Calcified Tissue International

, Volume 44, Issue 3, pp 157–167 | Cite as

Increasing age-adjusted risk of fragility fractures: A sign of increasing osteoporosis in successive generations?

  • Karl J. Obrant
  • Urban Bengnér
  • Olof Johnell
  • Bo E. Nilsson
  • Ingemar Sernbo


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  1. 1.
    Carlsson P (1918) Om behandling af brott å lårbenskaftet. Thesis, Malmö, Sweden (in Swedish)Google Scholar
  2. 2.
    Löfberg O (1924) The treatment of fractures of the neck of femur. Acta Chir Scand 57:504–534Google Scholar
  3. 3.
    Landin L (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes. Thesis, University of Lund, Sweden, 1–109Google Scholar
  4. 4.
    Udén G, Nilsson B (1986) Hip fracture frequency in hospital. Acta Orthop Scand 57:428–430PubMedGoogle Scholar
  5. 5.
    Rees JL (1982) Accuracy of hospital activity data in estimating the incidence of proximal femoral fracture. Br Med J 284:1856–1857Google Scholar
  6. 6.
    Melton LJ, O'Fallon M, Riggs BL (1987) Secular trends in the incidence of hip fractures. Calcif Tissue Int 41:57–64PubMedCrossRefGoogle Scholar
  7. 7.
    Cummings SR, Kelsey JL, Newitt MC, O'Dowd KJ (1985) Epidemiology of osteoporosis and osteoporotic fractures. Epidemiologic Reviews 7:178–208PubMedGoogle Scholar
  8. 8.
    Miller CW (1978) Survival and ambulation following hip fracture. J Bone Joint Surg (Am) 60A:930–934Google Scholar
  9. 9.
    Jensen JS, Tøndevold E (1979) Mortality after hip fractures. Acta Orthop Scand 50:161–167PubMedGoogle Scholar
  10. 10.
    Lewinnek G, Kelsey J, White A, Kreiger N (1980) The significance and comparative analysis of the epidemiology of hip fractures. Clin Orthop 152:35–43PubMedGoogle Scholar
  11. 11.
    Lindsay R, Dempster DW, Clemens T, Herrington BS, Wilt S (1985) Incidence cost and risk factors of fracture of the proximal femur in USA. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis 1985. Department of Clinical Chemistry, Glostrup Hospital, Denmark, pp 311–315Google Scholar
  12. 12.
    Sernbo I, Johnell O, Andersson T (1988) Differences in the incidence of hip fractures and some social conditions between an urban and a rural population in southern Sweden. Acta Orthop Scand 59:382–385PubMedGoogle Scholar
  13. 13.
    Johnell O, Nilsson B, Obrant KJ, Sernbo I (1984) Age and sex patterns of hip fracture—changes in 30 years. Acta Orthop Scand 55:290–292PubMedGoogle Scholar
  14. 14.
    Alffram P-A (1964) An epidemiologic study of cervical and trochanteric fractures of the femur in an urban population. Acta Orthop Scand (suppl) 65:1–109Google Scholar
  15. 15.
    Nilsson B, Obrant KJ (1978) Secular tendencies of the incidence of fracture of the upper end of the femur. Acta Orthop Scand 49:389–391PubMedGoogle Scholar
  16. 16.
    Falch J, Ilebekk A (1978) Fractures of the proximal end of the femur. Prevalence and incidence in Oslo 1950–1975. Tidskr Nor Laegerforen 14:738–739 (in Norwegian)Google Scholar
  17. 17.
    Zetterberg C, Andersson GBJ (1982) Fractures of the proximal end of the femur in Göteborg, Sweden 1940–1979. Acta Orthop Scand 53:419–426PubMedGoogle Scholar
  18. 18.
    Lühtje P (1983) Fractures of the proximal femur in Finland in 1980. Ann Chir Gynaecol 72:282–286Google Scholar
  19. 19.
    Frandsen PA, Kruse T (1983) Hip fractures in the county of Funen, Denmark. Acta Orthop Scand 54:681–686PubMedGoogle Scholar
  20. 20.
