Risk factors for vertebral fractures in postmenopausal women: a meta-analysis
Background Vertebral fractures are the most common osteoporotic fractures in postmenopausal women and are strongly associated with higher morbidity, lower quality of life, and higher risk of death. Identifying risk factors for vertebral fractures in postmenopausal women is essential for early prevention and intervention. The aim of this study was to systematically assess and quantify the risk factors for vertebral fractures in postmenopausal women by meta-analysis. Methods We conducted a comprehensive search in PubMed, Embase, Web of Science, and Cochrane Library databases to include all observational studies reporting risk factors for vertebral fractures in postmenopausal women. The search was conducted from the date of database creation to April 20, 2025, Study screening, data extraction, and quality assessment were performed by two independent reviewers, and study quality was assessed using the Newcastle-Ottawa scale. Data were analyzed using Stata15 software. Results A total of 11 studies involving 7,605 participants were included. The meta-analysis showed that advanced age [odds ratio (OR) = 1.07, 95% confidence interval (CI): 1.03–1.12], higher body mass index (BMI; OR = 1.07, 95% CI: 1.01–1.14), previous fracture (OR = 1.78, 95% CI: 1.29–2.45), low lumbar-spine bone mineral density (BMD; OR = 1.55, 95% CI: 1.27–1.89), glucocorticoid use (OR = 2.34, 95% CI: 1.34–4.09), and rheumatoid arthritis (OR = 2.99, 95% CI: 1.38–6.45) were associated with a higher likelihood of vertebral fracture in postmenopausal women. Conclusion This meta-analysis showed that risk factors for vertebral fracture in postmenopausal women include age over 60 years, higher body mass index, history of previous fracture, low lumbar bone density, glucocorticoid use, and rheumatoid arthritis. These factors significantly increase the risk of vertebral fractures. Therefore, early screening and intervention in these high-risk groups is warranted to reduce the incidence of vertebral fractures and to provide more individualized prevention and treatment strategies.