Osteoporotic Vertebral Compression Fracture Cohort Study

DXA will be used to measure lumbar spine (L1-L4) and bilateral hip density, recording the T-score for each site. Instrument precision will be set to 1% (i.e., repeated measurement error < 1%). Professionals will be responsible for post-use accuracy checks and maintenance.

Left and right handgrip strength in kilograms, which is determined by a handheld dynamometer. The normal range varies by age, gender, and dominant hand. When it is lower than the normal range, it may indicate muscle weakness, sarcopenia, or neuromuscular disorders; when it is higher than the normal range, it typically reflects good musculoskeletal health and physical fitness.

The bone marrow fat fraction (FF) of lumbar vertebrae (expressed as a percentage), which is determined by magnetic resonance imaging (MRI) analysis. The normal range varies with age and vertebral level, typically between 30-50% in healthy adults. When it is higher than the normal range, it may indicate osteoporosis, aging, or metabolic bone disease; when it is lower than the normal range, it may suggest conditions such as bone marrow edema, inflammation, or hematopoietic disorders.

The paravertebral muscle area (in cm²), which is determined by magnetic resonance imaging (MRI) analysis. The normal range varies based on vertebral level, age, and gender. When it is smaller than the normal range, it may indicate muscle atrophy, sarcopenia, or degenerative changes.

The degree of paravertebral muscle fatty infiltration (expressed as a percentage or fat fraction), which is determined by magnetic resonance imaging (MRI) analysis. The normal range varies with age and vertebral level. When it is higher than the normal range, it indicates increased intramuscular fat deposition, often associated with aging, disuse, or metabolic disorders.

The vertebral bone quality (VBQ) score, which is determined by magnetic resonance imaging (MRI) analysis. The normal range is 1.5-3.0. When it is higher than the normal range, it indicates poor bone quality and an increased risk of osteoporotic vertebral fractures; when it is lower than the normal range, it indicates better bone quality and a lower fracture risk.

Draw a straight line with a length of 10 cm on the white paper and mark "painless" and "severe pain" on both ends respectively to form VAS. The patient makes a mark on the straight line according to the degree of pain he feels. The distance from the starting point to the mark is the quantified degree of pain. Painless is represented by 0; 1-3 points represent mild pain; 4-6 points represent moderate pain, which is strong but tolerable; 7-10 points represent severe pain, gradually reaching intolerable level, which is severe pain. Draw a 10 cm long on a piece of white paper.

The ODI is a patient-reported questionnaire consisting of 10 sections (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and traveling). Each section is scored from 0 to 5, with higher scores indicating greater disability. Interpretation of ODI Scores:0-20%: Minimal disability (can perform daily activities normally).21-40%: Moderate disability (pain and functional limitations affect some activities).41-60%: Severe disability (pain significantly restricts daily life).61-80%: Crippling disability (most activities are severely limited).81-100%: Bed-bound or exaggerated symptoms.

Four patterns including Kidney Yang Deficiency, Spleen-Kidney Yang Deficiency, Liver-Kidney Yin Deficiency, Kidney Deficiency with Blood Stasis. Two professional TCM clinicians will independently determine the patient's syndrome pattern. In case of disagreement, a third physician will adjudicate.

Four patterns including Qi Stagnation and Blood Stasis, Kidney Deficiency with Blood Stasis, Liver-Kidney Yin Deficiency. Two professional TCM clinicians will independently determine the patient's syndrome pattern. In case of disagreement, a third physician will adjudicate.

Serum level of Beta-CrossLaps (β-CTX) in ng/mL, N-terminal propeptide of type l procollagen (P1NP) in ng/mL, which are determined by Electrochemiluminescence Method.The normal reference ranges of serum P1NP and ß-CTX are 16.3-78.2 ng/mL and 0.114-0.628 ng/mL, respectively.In case of abnormal conditions,the higher the β-CTX,the more serious the bone resorption.The lower the P1NP, the less bone formation and the worse the bone condition.

Serum level of bone glaprotein (BGP) in ug/L, which is determined by automatic biochemical analysis The normal value 48-10.2 ug/L.When it is lower than the normal value, it indicates that bone formation is reduced.

Serum level of 25-Hydroxyvitamin D (25(OH)D) in nmol/L, which is determined by automatic biochemical analysis. The normal value is 50-125 nmol/L. When it is lower than the normal value, it indicates vitamin D deficiency or insufficiency.

Serum level of Intact Parathyroid Hormone (PTH) in pg/mL, which is determined by automatic biochemical analysis. The normal value is 15-65 pg/mL. When it is higher than the normal value, it may indicate hyperparathyroidism; when it is lower than the normal value, it may indicate hypoparathyroidism or vitamin D intoxication.

Serum level of Total Cholesterol (TC) in mmol/L, which is determined by automatic biochemical analysis. The normal value is <5.2 mmol/L. When it is higher than the normal value, it indicates an increased risk of cardiovascular disease; when it is lower than the normal value, it may be associated with malnutrition or liver dysfunction.

Serum level of Triglycerides (TG) in mmol/L, which is determined by automatic biochemical analysis. The normal value is <1.7 mmol/L. When it is higher than the normal value, it indicates hypertriglyceridemia and an increased risk of cardiovascular disease; when it is lower than the normal value, it may be associated with malnutrition or malabsorption.