    Zain Flabdien BS, Olerud S, Karlström G, Smedby B (1984) Rising incidence of hip fracture in Uppsala 1965–1980. Acta Orthop Scand 55:284–289Google Scholar
  21. 21.
    Nilsson MH (1984) Trochanteric fractures. Treatment by Ender medullary fixation. Observed and predicted incidence in the Stockholm area. Thesis, University of Stockholm, pp 1–103Google Scholar
  22. 22.
    Hedlund R, Ahlbom A, Lindgren U (1985) Hip fracture incidence in Stockholm 1972–1981. Acta Orthop Scand 57:30–34Google Scholar
  23. 23.
    Falch JA, Ilebekk A, Slungaard U (1985) Epidemiology of hip fractures in Norway. Acta Orthop Scand 56:12–16PubMedGoogle Scholar
  24. 24.
    Lüthje P (1985) Incidence of hip fracture in Finland. A forecast for 1990. Acta Orthop Scand 56:223–225PubMedGoogle Scholar
  25. 25.
    Mannius S, Mellström D, Odén A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in Western Sweden 1974–1982. Acta Orthop Scand 58:38–42PubMedGoogle Scholar
  26. 26.
    Finsen V, Benum P (1987) Changing incidence of hip fractures in rural and urban areas of central Norway. Clin Orthop 218:104–111PubMedGoogle Scholar
  27. 27.
    Nilsson RSR, Löfman O, Berglund K, Larsson L, Toss G (1987) Hip fracture epidemics up to year 2000. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, pp 113–115Google Scholar
  28. 28.
    Simonen O, Gylling H (1987) Incidence of hip fractures in Finland; the use and forecasted need for acute surgical hospital beds for the care of hip fracture patients. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Cophenhagen, Denmark, pp 125–127Google Scholar
  29. 29.
    Hoogendoorn D (1982) Mededelingen stitching medische registratie. Ned T Geenesk 126:963–968 (in Dutch)Google Scholar
  30. 30.
    Nagant de Deuxchaisnes C, Devogelaer JP (1988) Increase in the incidence of hip fractures and of the ratio of trochanteric to cervical hip fractures in Belgium. Calcif Tissue Int 42:201–203PubMedCrossRefGoogle Scholar
  31. 31.
    Lewis AF (1981) Fracture of the neck of the femur; changing incidence. Br Med J 283:1217–1220Google Scholar
  32. 32.
    Swanson AJG, Murdock G (1983) Fractured neck of femur. Pattern of incidence and implications. Acta Orthop Scand 54:348–355PubMedGoogle Scholar
  33. 33.
    Wallace WA (1983) The increasing incidence of fractures of the proximal femur. An orthopedic epidemic. Lancet i:1413–1414CrossRefGoogle Scholar
  34. 34.
    Boyse WJ, Vessey MP (1985) Rising incidence of fracture of the proximal femur. Lancet i:150–151CrossRefGoogle Scholar
  35. 35.
    Horseman A (1976) Calciumphosphate and magnesium metabolism. Nordin BEC (ed) Edinburgh, Churchill, Livingstone 357–404Google Scholar
  36. 36.
    Martin AD, Silverthorn KG, Houston CS (1987) Agespecific increase in hip fractures in Canada. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, p 111Google Scholar
  37. 37.
    Baker MR (1980) An investigation into secular trends in the incidence of femoral neck fractures using hospital activity analysis. Publ Hlth Lond 94:368–374Google Scholar
  38. 38.
    Evans JG (1985) Incidence of proximal femoral fracture. Lancet i:925–926Google Scholar
  39. 39.
    Evans JG, Prudham D, Wandless I (1979) A prospective study of fractured proximal femur. Incidence and outcome. Publ Hlth Lond 93:235–241Google Scholar
  40. 40.
    Melton LJ, Ilstrup DM, Riggs BL, Beckenbaugh RD (1982) Fifty-year trend in hip fracture incidence. Clin Orthop 162:144–149PubMedGoogle Scholar
  41. 41.
    Jensen JS (1980) Incidence of hip fractures. Acta Orthop Scand 51:511–513PubMedGoogle Scholar
  42. 42.
