RESUMO
INTRODUCTION: Osteoporosis is a very common disease, and data on its epidemiology is important for health care strategy implementation. Brazil is a developing country; its population is aging, leading to an expected increase in hip fractures and their undesirable consequences. OBJECTIVE: Assess the incidence of osteoporotic hip fractures and subsequent mortality in Southern Brazil as part of a large epidemiological study aiming to reinforce the data for FRAX Brazil. STUDY DESIGN: This study evaluated all admissions for fragility hip fractures between April 1, 2010, and March 31, 2012, in the city of Joinville, including both genders of patients 50 years old or older, which corresponded to 19.2% of the local population. Joinville was chosen because it is the third largest city in the south of Brazil, with a representative population predominantly composed of descendants of European immigrants. RESULTS: There were 213 cases of hip fractures, predominantly in Caucasians (n = 204, 96.7%) whose mean age was 77.7, ± 10.5, of which 143 (67.1%) were women (79.5 ± 9.6 years) and 70 (32.9%) were men (74 ± 11.3 years). The annual incidence of hip fractures was 268.8 for women and 153.0 for men/100,000 inhabitants. In the 60 to 64-year group, the overall incidence was 92.1/100,000, with an age-related increase of 1410.1/100,000 in the 80 to 84-year group. The mortality rate during hospitalization was 7.5%, and 25% died during the 12 months following their fractures. CONCLUSION: The incidence of hip fractures among the oldest in this predominantly Caucasian population living in Southern Brazil was similar to that of European populations from the northern hemisphere. The annual incidence of fragility hip fractures among people in their 80s was 59 times higher than that among people in their 50s. The mortality rate was 4.3 times higher in the first year after hip fracture than in the age-related local population.
Assuntos
Fraturas do Quadril/epidemiologia , Fraturas por Osteoporose/epidemiologia , População Branca/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Feminino , Fraturas do Quadril/etnologia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/etnologiaRESUMO
Numerous studies have evaluated the association between estrogen receptor alpha (ESR1) gene PvuII polymorphism and fracture risk in postmenopausal women. However, the results have been inconsistent. We performed a meta-analysis to examine the association between the ESR1 gene PvuII polymorphism and fracture risk in postmenopausal women. Studies published from PubMed, Google Scholar, and China National Knowledge Infrastructure data were retrieved. Pooled odds ratios with 95% confidence intervals were calculated using fixed- or random-effects models. A total of 6 case-control studies containing 592 patients and 705 controls were included in this meta-analysis. We found no association between the PvuII polymorphism in the ESR1 gene and fracture in postmenopausal women. Taking into account the effect of ethnicity, further stratified analyses were performed. In the subgroup analysis, no significant association was found in Caucasians and in Asians. No publication bias was found in the present study (all P > 0.05). In conclusion, the ESR1 gene PvuII polymorphism may not be associated with fracture risk in postmenopausal women. Additional larger studies are needed to confirm this conclusion.
Assuntos
Desoxirribonucleases de Sítio Específico do Tipo II/genética , Receptor alfa de Estrogênio/genética , Fraturas Ósseas/genética , Predisposição Genética para Doença/genética , Fraturas por Osteoporose/genética , Polimorfismo Genético , Idoso , Povo Asiático , Estudos de Casos e Controles , Feminino , Fraturas Ósseas/etnologia , Genótipo , Humanos , Íntrons , Razão de Chances , Osteoporose Pós-Menopausa/etnologia , Osteoporose Pós-Menopausa/genética , Fraturas por Osteoporose/etnologia , Pós-Menopausa , Fatores de Risco , População BrancaRESUMO
SUMMARY: To determine whether there are race/ethnic differences in bone mineral density (BMD) by fracture history in men aged 65 years and older, we performed cross-sectional analysis in five large independent cohorts. Low BMD was associated with a higher prevalence of fracture in all cohorts, and the magnitude of the BMD differences by fracture status was similar across groups. INTRODUCTION: We aimed to determine whether there are race/ethnic and geographic differences in bone mineral density by fracture history in men aged 65 years and older. METHOD: The datasets included the Osteoporotic Fractures in Men (MrOS) Study (5,342 White, 243 African-American, 190 Asian, and 126 Hispanic), MrOS Hong Kong (1,968 Hong Kong Chinese), Tobago Bone Health Study (641 Afro-Caribbean), Namwon Study (1,834 Korean), and Dong-gu Study (2,057 Korean). The two Korean cohorts were combined. RESULTS: The prevalence of self-reported non-traumatic fracture was US white, 17.1 %; Afro-Caribbean, 5.5 %; US African-American, 15.1 %; US Hispanic, 13.7 %; US Asian, 10.5 %; Hong Kong Chinese, 5.6 %, and Korean, 5.1 %. The mean differences in hip and lumbar spine BMD between subjects with fracture and without fracture were statistically significant in all cohorts except US African American and US Asian men. There was a significant race/ethnic interaction for lumbar spine BMD by fracture status (p for interaction = 0.02), which was driven by the small number of Hispanic men. There was no interaction for femoral neck or total hip BMD. There were no significant race/ethnic differences in the odds ratio of fracture by BMD. CONCLUSIONS: Low BMD was associated with a higher prevalence of fracture in all cohorts and the magnitude of the BMD differences by fracture status was similar across groups suggesting homogeneity in the BMD-fracture relationship among older men.