Temporal trends in obesity, osteoporosis treatment, bone mineral density and fracture rates: A population-based historical cohort study
Journal of Bone and Mineral Research,  Clinical Article

Leslie WD et al. – Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. Major osteoporotic fracture rates declined substantially and linearly from 1996 to 2006, and this was explained by improvements in BMD rather than greater rates of obesity or osteoporosis treatment.

Methods

  • The authors studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996–2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD).
  • The Population Fracture Registry included women age 50-years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment.
  • The BMD Registry included all women age 50-years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD.
  • Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated.
  • Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated.

Results

  • In the Fracture Registry (N = 27,341), fracture rates declined -1.6% per year (95% CI, -1.3% to -2.0%).
  • Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment.
  • In the BMD Registry (N = 36,587), obesity increased from 12.7% to 27.4%.
  • Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (p < 0.001).
  • Major osteoporotic fracture rates decreased in models that did not include femoral neck BMD (fully adjusted annual change -1.8%, 95%CI, -2.9 to -0.5), but adjusting for femoral neck BMD accounted for the observed reduction (annual change -0.5%, 95%CI, -1.8 to +1.0).

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Orthopedics

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Orthopedics Articles

1 Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial BMJ, August 1, 2014    Clinical Article

2 A randomized trial of epidural glucocorticoid injections for spinal stenosis New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

3 Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement? A non-randomized, controlled study European Journal of Physical and Rehabilitation Medicine, August 4, 2014    Clinical Article

4 A systematic review and meta-analysis of the topical administration of tranexamic acid in total hip and knee replacement The Bone & Joint Journal, August 6, 2014    Review Article    Clinical Article

5 Non-steroidal anti-inflammatory drugs versus corticosteroid for treatment of shoulder pain: A systematic review and meta-analysis Archives of Physical Medicine and Rehabilitation, May 19, 2014    Evidence Based Medicine    Review Article    Clinical Article

6 Effective treatment of posttraumatic and postoperative edema in patients with ankle and hindfoot fractures: A randomized controlled trial comparing multilayer compression therapy and intermittent impulse compression with the standard treatment with ice The Journal of Bone & Joint Surgery, August 18, 2014    Evidence Based Medicine    Clinical Article

7 Denosumab rapidly increases cortical bone in key locations of the femur: A 3D bone mapping study in women with osteoporosis Journal of Bone and Mineral Research, August 5, 2014    Clinical Article

8 What is the best time point to identify patients at risk of developing persistent low back pain? Journal of Back and Musculoskeletal Rehabilitation, August 14, 2014    Clinical Article

9 Is statin use associated with new joint-related symptoms, physical function and quality of life? The Australian Longitudinal Study on Womens Health Arthritis Care & Research , July 8, 2014    Clinical Article

10 Wrist-ankle acupuncture for the treatment of pain symptoms: A systematic review and meta-analysis Full Text Evidence-based Complementary and Alternative Medicine , July 18, 2014    Free full text    Evidence Based Medicine    Review Article    Clinical Article

11 The bidirectional relationship between pain intensity and sleep disturbance/quality in patients with low back pain The Clinical Journal of Pain, August 7, 2014    Clinical Article

12 45-day mortality after 467 779 knee replacements for osteoarthritis from the National Joint Registry for England and Wales: an observational study The Lancet, July 25, 2014    Evidence Based Medicine    Clinical Article

13 Association between forearm muscle thickness and age-related loss of skeletal muscle mass, handgrip and knee extension strength and walking performance in old men and women: A pilot study Ultrasound in Medicine and Biology, August 27, 2014    Clinical Article

14 Accountability and empathy effects on medical students clinical judgments in a disability determination context for low back pain The Journal of Pain, August 25, 2014    Clinical Article

15 Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: Influences of age, gender and osteoarthritis affecting other joints Annals of Rheumatic Diseases, August 8, 2014    Clinical Article

16 Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis Clinical Rheumatology, August 12, 2014    Clinical Article

17 New tool could drastically reduce the number of potential future hip fractures The University of Manchester News, August 14, 2014

18 Hamstring autograft versus soft-tissue allograft in anterior cruciate ligament reconstruction: a systematic review and meta-analysis of randomized controlled trials Arthroscopy, August 8, 2014    Evidence Based Medicine    Review Article

19 Comparison of three knee braces in the treatment of medial knee osteoarthritis The Knee, August 1, 2014    Clinical Article

20 Sarilumab, a fully human monoclonal antibody against IL-6R{alpha} in patients with rheumatoid arthritis and an inadequate response to methotrexate: Efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial Annals of Rheumatic Diseases, August 12, 2014    Clinical Article

Indexed Journals in Orthopedics: Journal of Bone and Joint Surgery, Journal of Arthroplasty, Spine, The Kneemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close