22% and 5.05%, and a detection sensitivity of 65.38% and 53.85%, respectively. For men, 23 cases developed hip Fx (mean age: 81 years). Baseline FN T-score ≤ -2.1 and OVLFss ≤ -2.5 had a positive predictive value of 4.24% and 4.81%, and a detection sensitivity of 52.17% and 21.74%, respectively. CONCLUSION: Compared with FN T-score thresholds, OVLFss had a similar performance for future hip Fx risk estimation for women, for men OVLFss had a similar positive predictive value for future hip Fx risk but was associated with a lower detection sensitivity.

doi.org/10.1007/s00256-025-05079-xOpen accessPubMed 41249543Biomarkers