Hip fracture incidence in Lebanon: a national registry-based study with reference to standardized rates worldwide

Sibai, Abla Mehio; Nasser, Wael; Ammar, Walid; Khalife, Mohamad; Harb, Hilda L; Fuleihan, Ghada El‐Hajj

doi:10.1007/s00198-010-1468-y

Cited by 34 publications

(19 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well established that hip fracture rates vary markedly in different countries . International variations in hip fracture risk have been shown to have a latitudinal gradient which has prompted speculation that latitude might be a marker of sunlight exposure and, hence, of vitamin D status .…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that hip fracture rates vary markedly in different countries. (36,37) International variations in hip fracture risk have been shown to have a latitudinal gradient which has prompted speculation that latitude might be a marker of sunlight exposure and, hence, of vitamin D status. (38) In an analysis of a study reporting hip fracture rates around the world, (9) it was reported that there was approximately a 4% increment in hip fracture incidence for each 1°latitude difference from the equator.…”

Section: Latitudementioning

confidence: 99%

See 1 more Smart Citation

The Effect of Latitude on the Risk and Seasonal Variation in Hip Fracture in Sweden

Odén

Kanis

McCloskey

et al. 2014

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Although the optimal requirement of vitamin D for skeletal health in the general community is controversial, vitamin D deficiency impairs bone mineralization and increases bone turnover via secondary hyperparathyroidism, thus accelerating bone loss and increasing fracture risk. Support for a role of vitamin D deficiency in the epidemiology of hip fracture is found in the seasonal variation of hip fracture incidence that is reported in several studies. If the association were causal, then the incidence and amplitude of the seasonal variation in hip fracture risk should vary by latitude. We addressed this hypothesis by examining the incidence of hip fracture in men and women aged 50 years or more from Sweden (latitudes 55 to 69°) between 1987 and 2009. In order to reduce double counting, only one fracture in a period of a year was counted per individual. Men contributed 104,888 fractures in 33,313,065 person years and women 264,362 fractures in 38,387,660 person years. The effects of season and latitude were examined by Poisson regression. As expected, hip fracture rates were higher in women than in men. After adjustment for age, season and population density, hip fracture incidence increased by 3.0% (95% CI: 2.7-3.2%) per degree increase in latitude for men and by 1.9% (95% CI: 1.8-2.1%) for women. There was a marked seasonal variation of hip fracture with the highest risk in February and lower by 37.5% in men and by 23.5% women during the summer. There were significant interactions of amplitude of the seasonal variation with latitude (p < 0.001 for both men and women), indicating that seasonal variation during the year was more pronounced in the north of Sweden than in the south. The associations found with latitude and season is consistent with a role of vitamin D in hip fracture causation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Latitudementioning

confidence: 99%

The Effect of Latitude on the Risk and Seasonal Variation in Hip Fracture in Sweden

Odén

Kanis

McCloskey

et al. 2014

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…The only data on hip fracture trends in the Middle East comes from representative data on hip fracture rates from the Lebanese National Hip Fracture registry, for years 2007 to 2012 in men and women above 50 years of age (71) (Ahmadieh H, El-Hajj Fuleihan G, unpublished data). It showed no change in age-standardized rates in either gender.…”

Section: Middle Eastmentioning

confidence: 99%

Secular Trends in Hip Fractures Worldwide: Opposing Trends East Versus West

Ballane

Cauley

Luckey

et al. 2014

Journal of Bone and Mineral Research

164

118

View full text Add to dashboard Cite

Despite wide variations in hip rates fractures worldwide, reasons for such differences are not clear. Furthermore, secular trends in the age-specific hip fracture rates are changing the world map of this devastating disease, with the highest rise projected to occur in developing countries. The aim of our investigation is to systematically characterize secular trends in hip fractures worldwide, examine new data for various ethnic groups in the United States, evidence for divergent temporal patterns, and investigate potential contributing factors for the observed change in their epidemiology. All studies retrieved through a complex Medline Ovid search between 1966 and 2013 were examined. For each selected study, we calculated the percent annual change in age-standardized hip fracture rates de-novo. Although occurring at different time points, trend breaks in hip fracture incidence occurred in most Western countries and Oceania. After a steep rise in age-adjusted rates in these regions, a decrease became evident sometimes between the mid-seventies and nineties, depending on the country. Conversely, the data is scarce in Asia and South America, with evidence for a continuous rise in hip fracture rates, with the exception of Hong-Kong and Taiwan that seem to follow Western trends. The etiologies of these secular patterns in both the developed and the developing countries have not been fully elucidated, but the impact of urbanization is at least one plausible explanation. Data presented here show close parallels between rising rates of urbanization and hip fractures across disparate geographic locations and cultures. Once the proportion of the urban population stabilized, hip fracture rates also stabilize or begin to decrease perhaps due to the influence of other factors such as birth cohort effects, changes in bone mineral density and BMI, osteoporosis medication use and/or lifestyle interventions such as smoking cessation, improvement in nutritional status and fall prevention.

show abstract

“…A variety of studies have examined hip fracture rates in different regions of the world [5–11]. Greater than 10-fold differences have been found, largely on the basis of register studies undertaken on a regional or national level and at different calendar years.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of hip fracture incidence and probability of fracture worldwide

et al. 2012

View full text Add to dashboard Cite

SummaryThe country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture were determined on a worldwide basis from a systematic review of literature. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.IntroductionThe present study aimed to update the available information base available on the heterogeneity in the risk of hip fracture on a worldwide basis. An additional aim was to document variations in major fracture probability as determined from the available FRAX models.MethodsStudies on hip fracture risk were identified from 1950 to November 2011 by a Medline OVID search. Evaluable studies in each country were reviewed for quality and representativeness and a study (studies) chosen to represent that country. Age-specific incidence rates were age-standardised to the world population in 2010 in men, women and both sexes combined. The 10-year probability of a major osteoporotic fracture for a specific clinical scenario was computed in those countries for which a FRAX model was available.ResultsFollowing quality evaluation, age-standardised rates of hip fracture were available for 63 countries and 45 FRAX models available in 40 countries to determine fracture probability. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.ConclusionsWorldwide, there are marked variations in hip fracture rates and in the 10-year probability of major osteoporotic fractures. The variation is sufficiently large that these cannot be explained by the often multiple sources of error in the ascertainment of cases or the catchment population. Understanding the reasons for this heterogeneity may lead to global strategies for the prevention of fractures.

show abstract

Hip fracture incidence in Lebanon: a national registry-based study with reference to standardized rates worldwide

Abstract: The hip fracture age-standardized incidence rates in the Lebanese subjects receiving Ministry of Health coverage were lower than those found in northern Europe and the US and closest to rates derived for southern Europe.

Cited by 34 publications

References 39 publications

The Effect of Latitude on the Risk and Seasonal Variation in Hip Fracture in Sweden

The Effect of Latitude on the Risk and Seasonal Variation in Hip Fracture in Sweden

Secular Trends in Hip Fractures Worldwide: Opposing Trends East Versus West

A systematic review of hip fracture incidence and probability of fracture worldwide

Contact Info

Product

Resources

About