    Wallöe A, Andersson S, Herrlin K, Lidgren L (1983) Incidence and stability of trochanteric femoral fractures. Acta Orthop Scand 54:622–626PubMedGoogle Scholar
  43. 43.
    Engesaeter LB, Söreide O (1984) Incidence of hip fractures based on hospital admission rates. Acta Orthop Scand 55:707Google Scholar
  44. 44.
    Lauritzen JB, McNair P, Transbøl I (1987) Fall in the incidence of cervical hip fractures in women. Hvidovre osteoporosis study. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, pp 139–140Google Scholar
  45. 45.
    Uitewaal PJM, Lips P, Netelenbos JC (1987) An analysis of bone structure in patients with hip fracture. Bone and Mineral 3:63–73PubMedGoogle Scholar
  46. 46.
    Albright F, Smith PH, Richardson AM (1941) Postmenopausal osteoporosis. Its clinical features. JAMA 116:2465–2474Google Scholar
  47. 47.
    Gallagher JC, Aaron J, Horsman A, Marshall DH, Wilkinson R, Nordin BEC (1973) The crush fracture syndrome in postmenopausal women. Clin Endocrinol Metab 2:293–315PubMedCrossRefGoogle Scholar
  48. 48.
    Nordin BEC, Heyburn PJ, Peacock M, Horsman A, Aaron J, Marshall D, Crilly RG (1980) Osteoporosis and osteomalacia. Clin Endocrinol Metab 9:177–204PubMedCrossRefGoogle Scholar
  49. 49.
    Jensen GF, Christiansen C, Boeseen J, Hegedüs V, Transbøl I (1982) Epidemiology of postmenopausal spinal and long bone fractures: a unifying approach to postmenopausal osteoporosis. Clin Orthop 166:75–81PubMedGoogle Scholar
  50. 50.
    Pogrund H, Makin M, Robin G, Menczel J, Steinberg R (1977) Osteoporosis in patients with fractured femoral neck in Jerusalem. Clin Orthop 124:165–172PubMedGoogle Scholar
  51. 51.
    Fornasier VL, Czitrom AA (1978) Collapsed vertebrae: a review of 659 autopsies. Clin Orthop 131:261–265PubMedGoogle Scholar
  52. 52.
    Crilly R, Horsman A, Marshall DH, Nordin BEC (1979) Prevalence, pathogenesis and treatment of postmenopausal osteoporosis. Aust NZ J Med 9:24–30Google Scholar
  53. 53.
    Krølner B, Pors Nielsen S (1982) Bone mineral content of the lumbar spine in normal and osteoporotic women. Cross-sectional and longitudinal studies. Clin Sci 62:329–336PubMedGoogle Scholar
  54. 54.
    Peacock M, Horsman A, Marshall DH, Aaron J, Francis RM, Selby PL (1984) Senile and postmenopausal osteoporosis. Hormone Res 20:74–81PubMedGoogle Scholar
  55. 55.
    Marshall DH, Horsman A, Francis RM, Peacock M (1984) Fractures in elderly women. Prevalence of wrist, spine and femur fractures and their concurrence. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis 1985. Dept of Clin Chemistry, Glostrup Hospital, Denmark, pp 361–363Google Scholar
  56. 56.
    Härmä M, Heliövaara M, Aromaa A, Knekt P (1986) Thoracic spine compression fractures in Finland. Clin Orthop 205:188–194PubMedGoogle Scholar
  57. 57.
    Riggs BL, Melton LJ (1986) Involutional osteoporosis. N Engl J Med i:1676–1686CrossRefGoogle Scholar
  58. 58.
    Melton LJ (1987) Epidemiology of vertebral fractures. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, pp 33–37Google Scholar
  59. 59.
    Fujiwara S, Mizuno S, Takagi M, Hosoda Y (1987) Vertebral compression fractures in a fixed Japanese population 1958–1986; epidemiologic observations, In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, pp 90–92Google Scholar
  60. 60.
    Bengnér U, Johnell O, Redlund-Johnell I (1988) Changes in incidence and prevalence of vertebral fractures during 30 years. Calcif Tissue Int 42:293–296PubMedCrossRefGoogle Scholar
  61. 61.
