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30-year trends of hip and vertebral fracture incidence in Japan: a systematic review and meta-analysis

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Abstract

Introduction

A previous review study showed the trends of declining age- and sex-adjusted incidence of hip fractures in almost all the countries, except Austria and Japan, in the most recent of the periods studied. However, the expansion of devices for diagnosis and drugs for fracture prevention in Japan was roughly the same as in the other countries. This study aimed to conduct a comprehensive systematic review and meta-analyses of incidence rates (IRs) of osteoporotic fractures reported over 30-years in multiple communities in Japan and to evaluate secular trends.

Materials and Methods

We searched MEDLINE for observational studies reporting IRs of osteoporotic fractures in the general population. Additional studies were identified by hand searches of reference lists of published studies. Two reviewers and 1 expert independently assessed study eligibility. Pooled analyses of IRs were conducted by a random-effect model. Data from 3 periods (1985–1999, 2000–2009, and from 2010) were compared.

Results

Of 47 eligible studies, 21 with IRs or information enabling recalculation of IRs in the population aged 50 years and older were included. IRs of hip fractures per 100,000 person-years significantly increased over time in men: 1985–1999, 0.79 (95% CI 0.71–0.87); 2000–2009, 1.18 (95% CI 1.09–1.28); and 2010 onwards, 1.31 (95% CI 1.17–1.45). They also significantly increased in women: 2.23 (95% CI 1.89–2.58); 3.99 (95% CI 3.70–4.28); and 4.39 (95% CI 4.00–4.78), respectively.

Conclusion

IRs of hip fractures continuously increased in the past 30-years in men and women despite improved the diagnosis, treatment, and care. Such data from Japan, a leading aging society, provide important information for other countries.

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Availability of data and material

This is a systematic review, and all eligible studies and their reported information have been published previously.

Code availability

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Acknowledgements

Funding for this study was provided by Asahi Kasei Pharma Corporation.

Funding

Funding for this study was provided by Asahi Kasei Pharma Corporation.

Author information

Authors and Affiliations

  1. Medilead, Inc., Tokyo, Japan

    Ayako Shoji

  2. Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan

    Ayako Shoji

  3. School of Public Health, St. Luke’s International University, Tokyo, Japan

    Zhenyu Gao

  4. Asahi Kasei Pharma Corporation, Tokyo, Japan

    Koichi Arai

  5. Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    Noriko Yoshimura

Authors
  1. Ayako Shoji
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  2. Zhenyu Gao
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  4. Noriko Yoshimura
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Contributions

AS made substantial contributions to the study conception, design, and protocol; data collection and screening; statistical analyses; data interpretation; and drafting of the paper and revising it critically for important intellectual content. ZG made substantial contributions to the study design, study protocol, data collection and screening, and revising the draft critically for important intellectual content. KA made substantial contributions to the study design and protocol, data interpretation, and revising the draft critically for important intellectual content. NY made substantial contributions to the study conception, design, and protocol; data screening and interpretation; and drafting of the paper and revising it critically for important intellectual content. All authors had full access to all of the data in the study and had final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Noriko Yoshimura.

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Conflict of interest

AS declares that she is employed by Medilead Inc. ZG declares that he was employed by Medilead Inc. at the start of this study. KA declares that he is employed by Asahi Kasei Pharma Corporation. Although the Department of Preventive Medicine for Locomotive Organ Disorders at the University of Tokyo Hospital (Director, NY) was contracted by Asahi Kasei Pharma Corporation to perform this collaboration study and analyze the large database, NY declares that there is no conflict of interest in the present study.

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Shoji, A., Gao, Z., Arai, K. et al. 30-year trends of hip and vertebral fracture incidence in Japan: a systematic review and meta-analysis. J Bone Miner Metab 40, 327–336 (2022). https://doi.org/10.1007/s00774-021-01288-1

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  • DOI: https://doi.org/10.1007/s00774-021-01288-1

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