Læknablaðið - 01.10.2017, Síða 28

ENGLISH SUMMARY
In recent years, scientific papers have been published in Osteoporosis
International on the epidemiology of fractures in Iceland based on the
Icelandic Heart Association cohort. We report the main results with
emphasis on the major osteoporotic fractures (MOF), distal forearm,
upper arm, clinical vertebral and hip. Those four types of fractures have
been reported to cause about 90% of the total burden of all osteoporotic
fractures. The incidence of those four fractures in the Icelandic Heart
Association cohort have been used as the basis for the international
fracture risk calculator “FRAX “in Iceland. “FRAX” assesses the risk
of those fractures for the next 10 years in both sexes in the age group
40-90 years. FRAX Iceland was opened on the internet in the year 2013.
We emphasize the importance of previous fracture history as almost
40% of all major osteoporotic fractures occur after first MOF according
to our cohort. The results demonstrate the importance of time from the
first fracture as the risk of the second fracture is greater in the first two
years although increased risk remains during the next 20 years. This
indicates the importance of secondary prevention early after the first
fracture especially amongst elderly people. These results give a good
overall view about the epidemiology of fractures in Iceland in compari-
son with foreign studies and shows that age standardized incidence of
the most important osteoporotic fracture, the hip fracture, reached a
maximum around the millennium but has decreased among women until
2008 similar to what has been observed in Sweden and Denmark.
Review of epidemiology of fractures in the Icelandic Heart Association cohort
Gunnar Sigurdsson1, Kristín Siggeirsdottir1,2, Brynjolfur Y. Jonsson3, Brynjolfur Mogensen4, Elias F. Gudmundsson1, Thor Aspelund1,5, Vilmundur Gudnason1,5
1Icelandic Heart Association,2 Janus Rehabilitation,3 Lækning. 4The National University Hospital of Iceland, 5University of Iceland
Keywords: Osteoporosis, Major osteoprotic fractures, Risk assessment, FRAX Iceland.
Correspondence: Gunnar Sigurðsson, gunnars@hjarta.is
428 LÆKNAblaðið 2017/103
R A N N S Ó K N
Heimildir
1. Siggeirsdottir K, Aspelund T, Jonsson B, Mogensen
B, Gudmundsson E, Gudnason V, Sigurdsson G.
Epidemiology of fractures in Iceland and secular trends
in major osteoporotic fractures 1989–2008. Osteoporos Int.
2014;25(1):211–9.
2. Siggeirsdottir K, Aspelund T, Johansson H, Gudmundsson
E, Mogensen B, Jonsson B, et al. The incidence of a first
major osteoporotic fracture in Iceland and implications for
FRAX. Osteoporos Int. 2014;25(10):2445–51.
3. Johansson H, Siggeirsdottir K, Harvey N, Oden A,
Gudnason V, McCloskey E, et al. Imminent risk of fracture
after fracture. Osteoporos Int. 2016;28(3):775–80.
4. Kanis J, Oden A, Johnell O, Jonsson B, De Laet C, Dawson
A. The burden of osteoporotic fractures: a method
for setting intervention thresholds. Osteoporos Int.
2001;12(5):417–27.
5. Hernlund E, Svedbom A, Ivergard M, Compston
J, Cooper C, Stenmark J, et al. Osteoporosis in the
European Union: medical management, epidemiology
and economic burden A report prepared in collaboration
with the International Osteoporosis Foundation (IOF)
and the European Federation of Pharmaceutical Industry
Associations (EFPIA). Arch Osteoporos. 2013;8:136.
6. Kanis J. on behalf of the World Health Organization
Scientific Group. Assessment of osteoporosis at the
primary health-care level. Technical Report. WHO
Collaborating Centre, University of Sheffield, UK. 2008.
7. Kanis J, Johnell O, Oden A, Johansson H, McCloskey
E. FRAXTM and the assessment of fracture probabil-
ity in men and women from the UK. Osteoporos Int.
2008;19(4):385–97.
8. Jonsson B, Siggeirsdottir K, Mogensen B, Sigvaldason H,
Sigurdsson G. Fracture rate in a population-based sample
of men in Reykjavik. Acta Orthop Scand. 2004;75(2):195–
200.
9. Kanis J, Johnell O, Oden A, Sernbo I, Redlund-Johnell I,
Dawson A, et al. Long-Term Risk of Osteoporotic Fracture
in Malmö. Osteoporos Int. 2000;11(8):669–74.
