The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies

Maharlouei, Najmeh; Atefi, Sina; Namazi, Hamid; Kazemifar, Somayeh; Soveid, Mahmood; Shahraki, Hadi Raeisi; Farahmand, Zahra; Khodayari, Mohammad Taghi; Arab, P; Forouzan, Farkhondeh; Allamehzadeh, N.; Fazilat, Shiva; Khademolhosseini, Sara; Nafari, F.; Lankarani, Kamran Bagheri

doi:10.1007/s00198-017-3983-6

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…In general, in most patients, osteoporosis is not diagnosed until severe complications are encountered, such as OF. OF most commonly occur in the hip, distal radius, proximal humerus and vertebral body, related medical expenses due to fracture were in an exponential increase [8][9][10] . It is estimated that in China there will be 4.83 million cases of OF patients by 2035 and 5.99 million cases by 2050 11 .…”

Section: Discussionmentioning

confidence: 99%

Bone Turnover Markers and Bone Mineral Density to Predict Osteoporotic Fractures in Older Women: A Retrospective Comparative Study

Zheng

Chen

et al. 2019

Orthopaedic Surgery

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Objective To investigate the clinical significance of the detection of bone mineral density (BMD) and bone turnover markers (BTM) in older women with osteoporosis, and to compare their predictive power for osteoporotic fractures (OF). Methods In this retrospective study, 96 patients with OF and 107 patients with osteoporosis who were hospitalized in the Department of Orthopedics at the First Affiliated Hospital of Chengdu Medical College were examined from October 2017 to February 2019. All selected patients were divided into either the fracture group (96 cases, 47.3%) or the non‐fracture group (107 cases, 52.7%). BMD was measured by dual‐energy X‐ray absorptiometry (DXA). BTM were detected by electrochemical luminescence: aminoterminal propeptide of type I procollagen (PINP), β‐cross‐linked C‐telopeptide of type I collagen (β‐CTX), and molecular fragment of osteocalcin N terminal (N‐MID). Bone metabolism‐related indicators were detected, including alkaline phosphatase (ALP), calcium (Ca), and phosphorus (P). Independent‐samples t‐tests were used to compare the measurement data between the two groups, one‐way ANOVA to compare the gaps between groups, and binary logistic regression to analyze the correlation of BMD and BTM with OF. Results There were no significant differences in age, weight, height, body mass index, age, and time of menopause between the two groups. There were a total of 71 cases (35.0%) in group A (60–70 years), 80 cases (39.4%) in group B (71–80 years), and 52 cases (25.6%) in group C (81–90 years). The fracture group was compared with the non‐fracture group for BMD in the lumbar (0.75 ± 0.05 vs 0.88 ± 0.13, 0.75 ± 0.16 vs 0.87 ± 0.09, 0.74 ± 0.21 vs 0.87 ± 0.12 g/cm2; P < 0.05), BMD in the hip (0.62 ± 0.16 vs 0.74 ± 0.14, 0.61 ± 0.15 vs 0.73 ± 0.0, 0.58 ± 0.13 vs 0.73 ± 0.08 g/cm2; P < 0.05), PINP (83.7 ± 5.7 vs 74.8 ± 5.0, 80.7 ± 4.1 vs 72.1 ± 5.1, 81.2 ± 7.0 vs 68.7 ± 6.3 ng/mL, P < 0.05), and β‐CTX (829.7 ± 91.5 vs 798.8 ± 52.2, 848.1 ± 71.2 vs 812.4 ± 79.0, 867.3 ± 53.1 vs 849.1 ± 67.2 pg./mL, P < 0.05). N‐MID (19.0 ± 6.7 vs 21.3 ± 9.7, 16.2 ± 7.0 vs 18.0 ± 5.3 ng/mL, P < 0.05) in the fracture cases was lower than in the non‐fracture cases for groups B and C, and there was statistical significance. Among the fracture cases, PINP in group A was higher than in group B and C, and β‐CTX in group C was higher than in group A and B (P < 0.05). There was no significant difference in the ALP, P, and Ca between the two groups (P > 0.05). Binary logistic regression analysis showed that for BMD in the lumbar and hip, β‐CTX and OF were significantly correlated (respectively, odds ratio [OR] = −4.182, 95% confidence interval [CI] 1.672–3.448; OR = 6.929, 95% CI 2.586–12.106; OR = 7.572, 95% CI 1.441–3.059), and the differences were statistically significant. PINP and N‐MID were correlated with OF (respectively, OR = 4.213, 95% CI 0.978–1.005; OR = 2.510, 95% CI 1.070–1.134, P > 0.05), the difference was not statistically significant. Conclusion Osteoporotic older women, with lower bone density and hig...

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Section: Discussionmentioning

confidence: 99%

Bone Turnover Markers and Bone Mineral Density to Predict Osteoporotic Fractures in Older Women: A Retrospective Comparative Study

Zheng

Chen

et al. 2019

Orthopaedic Surgery

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“…Data was provided only for hip fractures in the included studies [16,[19][20][21][22][23][24][25]. The result of the meta-analysis shows that the annual cumulative incidence of hip fractures was 121.39 (95% CI: 82.93-177.69) per 100,000 persons in men and 129.82 (95% CI: 104.90-160.66) per 100,000 persons in women (Fig.…”

Section: Resultsmentioning

confidence: 99%

Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis

et al. 2021

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Background Osteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran. Methods A comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic. Results In all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively. Conclusion This study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model.

