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Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark

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Abstract

Aim: To compare the number of patients diagnosed with osteoporosis and osteoporotic fractures in Denmark, with the number of subjects expected to have osteoporosis. Subjects and methods: From the National Hospital Discharge Register, records for all patients diagnosed with osteoporosis and/or with osteoporotic fractures between 1995 and 1999 were retrieved. Based on normal Danish values for BMD, the expected number of subjects aged 50 years or more with osteoporosis according to the WHO definition was calculated. Results: The estimated prevalence of osteoporosis was 40.8% of women aged ≥50 years and 17.7% among men. The expected annual incidence was 58,658/million inhabitants in women ≥50 years of age and 23,648/million in men ≥50 years. However, the observed incidence was only 4,823 and 862/million per year, respectively (8.2% and 3.6% of the expected). In 1999, a total of 34,691 hip, spine, and forearm fractures were reported in subjects ≥50 years, and of these, 18,566 were potentially attributable to osteoporosis (14,240 fractures in women and 4,326 in men equaling 14,976 and 5,297/million per year). Only 0.3% of men ≥50 years were receiving a bisphosphonate, while 2.2% of women received a bisphosphonate or raloxifene. Among women ≥50 years, 27.7% received hormone replacement therapy. Conclusions: Osteoporotic fractures of the hip, spine, and forearm are rather frequent in Denmark, but the diagnosis of osteoporosis is rarely used. It seems that osteoporosis is markedly underdiagnosed and undertreated in Denmark as probably also elsewhere. This may have significant implications for the prevention of osteoporotic fractures.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus Amtssygehus, Aarhus, Denmark

    Peter Vestergaard, Lars Rejnmark & Leif Mosekilde

  2. The Osteoporosis Clinic, Aarhus Amtssygehus, Tage Hansens Gade 2, DK-8000, Aarhus C, Denmark

    Peter Vestergaard

Authors
  1. Peter Vestergaard
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  2. Lars Rejnmark
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  3. Leif Mosekilde
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Corresponding author

Correspondence to Peter Vestergaard.

Appendix: ICD10 codes for osteoporosis

Appendix: ICD10 codes for osteoporosis

M80.:

Osteoporosis with a pathological fracture

M80.0.:

Postmenopausal osteoporosis with a pathological fracture

M80.1.:

Osteoporosis after oophorectomy presenting with a pathological fracture

M80.2.:

Disuse osteoporosis with a pathological fracture

M80.3.:

Osteoporosis linked to malabsorption after surgery on the stomach or intestine presenting with a pathological fracture

M80.4.:

Drug-induced osteoporosis (e.g., glucocorticoid-induced osteoporosis—an ATC code is mandatory) presenting with a pathological fracture

M80.5.:

Idiopathic osteoporosis with a pathological fracture

M80.8.:

Other forms of osteoporosis with a pathological fracture

M80.9.:

Nonspecified osteoporosis with a pathological fracture

M81.:

Osteoporosis without a pathological fracture

M81.0.:

Postmenopausal osteoporosis

M81.1.:

Osteoporosis after oophorectomy

M81.2.:

Disuse osteoporosis

M81.3.:

Osteoporosis linked to malabsorption after surgery on the stomach or intestine

M81.4.:

Drug-induced osteoporosis (e.g., glucocorticoid induced osteoporosis—an ATC code is mandatory)

M81.5.:

Idiopathic osteoporosis

M81.6.:

Localized osteoporosis

M81.8.:

Other forms of osteoporosis

M81.9.:

Nonspecified osteoporosis

M82.:

Osteoporosis following other classified diseases

M82.0.:

Osteoporosis following multiple myeloma

M82.1.:

Osteoporosis following endocrine disorders (e.g., hyperthyroidism)

M82.8.:

Osteoporosis in other classified diseases

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Vestergaard, P., Rejnmark, L. & Mosekilde, L. Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16, 134–141 (2005). https://doi.org/10.1007/s00198-004-1680-8

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  • DOI: https://doi.org/10.1007/s00198-004-1680-8

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