Top

Archives of Osteoporosis

Published in:

01-12-2022 | Osteoporosis | Original Article

Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain

Authors: Xavier Surís, Emili Vela, Montserrat Clèries, Maria-Jesús Pueyo-Sánchez, Esteve Llargués, Marta Larrosa

Published in: Archives of Osteoporosis | Issue 1/2022

Abstract

Purpose

The aim of this study was to estimate the incidence of major osteoporotic fractures in Catalonia, Spain, in 2018 and 2019 and their association with age, sex, income, climate and a set of comorbidities.

Methods

Data on age, sex, smoking, alcohol abuse, comorbidities (obesity, Parkinson’s disease, arthritis, chronic kidney disease, hepatic cirrhosis, diabetes, chronic obstructive pulmonary disease, dementia, cerebrovascular disease, hyperthyroidism, multiple myeloma and epilepsy) and income levels in people aged ≥ 50 years with a new diagnosis of major osteoporotic fractures in 2018 and 2019 were collected from the Catalan Health Surveillance System (CHSS). Climatological variables were obtained from the Catalan Meteorological Service. Incidence rates were estimated for five major osteoporotic fractures (MOF). Associations between osteoporotic fractures and age, sex, income, comorbidities and climate variables were ascertained through multilevel generalized linear model analysis (Poisson’s regression).

Results

There were 60,671 MOF. The annual incidence rate per 1000 persons/years at risk (PYAR) was 10.6 (3.1 for hip, 2.3 for distal forearm, 2.2 for vertebrae, 1.7 for pelvis and 1.5 for proximal humerus). Female sex, older age, lower income, smoking, alcohol abuse and some common comorbidities were associated with a higher incidence of MOF while obesity was a protective factor.

Conclusions

MOF are frequent in the adult Catalan population, especially in older women and people on low incomes. Hip fracture is the most frequent, followed by forearm and vertebral fractures. Smoking, alcohol abuse and some comorbidities were associated with an increased incidence of fracture.

Available only for authorised users

Harvey N, Dennison E, Cooper C (2013) The epidemiology of osteoporotic fractures. In: Primer on the metabolic bone diseases and disorders of mineral metabolism, 8th edn. John Wiley & Sons, Inc., pp 348–356

Borgström F, Karlsson L, Ortsäter G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59. https://doi.org/10.1007/s11657-020-0706-yCrossRefPubMedPubMedCentral

Alvarez-Nebreda ML, Jiménez AB, Rodríguez P, Serra JA (2008) Epidemiology of hip fracture in the elderly in Spain. Bone 42:278–285. https://doi.org/10.1016/j.bone.2007.10.001CrossRefPubMed

Mazzucchelli R, Pérez Fernández E, Crespí Villarías N et al (2019) East-west gradient in hip fracture incidence in Spain: how much can we explain by following the pattern of risk factors? Arch Osteoporos 14:115. https://doi.org/10.1007/s11657-019-0665-3CrossRefPubMed

Mazzucchelli R, Crespí-Villarías N, Pérez-Fernández E et al (2018) Weather conditions and their effect on seasonality of incident osteoporotic hip fracture. Arch Osteoporos 13:28. https://doi.org/10.1007/s11657-018-0438-4CrossRefPubMed

Reyes C, Estrada P, Nogués X et al (2014) The impact of common co-morbidities (as measured using the Charlson index) on hip fracture risk in elderly men: a population-based cohort study. Osteoporos Int 25:1751–1758. https://doi.org/10.1007/s00198-014-2682-9CrossRefPubMed

Herrera A, Martínez AA, Ferrandez L et al (2006) Epidemiology of osteoporotic hip fractures in Spain. Int Orthop 30:11–14. https://doi.org/10.1007/s00264-005-0026-2CrossRefPubMed

Pagès-Castell A, Carbonell-Abella C, Avilés FF et al (2012) Burden of osteoporotic fractures in primary health care in Catalonia (Spain): a population-based study. BMC Musculoskelet Disord 13:79. https://doi.org/10.1186/1471-2474-13-79CrossRef

Cancio JM, Vela E, Santaeugènia S et al (2018) Influence of demographic and clinical characteristics of elderly patients with a hip fracture on mortality: a retrospective, total cohort study in North-East Spain. Bone 117:123–129. https://doi.org/10.1016/j.bone.2018.09.002CrossRefPubMed

10.

Farré N, Vela E, Clèries M et al (2017) Real world heart failure epidemiology and outcome: a population-based analysis of 88,195 patients. PLoS ONE 12(2):e0172745. https://doi.org/10.1371/journal.pone.0172745CrossRefPubMedPubMedCentral

11.

Miquel M, Clèries M, Vergara M, Vela E (2018) Economic burden of cirrhosis in Catalonia: a population-based analysis. BMJ Open 8:18012. https://doi.org/10.1136/bmjopen-2017-018012CrossRef

12.