10. Gronskag A, Forsmo S, Romundstad P, Langhammer A,
Schei B. Incidence and seasonal variation in hip fracture
incidence among elderly women in Norway. The HUNT
Study. Bone. 2010;46(5):1294–8.
11. Van Staa T, Dennison E, Leufkens H, Cooper C.
Epidemiology of fractures in England and Wales. Bone.
2001;29(6):517–22.
12. Ettinger B, Black D, Dawson-Hughes B, Pressman A,
Melton L. Updated fracture incidence rates for the US
version of FRAX®. Osteoporos Int. 2010;21(1):25–33.
13. Singer B, McLauchlan G, Robinson C, Christie J.
Epidemiology of fractures in 15,000 adults: the influence
of age and gender. J Bone Jt Surg Br. 1998;80(2):243–8.
14. Lofthus C, Osnes E, Falch J, Kaastad T, Nordsletten L,
Stensvold I, et al. Epidemiology of hip fractures in Oslo,
Norway. Bone. 2001;29(5):413–8.
15. Kanis J, Oden A, McCloskey E, Johansson H, Wahl D,
Cooper C. A systematic review of hip fracture incidence
and probability of fracture worldwide. Osteoporos Int.
2012;23(9):2239–56.
16. Ahlborg H, Rosengren B, Jarvinen T, Rogmark C, Nilsson
J, Sernbo I, et al. Prevalence of osteoporosis and incidence
of hip fracture in women-secular trends over 30 years.
BMC Musculoskelet Disord. 2010;11(1):48.
17. Rosengren B, Bjork J, Cooper C, Abrahamsen B. Recent hip
fracture trends in Sweden and Denmark with age-period-
-cohort effects. Osteoporos Int. 2017;28(1):139–49.
18. Abrahamsen B, Vestergaard P. Declining incidence of hip
fractures and the extent of use of anti-osteoporotic therapy
in Denmark 1997–2006. Osteoporos Int. 2010;21(3):373–80.
19. Cooper C, Cole Z, Holroyd C, Earl S, Harvey N, Dennison
E, et al. Secular trends in the incidence of hip and other
osteoporotic fractures. Osteoporos Int. 2011;22:1277.
20. Magnusson KA, Gunnarsson B, Sigurdsson GH, Mogensen
B, Olafsson Y, Karason S. Meðferð og afdrif sjúklinga með
mjaðmarbrot. Læknablaðið. 2016;102(3):119–25.
21. Vestergaard P, Rejnmark L, Mosekilde L. Loss of life years
after a hip fracture: Effects of age and sex. Acta Orthop.
2009;80(5):525–30.
22. Omslang TK, Emaus N, Tell GS, Ahmed LA, Center JR,
Nguyen ND, et al. Ten-year risk of second hip fracture. A
NOREPOS study. Bone. 2013;52I(1):493-7.
23. Langsetmo L, Goltzman D, Kovacs C, Adachi J, Hanley
D, Kreiger N, et al. Repeat Low-Trauma Fractures
Occur Frequently Among Men and Women Who Have
Osteopenic BMD. J Bone Miner Res. 2009;24(9):1515–22.
24. Klotzbuecher C, Ross P, Landsman P, Abbott T, Berger
M. Patients with Prior Fractures Have an Increased Risk
of Future Fractures: A Summary of the Literature and
Statistical Synthesis. J Bone Miner Res. 2000;15(4):721–39.
25. Lindsay R, Silverman S, Cooper C, Hanley D, Barton I,
Broy S, et al. Risk of new vertebral fracture in the year
following a fracture. JAMA. 2001;285(3):320–3.
26. Johnell O, Oden A, Caulin F, Kanis J. Acute and Long-
Term Increase in Fracture Risk after Hospitalization for
Vertebral Fracture. Osteoporos Int. 2001;12(3):207–14.
27. Kanis J, McCloskey E, Johansson H, Cooper C, Rizzoli R,
Reginster JY, on behalf of the Scientific Advisory Board of
the European Society for Clinical and Economic Aspects
of Osteoporosis and Osteoarthritis (ESCEO) and the
Committee of Scientific Advisors of the International
Osteoporosis Foundation (IOF). European guidance for
the diagnosis and management of osteoporosis in post-
menopausal women. Osteoporos Int. 2013;24(1):23–57.
28. Walters S, Khan T, Ong T, Sahota O. Fracture liais-
on services: improving outcomes for patients with
osteoporosis. Clin Interv Aging. 2017;12:117–27.