Fractures of the Hip and Distal Forearm in West Africa and the United Kingdom

Adebajo, Adewale; Cooper, C; Evans, John Grimley

doi:10.1093/ageing/20.6.435

Cited by 69 publications

(28 citation statements)

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“…In the case of Africa, the figures that were used [40], derived from the South African Bantu, are comparable to those reported from Ibadan [41] both in men and in women. Both studies may have suffered a degree of under-ascertainment of the fracture cases, which would make our estimates on the conservative side.…”

Section: Discussionsupporting

confidence: 68%

World-wide Projections for Hip Fracture

1997

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The aims of this study were to estimate the present and future incidence of hip fracture world-wide. From a survey of available data on current incidence, population trends and the secular changes in hip fracture risk, the numbers of hip fractures expected in 2025 and 2050 were computed. The total number of hip fractures in men and women in 1990 was estimated to be 338,000 and 917,000 respectively, a total of 1.26 million. Assuming no change in the age- and sex-specific incidence, the number of hip fractures is estimated to approximately double to 2.6 million by the year 2025, and 4.5 million by the year 2050. The percentage increase will be greater in men (310%) than in women (240%). With modest assumptions concerning secular trends, the number of hip fractures could range between 7.3 and 21.3 million by 2050. The major demographic changes will occur in Asia. In 1990, 26% of all hip fractures occurred in Asia, whereas this figure could rise to 37% in 2025 and to 45% in 2050. We conclude that the socioeconomic impact of hip fractures will increase markedly throughout the world, particularly in Asia, and that there is an urgent need to develop preventive strategies, particularly in the developing countries.

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Section: Discussionsupporting

confidence: 68%

World-wide Projections for Hip Fracture

1997

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“…BMD values are greater among those with bigger skeletons, i.e., African-Americans [21], since adjustment for the area scanned (in g/cm 2 ) does not completely account for the fact that wider bones are also thicker. However, BMD is not greater in all African populations [22][23][24] even though their fracture rates are still lower than those observed in whites [22,[25][26][27][28][29]. This suggests that the heterogeneity in bone density levels that has been described in Asian populations [30,31] might also exist in populations of African heritage.…”

Section: Introductionmentioning

confidence: 93%

Variations in Bone Density among Persons of African Heritage

Melton¹,

Marquez

Achenbach³

et al. 2002

Osteoporos Int

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The epidemiology of bone loss in populations of African heritage is still poorly known. We compared a convenience sample of 47 African-American (AA) residents of Rochester, Minnesota (32 women, 15 men) and 66 recent immigrants from Somalia (all women) with 684 white subjects (349 women, 335 men) previously recruited from an age-stratified random sample of community residents. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 for white subjects and the QDR 4500 for the others; the instruments were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 18% higher in AA ( p<0.001) and 4% lower in Somali ( p = 0.147) than white women. Femoral neck BMD was 27% higher in AA women but also 11% greater in Somali women (both p<0.001) compared with whites. Lumbar spine BMD was 6% higher ( p = 0.132) and femoral neck BMD 21% higher ( p<0.001) in AA than white men. No Somali men were studied. After correcting for bone size differences, both lumbar spine ( p<0.01) and femoral neck BMAD ( p<0.001) were greater for Somali than white women, but the difference between Somali and AA women persisted. Lumbar spine and femoral neck BMAD values also remained significantly greater for AA women (both p<0.001) and men ( p<0.05; p<0.001) compared with whites. Weight was associated with BMAD at both skeletal sites in all groups, but adjustment for differences in weight did not reduce the discrepancy in BMAD values between Somali and AA women or between the latter group and whites. This heterogeneity among different ethnic groups of African heritage may provide an opportunity for research to better explain race-specific differences in bone metabolism.

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“…Osteoporotic fractures are major public heath problems in Caucasian populations while age-adjusted fracture incidence in Africa and Asia is substantially lower (Solomon, 1968;Adebajo et al, 1991;Lau & Cooper, 1996;Yan et al, 1999). The aetiology of ethnic differences in osteoporotic fracture incidence is not known and cannot be explained by variations in dietary calcium intake or bone mineral density (BMD) (Prentice et al, 1991;Cummings et al, 1994;Aspray et al, 1996;Lau & Cooper, 1996).…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in osteocalcin γ-carboxylation, plasma phylloquinone (vitamin K1) and apolipoprotein E genotype

et al. 2004

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Objective: To investigate plasma osteocalcin g-carboxylation and its relationship to plasma phylloquinone concentration and apolipoprotein E (apoE) genotype in women from three ethnic groups with differing osteoporotic fracture risk. Design and subjects: Fasted blood samples were collected from postmenopausal Gambian (n ¼ 50), British (n ¼ 31) and Chinese women (n ¼ 23), and 11 premenopausal women in each group from three cross-sectional studies. Results: After adjustment for total osteocalcin, plasma undercarboxylated osteocalcin (adjusted ucOC) was lowest in Chinese and highest in British women postmenopause (British vs Chinese 103% higher, Po0.0001; Gambian vs Chinese 66% higher, Po0.01). No differences were observed premenopause. Within each ethnic group, adjusted ucOC was similar pre-and postmenopause. Postmenopause, plasma phylloquinone was higher in Chinese women (1.0 ng/ml) than in British (0.31 ng/ml) and Gambian women (0.36 ng/ml) (Po0.0001). Premenopause, plasma phylloquinone was higher in Gambian and Chinese women (0.6 ng/ml) than in British women (0.3 ng/ml; P ¼ 0.01). Plasma phylloquinone and adjusted ucOC were inversely related in postmenopausal British women (R 2 ¼ 32.4%; P ¼ 0.0008). ApoE4 frequency was Gambian 32.6%, British 13.8% and Chinese 6%. A lower adjusted ucOC was associated with apoE2 genotype in British and Chinese women. Ethnic differences in adjusted ucOC persisted after adjustment for phylloquinone and apoE genotype. Conclusion: These preliminary data indicate suboptimal vitamin K status in postmenopausal British compared to Chinese and Gambian women. Ethnic differences in apoE genotype may also influence osteocalcin g-carboxylation status. The study highlights the need for larger epidemiological investigations of ethnic differences in vitamin K status and the possible implications to bone health. Sponsorship: This work was funded by the MRC.

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Fractures of the Hip and Distal Forearm in West Africa and the United Kingdom

Cited by 69 publications

References 0 publications

World-wide Projections for Hip Fracture

World-wide Projections for Hip Fracture

Variations in Bone Density among Persons of African Heritage

Ethnic differences in osteocalcin γ-carboxylation, plasma phylloquinone (vitamin K1) and apolipoprotein E genotype

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