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Open Access 01-12-2020 | Osteoporosis | Original Article

Epidemiology of hip fracture and the development of a FRAX model for Uzbekistan

Authors: O Lesnyak, S Ismailov, M Shakirova, N Alikhanova, A Zakroyeva, L Abboskhujaeva, H Johansson, NC Harvey, E McCloskey, JA Kanis

Published in: Archives of Osteoporosis | Issue 1/2020

Abstract

Summary

A prospective population-based survey in a region of the Republic of Uzbekistan determined the incidence of fractures at the hip. The hip fracture rates were used to create a FRAX® model to facilitate fracture risk assessment in Uzbekistan.

Objective

This paper describes the epidemiology of hip fracture in the Republic of Uzbekistan that was used to develop a country-specific FRAX® tool for fracture prediction.

Methods

During a 1-year (2016/17) prospective population-based survey in the Pap district of the Republic of Uzbekistan, hip fractures were prospectively identified from hospital registers, trauma centres and primary care and community sources. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Uzbekistan. Fracture probabilities were compared with those from neighbouring Kazakhstan and Kyrgystan.

Results

Approximately 41% of hip fracture cases did not come to medical attention, and two thirds of patients overall were not admitted to hospital. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 16,764 and is predicted to increase more than three-fold to 60,272 in 2050. FRAX-based probabilities were higher in Uzbekistan than Kazakhstan or Kyrgystan.

Conclusion

The FRAX model should enhance accuracy of determining fracture probability among the Uzbek population and help guide decisions about treatment.

Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson 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

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

Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, McCloskey EV, Harvey NC, Javaid K, Kanis JA for the International Osteoporosis Foundation (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15: 59. https://doi.org/10.1007/s11657-020-0706-y

Kanis JA, Cooper C, Rizzoli R, Reginster J-Y, Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF) (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44CrossRef

Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary healthcare level Technical Report. WHO Collaborating Centre, University of Sheffield, UK. Available at . http://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf. Accessed 26 Feb 2020

Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397CrossRef

Odén A, McCloskey EV, Kanis JA, Harvey NC, Johansson H (2015) Burden of high fracture probability worldwide: secular increases 2010-2040. Osteoporos Int 26:2243–2248CrossRef

Kanis JA, Harvey NC, Cyrus Cooper C, Johansson H, Odén A, McCloskey EV, the Advisory Board of the National Osteoporosis Guideline Group (2016) A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11:25

Kanis JA, Johansson H, Harvey NC, McCloskey EV (2018) A brief history of FRAX. Arch Osteoporos 13:118. https://doi.org/10.1007/s11657-018-0510-0CrossRefPubMedPubMedCentral

10.

Lesnyak O, Ershova O, Belova K, Gladkova E, Sinitsina O, Ganert O, Romanova M, Khodirev V, Johansson H, McCloskey E, Kanis JA (2012) Epidemiology of fracture in the Russian Federation and the development of a FRAX model. Arch Osteoporos 7:67–73. https://doi.org/10.1007/s11657-012-0082-3CrossRefPubMed

11.

Lesnyak O, Sahakyan S, Zakroyeva A, Bilezikian JP, Hutchings N, Galstyan R, Lebedev A, Johansson H, Harvey NC, McCloskey E, Kanis JA (2017) Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate. Arch Osteoporos 12(1):98. https://doi.org/10.1007/s11657-017-0392-6CrossRefPubMedPubMedCentral

12.

Ramanau H, Chernyanin I, Rudenka E, Lesnyak O, Zakroyeva A, Bilezikian JP, Johansson H, Harvey NC, McCloskey EV, Kanis JA (2018) Epidemiology of hip fracture in Belarus: development of a country-specific FRAX model and its comparison to neighbouring country models. Arch Osteoporos 13:42. https://doi.org/10.1007/s11657-018-0454-4CrossRefPubMedPubMedCentral

13.

Zakroyeva A, Lesnyak O, Cazac V, Groppa L, Russu E, Chislari L, Rotaru L, Johansson H, Harvey NC, McCloskey E, Kanis JA (2020) Epidemiology of osteoporotic fracture in Moldova and development of a country specific FRAX model. Arch Osteoporos 15:13. https://doi.org/10.1007/s11657-019-0669-zCrossRefPubMedPubMedCentral

14.

Issayeva S, Lesnyak O, Zakroyeva A, Issayeva B, Dilmanova D, Johansson H, Harvey NC, McCloskey E, Kanis JA (2020) Epidemiology of osteoporotic fractures in the Republic of Kazakhstan and the development of country specific FRAX model. Arch Osteoporos 15(1):30. https://doi.org/10.1007/s11657-020-0701-3CrossRefPubMedPubMedCentral

15.

Lesnyak O, Zakroyeva A, Lobanchenko O, Johansson H, Liu E, Lorentzon M, Harvey NC, McCloskey E, Kanis JA (2020) A surrogate FRAX model for the Kyrgyz Republic. Arch Osteoporos 15:68. https://doi.org/10.1007/s11657-020-00743-2CrossRefPubMedPubMedCentral

16.

United Nations (2019) Department of Economic and Social Affairs/population division. World Population Prospects https://populationunorg/wpp/Download/Standard/Population/ Accessed 11 Jan 2020

17.