Serum level of High-Density Lipoprotein Cholesterol (HDL-C) in mmol/L, which is determined by automatic biochemical analysis. The normal value is ≥1.0 mmol/L. When it is higher than the normal value, it indicates a lower risk of cardiovascular disease; when it is lower than the normal value, it indicates an increased risk of cardiovascular disease.

Serum level of Low-Density Lipoprotein Cholesterol (LDL-C) in mmol/L, which is determined by automatic biochemical analysis. The normal value is <3.4 mmol/L. When it is higher than the normal value, it indicates an increased risk of cardiovascular disease; when it is lower than the normal value, it may be associated with genetic factors or liver dysfunction.

Serum level of Leptin in ng/mL, which is determined by automatic biochemical analysis. The normal value is 1.1-27.6 ng/mL. When it is higher than the normal value, it may indicate leptin resistance or obesity; when it is lower than the normal value, it may be associated with malnutrition or low body fat.

Serum level of Visfatin in ng/mL, which is determined by automatic biochemical analysis. The normal value is 10-50 ng/mL. When it is higher than the normal value, it may indicate obesity, insulin resistance, or inflammatory conditions; when it is lower than the normal value, it may be associated with metabolic dysregulation.

Serum level of Apelin in pg/mL, which is determined by automatic biochemical analysis. The normal value is 50-200 pg/mL. When it is higher than the normal value, it may indicate cardiovascular stress or metabolic disorders; when it is lower than the normal value, it may be associated with endothelial dysfunction or certain chronic diseases.

Serum level of Chemerin in ng/mL, which is determined by automatic biochemical analysis. The normal value is 50-150 ng/mL. When it is higher than the normal value, it may indicate obesity, insulin resistance, or inflammatory states; when it is lower than the normal value, it may be associated with metabolic dysregulation.

Serum level of Interleukin-6 (IL-6) in pg/mL, which is determined by automatic biochemical analysis. The normal value is <7 pg/mL. When it is higher than the normal value, it indicates an inflammatory response, infection, or autoimmune disease; when it is lower than the normal value, it is generally considered within the normal physiological range.

Serum level of Interleukin-10 (IL-10) in pg/mL, which is determined by automatic biochemical analysis. The normal value is <9.1 pg/mL. When it is higher than the normal value, it may indicate an anti-inflammatory response or certain chronic inflammatory conditions; when it is lower than the normal value, it may be associated with impaired immune regulation.

Serum level of Transforming Growth Factor-β (TGF-β) in ng/mL, which is determined by automatic biochemical analysis. The normal value is 5-30 ng/mL. When it is higher than the normal value, it may indicate fibrotic processes, chronic inflammation, or certain cancers; when it is lower than the normal value, it may be associated with impaired tissue repair or immune dysregulation.

Serum level of Tumor Necrosis Factor-α (TNF-α) in pg/mL, which is determined by automatic biochemical analysis. The normal value is <8.1 pg/mL. When it is higher than the normal value, it indicates systemic inflammation, infection, autoimmune diseases, or certain malignancies; when it is lower than the normal value, it is generally within the normal physiological range.

Serum level of Irisin in ng/mL, which is determined by automatic biochemical analysis. The normal value is 3-5 ng/mL. When it is higher than the normal value, it may indicate increased physical activity or improved metabolic status; when it is lower than the normal value, it may be associated with sedentary lifestyle, obesity, or metabolic disorders.

Serum level of Myostatin in ng/mL, which is determined by automatic biochemical analysis. The normal value is 5-15 ng/mL. When it is higher than the normal value, it may indicate muscle wasting conditions or impaired muscle regeneration; when it is lower than the normal value, it may be associated with increased muscle mass or certain metabolic adaptations.

Serum level of Testosterone in ng/dL, which is determined by automatic biochemical analysis. The normal range is 300-1000 ng/dL for adult males and 15-70 ng/dL for adult females. When it is higher than the normal range, it may indicate hyperandrogenism or endocrine disorders; when it is lower than the normal range, it may indicate hypogonadism or age-related decline.

Serum level of Estrogen (Estradiol, E2) in pg/mL, which is determined by automatic biochemical analysis. The normal range varies by gender and life stage: for premenopausal women it is 30-400 pg/mL (varies with menstrual cycle), for postmenopausal women it is <30 pg/mL, and for adult men it is 10-50 pg/mL. When it is higher than the normal range, it may indicate estrogen dominance or certain tumors; when it is lower than the normal range, it may indicate ovarian failure, menopause, or endocrine disorders.

Serum level of Creatinine in μmol/L, which is determined by automatic biochemical analysis. The normal range is 44-133 μmol/L for adult males and 70-106 μmol/L for adult females. When it is higher than the normal range, it may indicate impaired renal function or muscle disorders; when it is lower than the normal range, it may be associated with decreased muscle mass or liver disease.

Serum level of Cystatin C in mg/L, which is determined by automatic biochemical analysis. The normal range is 0.55-1.02 mg/L. When it is higher than the normal range, it indicates impaired renal function; when it is lower than the normal range, it may be associated with hyperthyroidism or pregnancy.