Shi T, Min M, Ye P et al (2019) Meteorological variables and the risk of fractures: a systematic review and meta-analysis. Sci Total Environ 685:1030–1041. https://doi.org/10.1016/j.scitotenv.2019.06.281CrossRefPubMed

13.

Warriner AH, Patkar NM, Curtis JR et al (2011) Which fractures are most attributable to osteoporosis? J Clin Epidemiol 64:46–53. https://doi.org/10.1016/j.jclinepi.2010.07.007CrossRefPubMedPubMedCentral

14.

Steele F (2010) Module 5: Introduction to multilevel modelling. In: LEMMA VLE, Centre for multilevel modelling. pp 1–5

15.

Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427. https://doi.org/10.1007/s001980170112CrossRefPubMed

16.

Sanders KM, Seeman E, Ugoni AM et al (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247. https://doi.org/10.1007/s001980050222CrossRefPubMed

17.

Melton LJ, Crowson CS, O’Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9:29–37. https://doi.org/10.1007/s001980050113CrossRefPubMed

18.

Svedbom A, Hernlund E, Ivergård M et al (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137. https://doi.org/10.1007/s11657-013-0137-0CrossRefPubMedPubMedCentral

19.

Pueyo-Sánchez M-J, Larrosa M, Suris X et al (2016) Secular trend in the incidence of hip fracture in Catalonia, Spain, 2003–2014. Age Ageing 46:324–328. https://doi.org/10.1093/ageing/afw196CrossRef

20.

Azagra R, López-Expósito F, Martin-Sánchez JC et al (2014) Changing trends in the epidemiology of hip fracture in Spain. Osteoporos Int 25:1267–1274. https://doi.org/10.1007/s00198-013-2586-0CrossRefPubMed

21.

Naves Díaz M, Bernardino Díaz López J, Gómez Alonso C et al (2000) Estudio de incidencia de fracturas osteoporóticas en una cohorte mayor de 50 años durante un período de 6 años de seguimiento. Med Clin (Barc) 115:650–653. https://doi.org/10.1016/S0025-7753(00)71651-4CrossRefPubMed

22.

Abtahi S, Driessen JHM, Vestergaard P et al (2019) Secular trends in major osteoporotic fractures among 50+ adults in Denmark between 1995 and 2010. Osteoporos Int 30:2217–2223. https://doi.org/10.1007/s00198-019-05109-0CrossRefPubMedPubMedCentral

23.

Wáng YXJ, Che-Nordin N, Leung JCS et al (2020) Elderly men have much lower vertebral fracture risk than elderly women even at advanced age: the MrOS and MsOS (Hong Kong) year 14 follow-up radiology results. Arch Osteoporos 15:176. https://doi.org/10.1007/s11657-020-00845-xCrossRefPubMed

24.

Schousboe JT (2016) Epidemiology of vertebral fractures. J Clin Densitom 19:8–22. https://doi.org/10.1016/j.jocd.2015.08.004CrossRefPubMed

25.

Cooper C, O’Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14 Suppl 1:S89-97. https://doi.org/10.1016/8756-3282(93)90358-hCrossRefPubMed

26.

Ghosh S, Aggarwal S, Kumar V et al (2019) Epidemiology of pelvic fractures in adults: our experience at a tertiary hospital. Chin J Traumatol 22:138–141. https://doi.org/10.1016/j.cjtee.2019.03.003CrossRefPubMedPubMedCentral

27.

Andrich S, Haastert B, Neuhaus E et al (2015) Epidemiology of pelvic fractures in Germany: considerably high incidence rates among older people. PLoS ONE 10:e0139078. https://doi.org/10.1371/journal.pone.0139078CrossRefPubMedPubMedCentral

28.

Prieto-Alhambra D, Avilés FF, Judge A et al (2012) Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality. Osteoporos Int 23:2797–2803. https://doi.org/10.1007/s00198-012-1907-zCrossRefPubMed

29.

Launonen AP, Lepola V, Saranko A et al (2015) Epidemiology of proximal humerus fractures. Arch Osteoporos 10:2. https://doi.org/10.1007/s11657-015-0209-4CrossRef

30.

Pueyo MJ, Surís X, Larrosa M et al (2012) Importancia de los problemas reumáticos en la población de Cataluña: Prevalencia y repercusión en la salud percibida, restricción de actividades y utilización de recursos sanitarios. Gac San 26:30–36. https://doi.org/10.1016/j.gaceta.2011.03.008CrossRef

31.

Reyes C, García-Gil M, Elorza JM et al (2015) Socioeconomic status and its association with the risk of developing hip fractures: a region-wide ecological study. Bone 73:127–131. https://doi.org/10.1016/j.bone.2014.12.019CrossRefPubMed

32.

Johnell O, Borgstrom F, Jonsson B, Kanis J (2007) Latitude, socioeconomic prosperity, mobile phones and hip fracture risk. Osteoporos Int 18:333–337. https://doi.org/10.1007/s00198-006-0245-4CrossRefPubMed

33.