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“…(18,19,24) Age and sex ratios In our study, the average women to men IRR was 1.8 (range, 1.5 to 2.1), which is consistent with ratios in other countries. (5,25,26) IRRs were reported at 1.7 in Jordan in 2008, (26) 1.4 in both Tunisia in 2001 (26) and Iran in 2011 to 2012, (23) 1.3 to 1.5 in 2009 to 2012 in Kuwait, (27) and 1.2 in Morocco (range, 0.9 to 1.2) from 2006 to 2009. (28) In Saudi Arabia, men experienced a slightly higher incidence of hip fractures in 2001 to 2006, and IRR was 0.83.…”

Section: Location Of Hip Fracturesmentioning

confidence: 99%

“…(19) However, data from Asia including Taiwan (20) and Japan, (21) and from the Mediterranean and Middle East regions including Crete (22) and Iran, (23) show higher proportions of trochanteric fractures. (5,25,26) IRRs were reported at 1.7 in Jordan in 2008, (26) 1.4 in both Tunisia in 2001 (26) and Iran in 2011 to 2012, (23) 1.3 to 1.5 in 2009 to 2012 in Kuwait, (27) and 1.2 in Morocco (range, 0.9 to 1.2) from 2006 to 2009. (17)(18)(19)21) Patients with trochanteric fractures are usually older (17)(18)(19)24) -as we documented here-shorter, (18,24) thinner, have lower bone mass, and are more likely to have experienced previous fragility fractures.…”

Section: Location Of Hip Fracturesmentioning

confidence: 99%

“…(16) A comparable trend is noted in Northern Europe (17,18) and the United States. (19) However, data from Asia including Taiwan (20) and Japan, (21) and from the Mediterranean and Middle East regions including Crete (22) and Iran, (23) show higher proportions of trochanteric fractures. These geographic disparities might stem from the significant differences that exist between individuals who sustain trochanteric fractures and those who sustain femoral neck fractures.…”

Section: Location Of Hip Fracturesmentioning

confidence: 99%

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Secular Trends of Hip Fractures in Lebanon, 2006 to 2017: Implications for Clinical Practice and Public Health Policy in the Middle East Region

Saad

Harb

Bou-Orm

et al. 2019

Journal of Bone and Mineral Research

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Country‐specific hip fracture incidence rates (IRs) and longevity allow the Fracture Risk Assessment Tool (FRAX) to be adapted to individual countries. Secular trends can affect tool calibration. Data on hip fracture IRs in the Middle East is scarce, and long‐term secular trend studies are nonexistent. Using the Ministry of Public Health hip fracture registry, we calculated age‐ and sex‐specific hip fracture IRs in Lebanon, from 2006 to 2017, among individuals aged ≥50 years. We used Kendall's tau‐b (τb) test to determine the correlation between time and hip fracture IRs, and calculated both the annual % change in IRs and the % change in IR compared to the baseline period (2006 to 2008). The registry recorded 6985 hip fractures, 74% at the femoral neck, 23% intertrochanteric, and 3% subtrochanteric. Men constituted 32% of the population, and were significantly younger than women (76.5 ± 11.0 years versus 77.7 ± 10.3 years; p < 0.001). Annual overall IRs, per 100,000, ranged from 126.6 in 2014 to 213.2 in 2017 in women, and 61.4 in 2015 to 111.7 in 2017 in men. The average women to men IR ratio was 1.8 (range, 1.5 to 2.1). IRs steadily increased with age, and IR ratios increased in parallel in both sexes, with a steeper and earlier rise (by 5 years) in women. Data showed a consistent decline in hip fracture IRs starting in 2006 in women, and in 2009 in men. There was a significant negative correlation between time (2006 to 2014) and hip fracture IRs in women (τb = −0.611, p = 0.022) but not in men (τb = −0.444, p = 0.095). The steady decrease in IRs reversed after 2015 in both sexes. This long‐term data on secular trends in the Middle East is novel and consistent with worldwide changes in hip fracture rates. The impact of such changes on national FRAX‐derived estimates is unclear, should be assessed, and may necessitate an update in the FRAX Lebanon calculator. © 2019 American Society for Bone and Mineral Research.

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The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies

Abstract: The rate of osteoporotic hip fracture was relatively low in southern Iran. However, by aging population, this rate will increase and health policy makers should implement targeted osteoporosis screening and management programs.

Cited by 10 publications

References 23 publications

Bone Turnover Markers and Bone Mineral Density to Predict Osteoporotic Fractures in Older Women: A Retrospective Comparative Study

Bone Turnover Markers and Bone Mineral Density to Predict Osteoporotic Fractures in Older Women: A Retrospective Comparative Study

Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis

Secular Trends of Hip Fractures in Lebanon, 2006 to 2017: Implications for Clinical Practice and Public Health Policy in the Middle East Region

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