Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop

Maulana Azad Medical College, New Delhi, India.
Indian Journal of Orthopaedics (Impact Factor: 0.64). 03/2011; 45(1):15-22. DOI: 10.4103/0019-5413.73656
Source: PubMed


Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates) and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.

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    • "Osteoporosis is commonly associated with females, remaining an under-diagnosed and undertreated disorder men (Briot et al., 2009). The incidence of osteoporosis varies by world-wide geographical regions with higher rates in developed nations, such as the USA, Europe and Australia (Dhanwal, Dennison, Harvey, & Cooper, 2011). The primary outcome of osteoporosis is fragility fractures. "
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    ABSTRACT: Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardised mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES=0.644; 95% CI=0.406 to 0.883; p=0.000), followed by total hip (ES=0.483, 95% CI= 0.255 to 0.711, p=0.000), femoral neck (ES=0.402, 95% CI=0.233 to 0.570, p=0.000) and lumbar spine (ES=0.306, 95% CI=0.173 to 0.440,p=0.000). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomised controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.
    International journal of sport nutrition and exercise metabolism 02/2015; DOI:10.1123/ijsnem.2014-0202 · 2.44 Impact Factor
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    • "Osteoporosis is a condition of skeletal fragility characterised by decreased bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in risk of fracture [1]. Osteoporosis is a worldwide health issue, with a high prevalence of disease not only in western countries but also in Asia and Latin America [2]. Women were found to have a higher risk of getting osteoporosis than men with the ratio of 1.6 : 1. Postmenopausal osteoporosis stems from the cessation of ovarian function at menopause which heightens and prolongs the rapid phase of bone loss characteristic of the early postmenopausal period [3]. "
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    ABSTRACT: Marine molluscs are widely distributed throughout the world and many bioactive compounds exhibiting antiviral, antitumor, antileukemic, and antibacterial activity have been reported worldwide. The present study was designed to investigate the beneficial effect of methanol extract of Euchelus asper (EAME) on estrogen deficiency induced osteoporosis in ovariectomised mice model. Forty-two female Swiss albino mice were randomly assigned into Sham operated (Sham) group and six ovariectomised (OVX) subgroups such as OVX with vehicle (OVX); OVX with estradiol (2 mg/kg/day); OVX with EAME of graded doses (25, 50, 100, and 200 mg/kg/day). Bone turnover markers like serum alkaline phosphatase (ALP), serum acid phosphatase (ACP), serum calcium, and histological investigations of tibia and uterus were analysed. Metaphyseal DNA content of the femur bone was also studied. Antiosteoclastogenic activity of EAME was examined. Administration of EAME was able to reduce the increased bone turnover markers in the ovariectomised mice. Histomorphometric analysis revealed an increase in bone trabeculation and restoration of trabecular separation by EAME treatment. Metaphyseal DNA content of the femur of the OVX mice was increased by EAME administration. EAME also showed a potent antiosteoclastogenic behaviour. Thus, the present study reveals that EAME was able to successfully reduce the estrogen deficiency induced bone loss.
    Journal of Osteoporosis 06/2014; 2014:348189. DOI:10.1155/2014/348189
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    • "During the past decade, however, a break in the trend has been seen in many parts of the world, with stable—or even decreasing—hip fracture rates (Kannus et al. 2006, Dhanwal et al. 2011, Rosengren et al. 2012). The many studies highlighting this down-turn have not been followed by an equal interest in new projections on the future number of hip fractures. "
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    ABSTRACT: Background and purpose The incidence and annual number of hip fractures have increased worldwide during the past 50 years, and projections have indicated a further increase. During the last decade, however, a down-turn in the incidence of hip fracture has been seen in the western world. We predicted the development of hip fractures in Sweden until the year 2050. Methods We reviewed surgical records for the period 2002–2012 in the city of Malmö, Sweden, and identified patients aged 50 years or more with a hip fracture. We estimated incidence rates by using official population figures as denominator and applied the rates to population projections each year until 2050. We also made projections based on our previously published nationwide Swedish hip fracture rates for the period 1987–2002. Since the projections are based on estimates, no confidence limits are given. Results During the period 2002–2012, there were 7,385 hip fractures in Malmö. Based on these data, we predicted that there would be approximately 30,000 hip fractures in Sweden in the year 2050. Use of nationwide rates for 2002 in the predictive model gave similar results, which correspond to an increase in the number of hip fractures by a factor of 1.9 (1.7 for women and 2.3 for men) compared to 2002. Interpretation The annual number of hip fractures will almost double during the first half of the century. Time trends in hip fractures and also changes in population size and age distribution should be continuously monitored, as such changes will influence the number of hip fractures in the future. Our results indicate that we must optimize preventive measures for hip fractures and prepare for major demands in resources.
    Acta Orthopaedica 04/2014; 85(3). DOI:10.3109/17453674.2014.916491 · 2.77 Impact Factor
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