Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018

Abstract Spine fractures represent a significant public health concern, particularly among aging populations. They are among the most common osteoporotic fractures and are associated with substantial morbidity, mortality, and healthcare costs. Trends in the prevalence of spine fractures have not bee...

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Main Authors: He-Gang Niu, Yang Hu, Yu-Kang Gong, Gao-Kai Hu, Gao-Qi Ye, Wen-Shan Gao
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94871-9
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author He-Gang Niu
Yang Hu
Yu-Kang Gong
Gao-Kai Hu
Gao-Qi Ye
Wen-Shan Gao
author_facet He-Gang Niu
Yang Hu
Yu-Kang Gong
Gao-Kai Hu
Gao-Qi Ye
Wen-Shan Gao
author_sort He-Gang Niu
collection DOAJ
description Abstract Spine fractures represent a significant public health concern, particularly among aging populations. They are among the most common osteoporotic fractures and are associated with substantial morbidity, mortality, and healthcare costs. Trends in the prevalence of spine fractures have not been well described in subgroups of demographic characteristics, and understanding trends in the prevalence of spine fractures and risk factors for spine fractures is critical to planning public health approaches to prevent and manage the disease in US adults. In this study, we evaluated the time trends in the prevalence of spine fractures and their associated risk factors in the US adult population from 1999 to 2018. The survey study comprised a series of cross-sectional analyses using nationally representative data from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2000 to 2017–2018. All study samples were weighted to represent the civilian resident US population. Spine fractures were defined by self-reporting of spine fracture diagnosis by a physician that they had spine fractures. Trends in the prevalence of spine fractures in subgroups of demographic characteristics for spine fractures were estimated using logistic regression analysis. The age-standardized prevalence (95% CI) of spine fractures increased from 2.54% (1.94-3.14%) in the 1999–2002 cycles to 5.04% (3.62-6.46%) in the 2015–2018 cycles (p < 0.05 for trend). The prevalence of spine fractures among Americans aged 50 and above was 3.24%, which was similar between those under 65 and those aged 65 and above (< 65 3.20% vs. aged ≥ 65 3.31%, p = 0.74). However, the prevalence of spine fractures in males is higher than that in females (males 3.81% vs. females 2.76%, p = 0.005). Univariate analysis showed that age, sex, race (mainly non-Hispanic white), marital status, osteoporosis, smoking, alcohol consumption, hypertension, and diabetes were risk factors for spine fractures. In multivariate analysis, sex (male), race (mainly non-Hispanic white), osteoporosis, smoking, and hypertension were independently associated with spine fractures. Based on NHANES surveys of US adults from 1999 to 2000 to 2017–2018, the prevalence of spine fractures showed an overall increasing trend, with variations across sociodemographic subgroups. In addition, age, sex, race (mainly non-Hispanic white), osteoporosis, smoking, alcohol consumption, hypertension, and diabetes may be closely linked to the occurrence of spine fractures.
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spelling doaj-art-50ce3aa95fe7443487ccb967c8f47cd82025-08-20T02:25:37ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-94871-9Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018He-Gang Niu0Yang Hu1Yu-Kang Gong2Gao-Kai Hu3Gao-Qi Ye4Wen-Shan Gao5Department of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Hebei UniversityAbstract Spine fractures represent a significant public health concern, particularly among aging populations. They are among the most common osteoporotic fractures and are associated with substantial morbidity, mortality, and healthcare costs. Trends in the prevalence of spine fractures have not been well described in subgroups of demographic characteristics, and understanding trends in the prevalence of spine fractures and risk factors for spine fractures is critical to planning public health approaches to prevent and manage the disease in US adults. In this study, we evaluated the time trends in the prevalence of spine fractures and their associated risk factors in the US adult population from 1999 to 2018. The survey study comprised a series of cross-sectional analyses using nationally representative data from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2000 to 2017–2018. All study samples were weighted to represent the civilian resident US population. Spine fractures were defined by self-reporting of spine fracture diagnosis by a physician that they had spine fractures. Trends in the prevalence of spine fractures in subgroups of demographic characteristics for spine fractures were estimated using logistic regression analysis. The age-standardized prevalence (95% CI) of spine fractures increased from 2.54% (1.94-3.14%) in the 1999–2002 cycles to 5.04% (3.62-6.46%) in the 2015–2018 cycles (p < 0.05 for trend). The prevalence of spine fractures among Americans aged 50 and above was 3.24%, which was similar between those under 65 and those aged 65 and above (< 65 3.20% vs. aged ≥ 65 3.31%, p = 0.74). However, the prevalence of spine fractures in males is higher than that in females (males 3.81% vs. females 2.76%, p = 0.005). Univariate analysis showed that age, sex, race (mainly non-Hispanic white), marital status, osteoporosis, smoking, alcohol consumption, hypertension, and diabetes were risk factors for spine fractures. In multivariate analysis, sex (male), race (mainly non-Hispanic white), osteoporosis, smoking, and hypertension were independently associated with spine fractures. Based on NHANES surveys of US adults from 1999 to 2000 to 2017–2018, the prevalence of spine fractures showed an overall increasing trend, with variations across sociodemographic subgroups. In addition, age, sex, race (mainly non-Hispanic white), osteoporosis, smoking, alcohol consumption, hypertension, and diabetes may be closely linked to the occurrence of spine fractures.https://doi.org/10.1038/s41598-025-94871-9TrendPrevalenceSpine fracturesRisk factorNHANES(National health and nutrition examination survey)
spellingShingle He-Gang Niu
Yang Hu
Yu-Kang Gong
Gao-Kai Hu
Gao-Qi Ye
Wen-Shan Gao
Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
Scientific Reports
Trend
Prevalence
Spine fractures
Risk factor
NHANES(National health and nutrition examination survey)
title Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
title_full Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
title_fullStr Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
title_full_unstemmed Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
title_short Trends in prevalence of spine fractures and risk factors in spine fractures among US adults, 1999–2018
title_sort trends in prevalence of spine fractures and risk factors in spine fractures among us adults 1999 2018
topic Trend
Prevalence
Spine fractures
Risk factor
NHANES(National health and nutrition examination survey)
url https://doi.org/10.1038/s41598-025-94871-9
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