Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies

Valentin, Gitte H; Ravn, Maiken Bay; Jensen, Emma Kejser; Friis, Karina; Bhimjiyani, Arti; Ben‐Shlomo, Yoav; Hartley, April; Nielsen, Charlotte; Langdahl, Bente; Gregson, Celia L

doi:10.1007/s00198-021-06038-7

Cited by 13 publications

(6 citation statements)

References 81 publications

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“…The results of the subgroup analyses showed that the correlations between WWI and hip fractures differed among the subgroups of education level. Results similar to this finding have been reported in previous studies [ 60 ]. Results from a cross-sectional study investigating American men aged 20 years and older suggest that higher education and income are significantly associated with high lumbar BMD and that the educational attainment of participants should be fully considered in the prevention and treatment of osteoporotic fractures [ 61 ].…”

Section: Discussionsupporting

confidence: 93%

Associations between weight-adjusted waist index and fractures: a population-based study

et al. 2023

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Introduction The weight-adjusted waist circumference index (WWI) is a novel obesity evaluation indicator that appears to be superior to body mass index (BMI) and waist circumference (WC) in evaluating muscle and fat mass. The purpose of this study was to investigate the association between WWI and fractures among adults. Methods In this cross-sectional study, multivariate logistic regression and smoothed curve fitting were used to investigate linear and nonlinear associations between WWI and fractures, based on data from 28,679 adult participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Results After adjusting for all covariates, the prevalence of hip/wrist/spine fractures among all participants was 1.09%, 8.87%, and 1.97%, respectively. A 1-unit increase in WWI was associated with a 5% increase in the odds of hip fractures [1.05 (1.01, 1.10)], and a 9% increase in the odds of spine fractures [1.09 (1.06, 1.13)], but not with the prevalence of wrist fractures [0.97 (0.94, 1.06)]. Conclusions Higher WWI was associated with an increased prevalence of hip fracture and spine fracture, but not wrist fracture.

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Section: Discussionsupporting

confidence: 93%

Associations between weight-adjusted waist index and fractures: a population-based study

et al. 2023

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“…Compared with rural areas, the social level in urban areas is higher. It is reported that low socio-economic status has been confirmed as a risk factor for hip fracture ( 20 ). The results of a Chinese study show that income level is positively correlated with awareness of the perceived risk of osteoporosis ( 21 ).…”

Section: Resultsmentioning

confidence: 99%

Recent advances in the identification of related factors and preventive strategies of hip fracture

Wang

Hou

et al. 2023

Front. Public Health

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Hip fracture is the most devastating type of osteoporosis-related fracture, and is a major worldwide public health problem with a high socioeconomic burden, morbidity rate, and mortality rate. Thus, it is crucial to uncover the risk factors and protective factors to create a hip fracture prevention strategy. In addition to a briefly review of some well accepted risk and protective factors of hip fracture, this review mainly summarized the recent advances in the identification of emerging risk or protective factors for hip fracture, in terms of regional differences in medical services, diseases, drugs, mechanical load, neuromuscular mass, genes, blood types, cultural differences. This review provides a comprehensive review of the associated factors and effective prevention measures for hip fracture, and discusses issues that need further investigation. These issues include the determination of the influencing mechanism of risk factors triggering hip fracture and their interlinked correlation with other factors, as well as the confirmation or correction of emerging factors associated with hip fracture, particularly those that are still controversial. These recent findings will aid in optimizing the strategy for preventing hip fracture.

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“…This would appear to support the inding of higher incidence of ATR being associated with lower levels of deprivation. SEDS has been shown to inluence the epidemiology of traumatic injuries [11,13,15,42], osteoarthritis [31], musculoskeletal [21,41], and non-orthopaedic [9] conditions. However, the relationship identiied with ATR is the inverse that seen with respect to all the above, where increasing levels of deprivation are associated with higher rates of incidence [9,11,13,15,21,31,41].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic deprivation status predicts both the incidence and nature of Achilles tendon rupture

Maempel

Clement

Mackenzie

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this study was to describe the epidemiology of Achilles tendon rupture (ATR) and its relationship with socioeconomic deprivation status (SEDS). The hypothesis was that ATR occurs more frequently in socioeconomically deprived patients. Secondary aims were to determine variations in circumstances of injury between more and less deprived patients. Methods A 6-year retrospective review of consecutive patients presenting with ATR was undertaken. The health-board population was deined using governmental population data and SEDS was deined using the Scottish Index of Multiple Deprivation. The primary outcome was an epidemiological description and comparison of incidence in more and less deprived cohorts. Secondary outcomes included reporting of the relationship between SEDS and patient and injury characteristics with univariate and binary logistic regression analyses. Results There were 783 patients (567 male; 216 female) with ATR. Mean incidence for adults (≥ 18 years) was 18.75/100,000 per year (range 16.56-23.57) and for all ages was 15.26/100,000 per year (range 13.51 to 19.07). Incidence in the least deprived population quintiles (4th and 5th quintiles; 18.07 per 100,000/year) was higher than that in the most deprived quintiles (1st and 2nd; 11.32/100,000 per year; OR 1.60, 95%CI 1.35-1.89; p < 0.001). When adjusting for confounding factors, least deprived patients were more likely to be > 50 years old (OR 1.97; 95%CI 1.24-3.12; p = 0.004), to sustain ATR playing sports (OR 1.72, 95%CI 1.11-2.67; p = 0.02) and in the spring (OR 1.65, 95%CI 1.01-2.70; p = 0.045) and to give a history of preceding tendinitis (OR 4.04, 95%CI 1.49-10.95; p = 0.006). They were less likely to sustain low-energy injuries (OR 0.44, 95%CI 0.23-0.87; p = 0.02) and to be obese (OR 0.25-0.41, 95%CI 0.07-0.90; p ≤ 0.03). Conclusions The incidence of ATR was higher in less socioeconomically deprived populations and the hypothesis was therefore rejected. Signiicant variations in patient and predisposing factors, mechanisms of injury and seasonality were demonstrated between most and least deprived groups, suggesting that circumstances and nature of ATR may vary with SEDS and these are not a homogenous group of injuries. Level of Evidence Prognostic Study Level III.

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Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies

Cited by 13 publications

References 81 publications

Associations between weight-adjusted waist index and fractures: a population-based study

Associations between weight-adjusted waist index and fractures: a population-based study

Recent advances in the identification of related factors and preventive strategies of hip fracture

Socioeconomic deprivation status predicts both the incidence and nature of Achilles tendon rupture

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