Estimating the avoidable burden of certain modifiable risk factors in osteoporotic hip fracture using Generalized Impact Fraction (GIF) model in Iran

Abstract

BackgroundsThe number of hip fractures, the most common complication of osteoporosis, has increased rapidly over the past decades. The goal of this study is to estimate the avoidable burden of certain modifiable risk factor of the condition using the Generalized Impact Fraction (GIF) model, which has been suggested and used by epidemiologists to overcome the drawbacks associated with the use of Attributable Fraction index. In addition to preventing a risk factor or the avoidable fraction of burden, this index can also calculate the change in the burden, when a risk factor is altered.MethodsInternational databases were searched through PubMed, CINAHLD, Embase using OVID and Google scholar. National resources were searched through IranDoc, IranMedex, SID and Journal sites. Other resources include abstract books and articles sent to the IOF congress. The following search strategy was used: (“Osteoporotic fracture” OR “Fragility Hip fracture” OR “Calcium” OR “vitamin D” OR “BMI” OR “lean body weight” OR “Physical activity” OR “exercise” OR “Smoke”) AND (“prevalence” OR “incidence” OR “relative risk”) and limited to “humans.”ResultsWith regards to different scenarios already explained in modifying the studied risk factors, the greatest impact in reducing the prevalence of risk factors on osteoporotic hip fractures, was seen in low serum vitamin D levels, low physical activity and low intake of calcium and vitamin D, respectively. According to the fact that interventions for low serum vitamin D and low intake of calcium and vitamin D, are related to each other, it can be concluded that implementing interventions to change these two risk factors, in the easy, moderate and difficult scenarios, would result in approximately a 5%, 11% and 17% decrease in the burden of osteoporotic hip fractures, respectively. The addition of interventions addressing low physical activity in the easy, moderate and difficult scenarios, an 8%, 21% and 35% reduction in the burden of osteoporotic hip fractures would be reported, respectively.ConclusionImproving serum vitamin D levels, recommending the consumption of calcium and vitamin D supplementations and advocating physical activity are the most effective interventions to reduce the risk of osteoporotic hip fractures.

Whole Body Vibration Exercises and the Improvement of the Flexibility in Patient with Metabolic Syndrome

“…Considering the patients with osteoporosis, exercise is associated with a decreased risk of hip fractures [ 8 , 9 ]. Compared to a weight loss diet alone, diet related exercise or exercise and resistance training brings a relevant and important reduction in body fat and enhanced preservation of body lean mass [ 10 ].…”

Osteoporosis is a neglected health priority in Arab World: a comparative bibliometric analysis

“…In Middle East, the problem of osteoporosis will soon be of greater importance considering the steady growth of the ageing population ((Maalouf et al 2007 ); IOF 2011a , 2012 ). Iran accounts for 0.85% of the global burden of hip fractures and 12.4% of the burden of hip fractures in the Middle East (Soveid et al 2005 ; Moayyeri et al 2006 ; Ahmadi-Abhari et al 2007 ; Beyranvand & Mohammadi 2009 ; Shahnazari et al 2013 ). Furthermore, hypovitaminosis D is highly prevalent in Middle Eastern countries and might be a strong contributing factor for osteoporosis (Gannage-Yared et al 2000 ).…”

Review of osteoporotic fracture research in Endocrinology and Metabolism Research Institute; where we started and where to go

“…We found four papers published on the burden of osteoporosis and osteoporotic fractures [5,10,16,19]. In 2001, a study was conducted to estimate the burden of osteoporosis in Iran, considering the fractures of the hip, spine, and forearm as the most common sites of fractures in older ages.…”

“…Considering the burden of hip fracture, Shahnazari et al estimated the preventable burden of the known modifiable risk factor of osteoporotic hip fractures in Iran, using the Generalized Impact Fraction model [16]. They considered different scenarios showed that the highest impact in reducing the prevalence of osteoporotic hip fractures could be achieved by reducing the prevalence of low vitamin D, low physical activity, and low vitamin D and calcium intake, respectively.…”

“…Adding the interventions focusing on insufficient physical activity resulted in an 8 %, 21 %, and 35 % decrease in the burden of osteoporotic hip in the easy, moderate, and challenging scenarios, respectively. They concluded that calcium vitamin D supplementations and improving physical activity could be the most effective interventions to reduce the burden of osteoporotic hip fractures in Iran [16].…”