Bacon WE, Hadden WC (2000) Occurrence of hip fractures and socioeconomic position. J Aging Health 12:193–203. https://doi.org/10.1177/089826430001200203CrossRefPubMed

34.

Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162. https://doi.org/10.1007/s00198-004-1640-3CrossRefPubMed

35.

Fung TT, Mukamal KJ, Rimm EB et al (2019) Alcohol intake, specific alcoholic beverages, and risk of hip fractures in postmenopausal women and men age 50 and older. Am J Clin Nutr 110:691–700. https://doi.org/10.1093/ajcn/nqz135CrossRefPubMedPubMedCentral

36.

Peris P, Guañabens N, Parés A et al (1995) Vertebral fractures and osteopenia in chronic alcoholic patients. Calcif Tissue Int 57:111–114. https://doi.org/10.1007/BF00298430CrossRefPubMed

37.

Turcotte AF, O’Connor S, Morin SN, et al (2021) Association between obesity and risk of fracture, bone mineral density and bone quality in adults: a systematic review and meta-analysis. PLoS One 16.https://doi.org/10.1371/JOURNAL.PONE.0252487

38.

Prieto-Alhambra D, Premaor MO, Avilés FF et al (2012) The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res 27:294–300. https://doi.org/10.1002/JBMR.1466CrossRefPubMed

39.

Porter CJ, Moppett IK, Juurlink I et al (2017) Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury. BMC Nephrol 18:1–11. https://doi.org/10.1186/S12882-017-0437-5CrossRef

40.

Cawthon PM (2011) Gender differences in osteoporosis and fractures. In: Clin Orthop Relat Res 469:1900–1905. https://doi.org/10.1007/s11999-011-1780-7

41.

Koromani F, Ghatan S, van Hoek M et al (2021) Type 2 diabetes mellitus and vertebral fracture risk. Curr Osteoporos Rep 19:50–57. https://doi.org/10.1007/s11914-020-00646-8CrossRefPubMedPubMedCentral

42.

Vilaca T, Schini M, Harnan S et al (2020) The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: a systematic review and meta-analysis update. Bone 137.https://doi.org/10.1016/j.bone.2020.115457

43.

Wallander M, Axelsson K, Nilsson A et al (2017) Type 2 diabetes and risk of hip fractures and non-skeletal fall injuries in the elderly: a study from the fractures and fall injuries in the elderly cohort (FRAILCO). J Bone Miner Res 32:449–460. https://doi.org/10.1002/JBMR.3002CrossRefPubMed

44.

Vestergaard P, Rejnmark L, Mosekilde L (2005) Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia 48:1292–1299. https://doi.org/10.1007/s00125-005-1786-3CrossRefPubMed

45.

Blum MR, Bauer DC, Collet TH et al (2015) Subclinical thyroid dysfunction and fracture risk a meta-analysis. JAMA 313:2055–2065. https://doi.org/10.1001/jama.2015.5161CrossRefPubMedPubMedCentral

46.

Vestergaard P, Mosekilde L (2003) Hyperthyroidism, bone mineral, and fracture risk—a meta-analysis. Thyroid 13:585–593. https://doi.org/10.1089/105072503322238854CrossRefPubMed

47.

Vestergaard P, Rejnmark L, Weeke J, Mosekilde L (2000) Fracture risk in patients treated for hyperthyroidism. Thyroid 10:341–348. https://doi.org/10.1089/thy.2000.10.341CrossRefPubMed

48.

Nilson F, Moniruzzaman S, Andersson R (2014) A comparison of hip fracture incidence rates among elderly in Sweden by latitude and sunlight exposure. Scand J Public Health 42:201–206. https://doi.org/10.1177/1403494813510794CrossRefPubMed

49.

Servei Català de la Salut, Unitat d'Informació i Coneixement. Atenció sanitària: pública o privada; 2005-2017. Barcelona: Servei Català de la Salut; 2018. (Informes breus; 18/2018). http://hdl.handle.net/11351/3667

Title: Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain
Authors: Xavier Surís
Emili Vela
Montserrat Clèries
Maria-Jesús Pueyo-Sánchez
Esteve Llargués
Marta Larrosa
Publication date: 01-12-2022
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Forearm Fracture
Published in: Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01081-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2022

Osteoporosis knowledge, health beliefs, and self-efficacy in Hong Kong Chinese men

Prognostic value of preoperative low bone mineral density in patients with digestive cancers: a systematic review and meta-analysis

Fracture incidence in children and adolescents 0–19 years old in Mexico: a 12-year cross-sectional analysis

An optimal intervention threshold of FRAX in postmenopausal Thai women

A model-based cost-effectiveness analysis of fracture liaison services in China

Decreasing hip fracture rates among older adults in Chile, 2001–2019