    Alffram P-A, Bauer GCH (1962) Epidemiology of fractures of the forearm. A biomechanical investigation of bone strength. J Bone J Surg 44 A:105–114Google Scholar
  62. 62.
    Horak J, Nilsson BE (1975) Epidemiology of fracture of the upper end of humerus. Clin Orthop 112:250–253PubMedGoogle Scholar
  63. 63.
    Nilsson BE (1969) Age and incidence of ankle fractures. Acta Orthop Scand 40:122–129PubMedGoogle Scholar
  64. 64.
    Melton LJ, Sampson J, Morrey B, Ilstrup DM (1981) Epidemiologic features of pelvic fractures. Clin Orthop 155:43–47PubMedGoogle Scholar
  65. 65.
    Buhr AJ, Cooke AM (1959) Fracture patterns. Lancet 1:531–536PubMedCrossRefGoogle Scholar
  66. 66.
    Knowelden J, Buhr AJ, Dunbar O (1964) Incidence of fractures in persons over 35 years of age. Br J Prev Soc Med 18:130–141PubMedGoogle Scholar
  67. 67.
    Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BEC (1979) Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 32:540–549PubMedGoogle Scholar
  68. 68.
    Owen RA, Melton LJ, Johnson KA, Ilstrup DM, Riggs BL (1982) Incidence of Colles fracture in a North American community. Am J Publ Health 72:605–607Google Scholar
  69. 69.
    Melton LJ, Riggs BL (1983) Epidemiology of age-related fractures. In: Avioli LV (ed) The osteoporotic syndrome. Grune and Stratton, New York, pp 45–72Google Scholar
  70. 70.
    Falch JA (1983) Epidemiology of fractures of the distal forearm in Oslo, Norway. Acta Orthop Scand 54:291–295PubMedGoogle Scholar
  71. 71.
    Solgaard S, Petersen VS (1985) Epidemiology of distal radius fractures. Acta Orthop Scand 56:391–393PubMedCrossRefGoogle Scholar
  72. 72.
    Lauritzen JB, Schwartz P, McNair P, Transbøl I (1987) The incidence of extremity fractures in women. Hvidovre osteoporosis study. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis 1987. Osteopress ApS, Copenhagen, Denmark, pp 137–138Google Scholar
  73. 73.
    Rose SH, Melton LJ, Morrey BF, Ilstrup DM, Riggs BL (1982) Epidemiologic features of humeral fractures. Clin Orthop 168:24–30PubMedGoogle Scholar
  74. 74.
    Garraway WM, Stauffer RN, Kurland LT, O'Fallon WM (1979) Limb fractures in a defined population. Frequency and distribution. Mayo Clin Proc 54(11):701–707PubMedGoogle Scholar
  75. 75.
    Bauer M, Bengnér U, Johnell O, Redlund-Johnell I (1987) Supination-eversion fractures of the ankle joint: changes in incidence over 30 years. Foot and Ankle 8:26–28PubMedGoogle Scholar
  76. 76.
    Daly PJ, Fitzgerald R, Melton LJ, Ilstrup DM (1987) Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop Scand 1987;58:539–544Google Scholar
  77. 77.
    Bengnér U, Johnell O (1985) Increasing incidence of forearm fractures. A comparison of epidemiologic patterns 25 years apart. Acta Orthop Scand 56:158–160PubMedGoogle Scholar
  78. 78.
    Bengnér U, Johnell O, Redlund-Johnell I (1986) Epidemiology of ankle fracture 1950 and 1980. Increasing incidence in elderly women. Acta Orthop Scand 57:35–37PubMedGoogle Scholar
  79. 79.
    Bengnér U, Johnell O, Redlund-Johnell I (1988) Changes in the incidence of fracture of the upper end of the humerus during 30 years. A study of 2,125 fractures. Clin Orthop 231:179–182PubMedGoogle Scholar
  80. 80.
    Bengnér U, Johnell O, Redlund-Johnell I (1986) Increasing incidence of tibia condyle and patella fractures. Acta Orthop Scand 57:334–336PubMedGoogle Scholar
  81. 81.