Republic Uzbekistan State Department of Statistics (2018). www.stat.uz Accessed 27 Dec 2019

18.

The state committee of the Republic of Uzbekistan on statistics (2020) https://stat.uz/en/181-ofytsyalnaia-statystyka-en/6383-demography Accessed 19 March 2020

19.

International Osteoporosis Foundation (2011) The Eastern European & Central Asian Regional Audit. Epidemiology, costs & burden of osteoporosis in 2010. Naturaprint, France. Available at https://www.iofbonehealth.org/sites/default/files/PDFs/Audit%20Eastern%20Europe_Central%20Asia/Eastern_European_Central_Asian_Audit_2010.pdf. Accessed 11 Dec 2019

20.

United Nations (2017) Department of Economic and Social Affairs/population division. World Population Prospects https://wwwworldometersinfo/world-population/uzbekistan-population/ Accessed 12 May 2020

21.

Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427CrossRef

22.

Siggeirsdottir K, Aspelund T, Johansson H, Gudmundsson EF, Mogensen B, Jonsson BY, Gudnason V, McCloskey E, Oden A, Sigurdsson G, Kanis JA (2014) The incidence of a first major osteoporotic fracture in Iceland and implications for FRAX. Osteoporos Int 25:2445–2451CrossRef

23.

Lam A, LeslieWD LLM, Yogendran M, Morin SN, Majumdar SR (2014) Major osteoporotic to hip fracture ratios in Canadian men and women with Swedish comparisons: a population-based analysis. J Bone Miner Res 29:1067–1073CrossRef

24.

World Health Organization (2018) Health statistics and information systems: http://www.who.int/healthinfo/statistics/mortality_rawdata/en/ Accessed 17th June 2019

25.

Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244CrossRef

26.

Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl D, Cyrus Cooper C on behalf of the IOF Working Group on Epidemiology and Quality of Life (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256CrossRef

27.

Povoroznyuk VV, Grygorieva NV, Kanis JA, McCloskey EV, Johansson H, Harvey NC, Korzh MO, Strafun SS, Vaida VM, Klymovytsky FV, Vlasenko RO, Forosenko VS (2017) Epidemiology of hip fracture and the development of FRAX in Ukraine. Arch Osteoporos 12:53CrossRef

28.

Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, LJ DEMM, Cummings SR, Kanis JA, the IOF CSA Working Group on Fracture Epidemiology (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288CrossRef

29.

Melton LJ, Crowson CS, O’Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban and with rural rates and changes in urban rates over time. Osteoporos Int 9:29–37CrossRef

30.

Singer BR, McLauchlan CJ, Robinson CM, Christie J (1998) Epidemiology of fracture in 15.000 adults. The influence of age and gender. J Bone Joint Surg 80B:234–238

31.

Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender specific rate of fractures in Australia: a population-based study. Osteoporos Int 10(2):40–47

32.

Johnell O, Gullberg B, Kanis JA (1997) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7:138–144CrossRef

33.

Melton LJ (1995) Epidemiology of fractures. In: Riggs BL, Melton LJ (eds) Osteoporosis: etiology, diagnosis and management, 2nd edn. Lippincott-Raven, Philadelphia, pp 225–227

34.

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

35.

Karacić TP, Kopjar B (2009) Hip fracture incidence in Croatia in patients aged 65 years and more. Lijec Vjesn 131:9–13PubMed

36.

Lippuner K, Johansson H, Kanis JA, Rizzoli R (2010) FRAX assessment of osteoporotic fracture probability in Switzerland. Osteoporos Int 21:381–389CrossRef

37.

Emaus N, Olsen LR, Ahmed LA, Balteskard L, Jacobsen BK, Magnus T, Ytterstad B (2011) Hip fractures in a city in Northern Norway over 15 years: time trends, seasonal variation and mortality: the Harstad Injury Prevention Study. Osteoporos Int 22:2603–2610CrossRef

38.

Morosano M, Masoni A, Sánchez A (2005) Incidence of hip fractures in the city of Rosario. Argentina: Osteoporos Int 16:1339–1344PubMed

39.

Elffors L, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilzen G, Gennari C, Lopez-Vaz AA, Lyritis G, Mazzuoli GF, Miravet L, Passeri M, Perez Cano R, Rapado A, Ribot C (1994) The variable incidence of hip fracture in Southern Europe. The MEDOS Study. Osteoporos Int 4:253–263CrossRef

40.

Kanis JA, Johansson H, Oden A, Dawson-Hughes B, Melton LJ 3rd, McCloskey EV (2010) The effects of a FRAX® revision for the USA. Osteoporos Int 21:35–40CrossRef

Title: Epidemiology of hip fracture and the development of a FRAX model for Uzbekistan
Authors: O Lesnyak
S Ismailov
M Shakirova
N Alikhanova
A Zakroyeva
L Abboskhujaeva
H Johansson
NC Harvey
E McCloskey
JA Kanis
Publication date: 01-12-2020
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2020
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-020-00792-7

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Springer Medicine

Epidemiology of hip fracture and the development of a FRAX model for Uzbekistan

Abstract

Summary

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Objective

Methods

Results

Conclusion

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