| Objective To study the associated risk factors of the cascade of vertebral fractures (VFCs). Methods The clinical data of 444 patients diagnosed with osteoporotic vertebral fractures from January 1, 2015 to December 31, 2020 in Beijing Shijitan Hospital affiliated to Capital Medical University were retrospectively analyzed. All the patients were counted for age, sex, BMI, location of fracture, bone mineral density, presence of diabetes mellitus, presence of chronic obstructive pulmonary disease (COPD), and history of oral hormones. The risk factors associated with cascade (VFC) of vertebral fractures were analyzed. Patients were divided into two groups according to whether VFC occurred or not. The risk factors were analyzed using a binary logistic retrospective model. Results In the univariate analysis, risk factors for VFCs included previous history of diabetes mellitus (P=0.084), history of previous oral glucocorticoid therapy (P=0.022), COPD (P=0.048), fractures occurring in the thoracolumbar segment (P<0.001), severe osteoporosis (T-Score ≤ -3.0, P =0.087), and BMI ≥2 8 kg/m2 (P=0.012). In the multifactor risk analysis, risk factors for VFCs included history of diabetes mellitus (risk ratio 1.689, P=0.047), history of previous oral glucocorticoid therapy (risk ratio 1.839, P=0.010), COPD (risk ratio 2.103, P=0.026), fracture occurring in the thoracolumbar segment (risk ratio 2.686, P<0.001), and BMI ≥28 kg/m2 (risk ratio 1.769, P=0.010). Conclusion History of diabetes mellitus, previous oral glucocorticoid therapy, COPD, fractures in the thoracolumbar region, and BMI≥28 are identified as independent risk factors for VFCs. Among them, the occurrence of fractures in the thoracolumbar region is the most important risk factor. |