    Cooper A (1842) A treatise on dislocations and fractures of the joints. John Churchill, LondonGoogle Scholar
  82. 82.
    Albright F (1947) Osteoporosis. Ann Int Med 27:861–882PubMedGoogle Scholar
  83. 83.
    Sernbo I, Johnell O (1988) Changes in bone mass and fracture type in patients with hip fracture. A comparison between 1950 and 1980 in Malmö, Sweden. Clin Orthop 233:95–103Google Scholar
  84. 84.
    Bengnér U (1987) Age-related fractures 1–73. Thesis, University of Lund, SwedenGoogle Scholar
  85. 85.
    Sernbo I (1988) Hip Fracture, Thesis 1–200, University of Lund, SwedenGoogle Scholar
  86. 86.
    Johnell O, Obrant KJ (1983) Halka bakomliggande orsak till trefaldig ökning av radius och fotledsfrakturer. Läkartidningen 41:3777 (in Swedish)Google Scholar
  87. 87.
    Gryfe CI, Amies A, Ashley MJ (1977) A longitudinal study of falls in an elderly population. Incidence and morbidity. Age Ageing 6:201–210PubMedCrossRefGoogle Scholar
  88. 88.
    Prudham D, Evans J (1981) Factors associated with falls in the elderly: a community study. Age Ageing 10:141–146PubMedGoogle Scholar
  89. 89.
    Uden G (1985) Inpatient accident in hospitals. J. Am Ger Soc 33:833–841Google Scholar
  90. 90.
    Lucht U (1971) A prospective study of accidental falls and resulting injuries in the home among elderly people. Acta Socio-Medica Scand 2:105–120Google Scholar
  91. 91.
    Anonymous (1985) Swedish statistical central bureau. Befolkningsförändringar 3∶116 (in Swedish)Google Scholar
  92. 92.
    Wotton R, Bryson E, Elsasser U (1981) Risk factors for fractured neck of femur in the elderly. Age Ageing 20:141–146Google Scholar
  93. 93.
    Johnell O, Sernbo I (1986) Health and social status in patients with hip fractures and controls. Age Ageing 15:285–291PubMedCrossRefGoogle Scholar
  94. 94.
    Sernbo I, Johnell O (1987) Background factors in patients with hip fractures—differences between cervical and trochanteric fractures. Compr Gerontol A: 1:109–111PubMedGoogle Scholar
  95. 95.
    Sernbo I, Hansson A, Johnell O (1987) Drug consumption in patients with hip fractures compared with controls. Compr Gerontol A; 1:93–96PubMedGoogle Scholar
  96. 96.
    Udén G (1986) Drug use in relation to accidents in hospitalized patients. J Soc Pharm 3:98–101Google Scholar
  97. 97.
    Hahn TJ (1978) Corticosteroid-induced osteopenia. Arch Int Med 138:882–885Google Scholar
  98. 98.
    Adinoff AD, Hollister JR (1983) Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med 309:265–268PubMedCrossRefGoogle Scholar
  99. 99.
    Hahn TJ, Hendin BA, Sharp CR, Boisseau VC, Haddad JG (1975) Serum 25-hydroxycalciferol levels and bone mass in children on chronic anticonvulsant therapy. N Engl J Med 292:550–554CrossRefGoogle Scholar
  100. 100.
    Johnell O, Nilsson BE, Wallöe A, Wiklund PE (1979) Bone morphology in epileptics. Calcif Tissue Int 28:93–97PubMedCrossRefGoogle Scholar
  101. 101.
    Ettinger B, Wingerd J (1982) Thyroid supplements: effect on bone mass. West J Med 136:472–476Google Scholar
  102. 102.
    Spencer H, Kramer L, Norris C, Osis D (1982) Effects of small doses of aluminum-containing antacids on calcium and phosphorus metabolism. Am J Clin Nutr 36:32–40PubMedGoogle Scholar
  103. 103.
    Wasnich RD, Benfante RJ, Yano K, Heilbrun L, Vogel JM (1983) Thiazide effect on the mineral content of bone. N Engl J Med 309:344–347PubMedCrossRefGoogle Scholar
  104. 104.
