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Variation in Fracture Rates by Country May Not Be Explained by Differences in Bone Mass

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Abstract

It is unclear whether the high fracture incidence in Sweden compared with other countries is related to low bone mass. We present and compare bone mineral density (BMD, g/cm2) at the femoral neck in a mainly osteoporotic referral population consisting of 2,031 men and 6,932 women with that of previous population-based cohorts. BMD measurements were collected at a single study center in Sweden, and data on validated hip fractures were collected from the corresponding health-care district and the cohort investigated. The BMD values of our cohort were similar to those of population-based cohorts from other countries. In contrast, the total incidence of hip fractures in 80-year-old women and men in the health-care district where our BMD measurements were performed was high (1.8% and 0.9%, respectively). The correlation between age and BMD was more negative in men aged 20–49 years than in women of the same age group (–0.011 vs. –0.006 g/cm2 yearly, P < 0.001). In contrast, at 50–80 years of age, more negative regression coefficients were seen in women (–0.007 vs. –0.004 g/cm2 yearly, P < 0.001 for comparison). In conclusion, a low BMD may not be the key factor explaining Sweden’s comparatively high fracture incidence. In our cross-sectional data, age trends in BMD at the femoral neck differ between men and women. It would be highly interesting to further study the underlying causes of the global variations in fracture incidence rates.

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Acknowledgement

The present study was supported by funding from Västerbottens Läns Landsting.

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Authors and Affiliations

  1. Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden

    Fredrik Eklund & Anna Nordström

  2. Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden

    Anna Nordström

  3. Department of Internal Medicine, Obesity Unit M73, Karolinska Institutet, Stockholm, Sweden

    Martin Neovius

  4. Department of Surgical and Perioperative Sciences, Orthopedics, Umeå University, Umeå, Sweden

    Olle Svensson

  5. Department of Community Medicine and Rehabilitation, Geriatrics, Umeå University, 901 85, Umeå, Sweden

    Peter Nordström

Authors
  1. Fredrik Eklund
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  2. Anna Nordström
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  3. Martin Neovius
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  4. Olle Svensson
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  5. Peter Nordström
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Correspondence to Peter Nordström.

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Eklund, F., Nordström, A., Neovius, M. et al. Variation in Fracture Rates by Country May Not Be Explained by Differences in Bone Mass. Calcif Tissue Int 85, 10–16 (2009). https://doi.org/10.1007/s00223-009-9265-3

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  • DOI: https://doi.org/10.1007/s00223-009-9265-3

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