Subjects with conditions associated with vertebral deformity, including osteomalacia, Paget’s disease,

Scheuermann’s disease, hyperparathyroidism, renal bone disease and malignancy with bone metastasis, were excluded. Information on symptoms associated with vertebral fractures was also collected, including difficulty in bending forward, kyphosis (occiput-to-wall >0 cm and/or gap between the costal margin and iliac crest <3 fingerbreadths), low back pain and height loss more than 2 cm since the age of 25 years. These data were collected from interviews conducted by a trained research assistant. All subjects were followed annually via telephone interviews using a structured questionnaire for assessment of the clinical outcome of incident fractures, falls, hospitalization, AZD0530 use of anti-osteoporotic medications,

living status and functional status. Subjects who commenced anti-osteoporosis medication prior to the occurrence of a primary fracture were excluded. Medical history and incident fractures were verified with the computerized patient information system of the Hospital Authority of the Hong Kong Government. For this study, only non-traumatic incident hip fractures and clinical vertebral fractures were Selleckchem Ganetespib included in the analysis. Hip fractures were defined as having a diagnosis coded as International Classification

of Disease, Tenth Revision (ICD-10) S72.0-S72.2 (fracture of the femoral neck, GSK1120212 supplier intertrochanteric, trochanteric, or subtrochanteric), and clinical vertebral fractures were identified in subjects who received medical attention from a physician with a diagnosis coded as ICD-10S22.0-S22.1 (fracture of the thoracic vertebra/multiple thoracic vertebrae), S32.0 or S32.7 (fracture of the lumbar vertebra/multiple lumbar vertebrae). Pathological fractures or fractures caused by traffic accidents or falls from standing heights were Osimertinib clinical trial excluded. The study was approved by the Institutional Review Board of the University of Hong Kong and the Hong Kong West Clusters Hospital of the Hospital Authority. Japan The hip and clinical vertebral fracture incidence rates for the Japanese were obtained from previously published data used to develop the Japanese version of FRAX® [24]. The hip fracture incidence rate was based on data from a census study in Tottori Prefecture, Japan, in 1994 [25]. The incidence of vertebral fracture was based on data obtained from the Adult Health Study in Hiroshima, Japan [26]. Participants were followed through biennial medical examination including radiology assessments since the establishment of the study in 1958.