    Hale WE, Stewart RB, Marks RG (1984) Central nervous system symptoms of elderly subjects using antihypertensive drugs. J Am Geriatr Soc 32:5–10PubMedGoogle Scholar
  105. 105.
    Anonymous (1985) National corporation of pharmacies in Sweden 1977, 1985. Apoteksbolaget, Svensk läkemedelsstatistik, Stockholm, Sweden (in Swedish)Google Scholar
  106. 106.
    Aloia JF, Cohn SH, Bab T, Abesamic C, Kalici N, Ellis K (1978) Skeletal mass and body composition in marathon runners. Metabolism 27:1793–1796PubMedCrossRefGoogle Scholar
  107. 107.
    Lindsay R, Hart DM, Aitken J, MacDonald EB, Andersson J, Clark AC (1976) Long-term prevention of postmenopausal osteoporosis by estrogens. Lancet i:1038–1041CrossRefGoogle Scholar
  108. 108.
    Horsman A, Jones, M, Francis R, Nordin C (1983) The effect of estrogen dose on postmenopausal bone loss. N Engl J Med 309:1405–1407PubMedCrossRefGoogle Scholar
  109. 109.
    Anonymous (1985) Swedish statistical central bureau. Befolkningsförändringar 1985;3∶3 (in Swedish)Google Scholar
  110. 110.
    Anonymous (1968) Swedish statistical central bureau. Historisk statistik för Sverige; part 1∶105 (in Swedish)Google Scholar
  111. 111.
    Heaney R (1988) Nutritional factors in bone health. In: Riggs BL, Melton LJ (eds) Osteoporosis: etiology, diagnosis and management 1988. Raven Press, New York, pp 359–372Google Scholar
  112. 112.
    Becker W (1982) Swedish food. Svensk kost. Statens Livsmedelsverk 1982;1–101 (in Swedish)Google Scholar
  113. 113.
    Avioli LV, McDonald JE, Sook WL (1965) The influence of age on the intestinal absorption of 47-CA in women and its relation to 47-Ca absorption in postmenopausal osteoporosis. J Clin Invest 44:1960–1966PubMedGoogle Scholar
  114. 114.
    Gallagher JC, Riggs BL, Eisman J, Hamstra A, Arnaud SB, DeLuca HF (1979) Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients: effect of age and dietary calcium. J Clin Invest 64:729–736PubMedGoogle Scholar
  115. 115.
    Heaney RP, Recker R, Saville P (1978) Menopausal changes in calcium balance performance. J Lab Clin Med 92:953–963PubMedGoogle Scholar
  116. 116.
    Heaney R, Gallagher JC, Johnston CC, Neer R, Parfitt AM, Whedon GD (1982) Calcium nutrition and bone health in the elderly. Am J Clin Nutr 36:986–1013PubMedGoogle Scholar
  117. 117.
    Nilas L, Christiansen C, Rødbro P (1985) Oral calcium without effect on postmenopausal bone loss. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis 1985. Dept Clin Chemistry, Glostrup Hospital, Denmark, pp 639–642Google Scholar
  118. 118.
    DeLuca HF (1985) The functions and metabolites of vitamin D and their possible implications in osteoporosis. In: Christiansen C, Arnaud GD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis 1985. Dept Clin Chemistry, Glostrup Hospital, Denmark, pp 717–724Google Scholar
  119. 119.
    Donaldson CL, Hulley SB, Vogel JM, Hattner RS, Bayers JH, MacMillan DE (1970) Effect of prolonged bed rest on bone mineral. Metabolism 19:1071–1084PubMedCrossRefGoogle Scholar
  120. 120.
    Minaire P, Meunier P, Edouard C, Bernard J, Courpron P, Bourret J (1974) Quantitative histological data on disuse osteoporosis. Calcif Tissue Res 17:57–73PubMedCrossRefGoogle Scholar
  121. 121.
    Krølner B, Toft B, Pors Nielsen S, Tøndevold E (1983) Physical exercise as prophylaxis against involutional vertebral bone loss: a controlled trial. Clin Sci 64:541–546PubMedGoogle Scholar
  122. 122.
