Distal forearm fractures in immigrant groups:​ a national Swedish study

Wändell, Per<sup>1</sup>; Li, Xinjun<sup>2</sup>; Carlsson, Axel C.<sup>1,3</sup>; Sundquist, Jan<sup>2,4,5</sup>; Sundquist, Kristina<sup>2,4,5</sup>

Affiliations

¹Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

²Center for Primary Health Care Research, Lund University, Malmö, Sweden

³Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden

⁴Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA

⁵Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan

Abstract and keywords

Objective: The aim was to analyse risk of forearm fractures in first- and second-generation immigrants to Sweden.

Methods: A nationwide study of individuals 20 years of age and older was conducted. Forearm fractures were defined as at least one registered diagnosis in the National Patient Register between January 1, 1998 and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident forearm fractures compared to Swedish-born individuals, or in second-generation immigrant groups relative to individuals with Swedish-born parents. Cox regression models were stratified by sex and adjusted for age, sociodemographic status, and co-morbidities.

Results: A total of 5,953,764 individuals were included in the first-generation study (2,861,256 men, and 3,092,508 women), and a forearm fracture was registered in 166,955 individuals (2.8%). The second-generation study included 4,656,023 individuals (2,368,585 men, and 2,287,438 women) with a registered forearm fracture in 111,576 individuals (2.4%). Fully adjusted HRs showed marginally lower risks when all immigrants were studied, for first-generation men 0.95 (95% CI 0.92–0.98) and women 0.95 (95% CI 95 0.92–0.97), and for second-generation men 0.93 (95% CI 0.90–0.97) and women 0.90 (95% CI 0.88–0.93). An increased risk was found among some first-generation immigrant men, especially in men from the Middle East.

Conclusions: We observed a marginally lower overall risk of fractures among immigrants, but with differences among the immigrant groups.

Keywords: Forearm fractures; Gender; Immigrants; Neighbourhood; Socioeconomic status

Links

DOI: 10.1016/j.bone.2020.115508

PubMed: 32599220

WoS: 000557876000036

History

Received: 2020-03-10

Revised: 2020-06-23

Accepted: 2020-06-23

Online: 2020-06-27

Cited Works (3)

Year	Entry
2002	Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SAA, Howard BV, Johnson KC, Kotchen JM, Ockene J; Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative Randomized Controlled Trial. JAMA. July 17, 2002;288(3):321-333.
2006	Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. December 2006;17(12):1726-1733.
2017	Ballane G, Cauley JA, Luckey MM, Fuleihan GE-H. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int. May 2017;28(5):1531-1542.

Cited By (1)

Year	Entry
2021	Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Osteoporotic fractures among foreign-born individuals: a national Swedish study. Osteoporos Int. February 2021;32(2):343-352.