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Osteoporosis International

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Open Access 01-07-2021 | Forearm Fracture | Original Article

Osteoporotic fractures in second-generation immigrants and Swedish natives

Authors: P. Wändell, X. Li, A.C. Carlsson, J. Sundquist, K. Sundquist

Published in: Osteoporosis International | Issue 7/2021

Abstract

Summary

In this national study of osteoporotic fractures in second-generation immigrants in Sweden, we found a similar risk of osteoporotic fractures in general compared to Swedish natives, which suggests that environmental factors are important for the high risk of osteoporotic fractures in Nordic countries.

Introduction

Second generation immigrants may have a similar environment as individuals with two native-born parents. These individuals may be of interest to study concerning whether environmental or hereditary factors could be mostly associated to the risk of osteoporotic fractures. The aim of this study was to analyse the risk of osteoporotic fractures in second-generation immigrants compared to Swedish natives.

Methods

This was a nationwide study of individuals aged 50 years of age and older (N = 1,377,035; 691,750 men and 685,285 women). Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm or vertebrae, in the National Patient Register between January 1, 1998, and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident osteoporotic fractures in second generation immigrants compared to Swedish natives. The Cox regression models were adjusted for age, comorbidities and for sociodemographic status.

Results

A total of 114,505 osteoporotic fractures were registered, 109,622 (8.4%) were among individuals with Swedish-born parents and 4883 (7.5%) among those with foreign-born parents, with distal forearm fractures dominating in general (44.9%). Fully adjusted HRs (95% CI) were for all immigrants 0.95 (95% CI, 0.91–0.99), for men 0.96 (95% CI, 0.89–1.04) and for women 0.95 (95% CI, 0.90–1.00).

Conclusions

We observed a similar risk of osteoporotic fractures among second-generation immigrants as in Swedish natives, which suggests that environmental factors are important for osteoporotic fractures.

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Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRef

Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRef

Cauley JA, Chalhoub D, Kassem AM, Fuleihan Gel H (2014) Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol 10:338–351CrossRef

Wang XF, Seeman E (2012) Epidemiology and structural basis of racial differences in fragility fractures in Chinese and Caucasians. Osteoporos Int 23:411–422CrossRef

Lofthus CM, Frihagen F, Meyer HE, Nordsletten L, Melhuus K, Falch JA (2008) Epidemiology of distal forearm fractures in Oslo, Norway. Osteoporos Int 19:781–786CrossRef

Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C, Epidemiology IOFWGo, Quality of L (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256CrossRef

Ross PD, Huang C (2000) Hip fracture incidence among Caucasians in Hawaii is similar to Japanese A population-based study. Aging (Milano) 12:356–359

Statistics Sweden (2016) Foreign-born persons in Sweden by country of birth, age and sex. Year 2000 - 2015. Statistics Sweden,

Wandell PE (2013) Population groups in dietary transition. Food Nutr Res 57:21668CrossRef

10.

Wandell PE, Carlsson A, Steiner KH (2010) Prevalence of diabetes among immigrants in the Nordic countries. Curr Diabetes Rev 6:126–133CrossRef

11.

Albin B, Hjelm K, Elmstahl S (2010) Lower prevalence of hip fractures in foreign-born individuals than in Swedish-born individuals during the period 1987-1999. BMC Musculoskelet Disord 11:203CrossRef

12.

Johansson H, Oden A, Lorentzon M, McCloskey E, Kanis JA, Harvey NC, Karlsson MK, Mellstrom D (2015) Is the Swedish FRAX model appropriate for Swedish immigrants? Osteoporos Int 26:2617–2622CrossRef

13.

Wandell P, Li X, Carlsson AC, Sundquist J, Sundquist K (2020) Distal forearm fractures in immigrant groups: a national Swedish study. Bone 138:115508CrossRef

14.

Wandell P, Li X, Carlsson AC, Sundquist J, Sundquist K (2020) Osteoporotic fractures among foreign-born individuals: a national Swedish study. Osteoporos Int. https://doi.org/10.1007/s00198-020-05597-5

15.

Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674CrossRef

16.

Sandhu SK, Hampson G (2011) The pathogenesis, diagnosis, investigation and management of osteoporosis. J Clin Pathol 64:1042–1050CrossRef

17.

McCloskey EV, Harvey NC, Johansson H, Kanis JA (2016) FRAX updates 2016. Curr Opin Rheumatol 28:433–441CrossRef

18.

Stoen RO, Nordsletten L, Meyer HE, Frihagen JF, Falch JA, Lofthus CM (2012) Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway. Osteoporos Int 23:2527–2534CrossRef

19.

Gutierrez OM, Farwell WR, Kermah D, Taylor EN (2011) Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int 22:1745–1753CrossRef

20.

Redmond J, Jarjou LM, Zhou B, Prentice A, Schoenmakers I (2014) Ethnic differences in calcium, phosphate and bone metabolism. Proc Nutr Soc 73:340–351CrossRef

21.

Tiruneh A, Siman-Tov M, Radomislensky I, Itg PK (2017) Characteristics and circumstances of injuries vary with ethnicity of different population groups living in the same country. Ethn Health 22:49–64CrossRef

22.

Lips P (2007) Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103:620–625CrossRef

23.

Lips P (2010) Worldwide status of vitamin D nutrition. J Steroid Biochem Mol Biol 121:297–300CrossRef

24.

Carlsson AC, Johansson SE, Theobald H, Wandell PE (2013) Blood pressure measures and their predictive ability of cardiovascular mortality: a 26-year follow-up. Blood Press Monit 18:72–77CrossRef

25.

Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO (2011) External review and validation of the Swedish national inpatient register. BMC Public Health 11:450CrossRef

Title: Osteoporotic fractures in second-generation immigrants and Swedish natives
Authors: P. Wändell
X. Li
A.C. Carlsson
J. Sundquist
K. Sundquist
Publication date: 01-07-2021
Publisher: Springer London
Keyword: Forearm Fracture
Published in: Osteoporosis International / Issue 7/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05776-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Osteoporotic fractures in second-generation immigrants and Swedish natives

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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