    Obrant KJ, Nilsson BE (1984) Histomorphologic changes in the tibial epiphysis after diaphyseal fracture. Clin Orthop 185:148–153Google Scholar
  123. 123.
    Abramson AS, Delagi EF (1961) Influence of weight bearing and muscle contraction on disuse osteoporosis. Arch Phys Med Rehabil 42:147–151PubMedGoogle Scholar
  124. 124.
    Nilsson BE, Westlin N (1971) Bone density in athletes. Clin Orthop 77:179–182PubMedGoogle Scholar
  125. 125.
    Dalén N, Olsson KE (1974) Bone mineral content and physical activity. Acta Orthop Scand 45:170–174PubMedGoogle Scholar
  126. 126.
    Margulies JY, Simkin A, Leichter I, Bivas A, Steinberg R, Giladi M, Stein M, Kashtan H, Milgrom C (1986) Effect of intense physical activity on bone mineral content in the lower limbs of young adults. J Bone Joint Surg 68A:1090–1093Google Scholar
  127. 127.
    Simkin A, Ayalon J, Leichter I (1987) Increased trabecular bone density due to bone-loading exercises in postmenopausal osteoporotic women. Calcif Tissue Int 40:59–63PubMedGoogle Scholar
  128. 128.
    Anonymous (1987) Swedish statistical central bureau. Perspektiv pà välfärden 1987;53 (in Swedish)Google Scholar
  129. 129.
    Zetterberg C, Mellström D, Rundgren Å, Andersson GBJ, Frennered K, Hansson T (1983) Hip fractures in elderly people epidemiology. Läkartidningen 80:2040–2043 (in Swedish)PubMedGoogle Scholar
  130. 130.
    Daniell HW (1976) Osteoporosis of the slender smoker: vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and lack of obesity. Arch Int Med 298–304Google Scholar
  131. 131.
    Lindsay R 91981) The influence of cigarette smoking on bone mass and bone loss. In: DeLuca HF, Frost HM, Webster SSJ, Johnston CC, Parfitt AM (eds) Osteoporosis—recent advances in pathogenesis and treatment. Baltimore University Park Press, p 481.Google Scholar
  132. 132.
    Rundgren Å, Mellström D (1984) The effect of tobacco smoking on the bone mineral content of the ageing skeleton. Mech Ageing Dev 28:273–281PubMedCrossRefGoogle Scholar
  133. 133.
    Suominen H, Heikkinen E, Vaino P, Lahtinen T (1984) Mineral density of calcaneus in men at different ages: a population study with special reference to life-style factors. Age Ageing 13:273–281PubMedCrossRefGoogle Scholar
  134. 134.
    Williams AR, Weiss NS, Ure CL (1982) Effect of weight, smoking and estrogen use on the risk of hip and forearm fractures in postmenopausal women. Obstetr Gynecol 60:695–699Google Scholar
  135. 135.
    Edén S, Jagenburg R, Lindstedt G, Lundberg PA, Mellström D (1984) Thyreoregulatory changes associated with smoking in 70-year-old-men. J Clin Endocrinol Metab 21:605–610Google Scholar
  136. 136.
    Jensen J, Hummer L, Christiansen C, Rødbro P (1985) Cigarette smoking, serum estrogens and bone loss in early postmenopausal women during hormone replacement therapy. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis, Dept Clin Chem, Glostrup Hospital, Copenhagen, Denmark, pp 401–402Google Scholar
  137. 137.
    Kauffman DW, Slone D, Rosenberg L, Miettinen OS, Shapiro S (1980) Cigarette smoking and age at natural menopause. Am J Public Health 70:420–422Google Scholar
  138. 138.
    Anonymous (1960) Historical statistics of Sweden. Central bureau of statistics. Stockholm: 122 (in Swedish)Google Scholar
  139. 139.
    Anonymous (1988) Statistical abstract of Sweden. Central bureau of statistics. Stockholm: 151 (in Swedish)Google Scholar
  140. 140.
    Waller J (1978) Falls among the elderly: Human and environmental factors. Accident Anal Prev 10:21–33CrossRefGoogle Scholar
  141. 141.
    Saville PD (1965) Changes in bone mass with age and alcoholism. J Bone Joint Surg 47A:493–499Google Scholar
  142. 142.
    Nilsson BE, Westlin NE (1973) Changes in bone mass in alcoholics. Clin Orthop 90:229–232PubMedGoogle Scholar
  143. 143.
    Johnell O, Nilsson BE, Wiklund PE (1982) Bone morphometry in alcoholics. Clin Orthop 165:253–258PubMedGoogle Scholar
  144. 144.
    De Vernejoul MC, Bielakoff J, Herve M, Gueris J, Hott M, Modrowski D, Kuntz D, Miravet L, Ryckwaert A (1983) Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middleaged men. Clin Orthop 179:107–115PubMedGoogle Scholar
  145. 145.
    Williams GA, Bowser EN, Hargis GK, Kukreja SC, Shah JH, Vora NK, Henderson WJ (1978) Effect of ethanol on parathyroid hormone and calcitonin secretion in man. Proc Soc Exp Biol Med 159:187PubMedGoogle Scholar
  146. 146.
    Trotter M, Broman GE, Peterson RR (1960) Densities of bone of white and Negro skeletons. J Bone Joint Surg (Am) 42A:50–58Google Scholar
  147. 147.
    Bollett AJ, Engh G, Parson W (1965) Epidemiology of osteoporosis. Arch Int Med 16:191–194Google Scholar
  148. 148.
    Farmer ME, White LR, Brody JA, Bailey KR (1984) Race and sex differences in hip fracture incidence. Am J Publ Health 74:1374–1380CrossRefGoogle Scholar
  149. 149.
    Cohn SH, Abesamis C, Yasimura S, Aloia JF, Zanzi I, Ellis KJ (1977) Comparative skeletal mass and radial bone mineral content in black and white women. Metabolism 26:171–178PubMedCrossRefGoogle Scholar
  150. 150.
    Solomon L (1968) Osteoporosis and fracture of the femoral neck in the South African Bantu. J Bone Joint Surg [Br] 50B:2–13Google Scholar
  151. 151.
    Smith DM, Nance WC, Kang KW, Christian JC, Johnston CC (1973) Genetic factors in determining bone mass. J Clin Invest 52:2800–2808PubMedCrossRefGoogle Scholar
  152. 152.
    Dequeker, J, Nijs J, Verstraeten A, Geusens P, Gevers G (1987) Genetic determinants of bone mineral content at the spine and radius. A twin study. Bone 8:207–209PubMedCrossRefGoogle Scholar
  153. 153.
    Gärdsell P, Lindberg H, Obrant K (in press) Osteoporosis and heredity. Clin OrthopGoogle Scholar
  154. 154.
    Mjöberg B (in press) Aluminium-induced hip fractures: a hypothesis on bone fragility. J Bone Joint Surg [Am]Google Scholar
  155. 155.
    Spencer H, Lender M (1979) Adverse effects on aluminium-containing antacid on mineral metabolism. Gastroenterology 76:603–606PubMedGoogle Scholar
  156. 156.
    Blumenthal NC, Posner AS (1984) In vitro model of aluminium-induced osteomalacia: inhibition of hydroxyapatite formation and growth. Calcif Tissue Int 36:439–441PubMedCrossRefGoogle Scholar
  157. 157.
    Nyholm NEI (1981) Evidence of involvement of aluminium in causation of defective formation of eggshells and of impaired breeding in wild passerine birds, Environmental Res 26:363–371CrossRefGoogle Scholar
  158. 158.
    Skinner HB, Harris JR, Cook SD, O'Neill WM (1983) Bilateral sequential tibial and fibular fatigue fractures associated with aluminum intoxication osteomalacia. J Bone Joint Surg 65 [Am] 843–847PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • Karl J. Obrant
    • 1
  • Urban Bengnér
    • 1
  • Olof Johnell
    • 1
  • Bo E. Nilsson
    • 1
  • Ingemar Sernbo
    • 1
  1. 1.Department of Orthopedic Surgery Malmö Allmänna SjukhusUniversity of LundSweden

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