Fracture incidence and the relevance of dietary and lifestyle factors differ in the United Kingdom and Hong Kong: An international comparison of longitudinal cohort study data

Hayhoe, Richard P G, Chan, Ruth, Skinner, Jane, Leung, Jason, Jennings, Amy, Khaw, Kay-Tee, Woo, Jean and Welch, Ailsa A (2021) Fracture incidence and the relevance of dietary and lifestyle factors differ in the United Kingdom and Hong Kong: An international comparison of longitudinal cohort study data. Calcified Tissue International, 109 (5). 563–576. ISSN 0171-967X

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Abstract

Geographic variation in fracture risk may be due to divergent profiles of dietary, lifestyle, and other risk factors between populations. We investigated differences in fracture rates between two older-population cohorts: the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk cohort (n = 7732) in the United Kingdom (UK), and the Mr and Ms Os cohort (n = 3956) in Hong Kong (HK). Data were collected by questionnaires, laboratory assessments, and hospital records. Incidence of hip, spine, and wrist fractures in the two cohorts was calculated and multivariable regression was used to explore variables important to fracture risk. Total hip, spine, and wrist fracture incidence was higher in the UK vs HK for women (13.70 vs 8.76 per 1000 person-years; p < 0.001), but not men (5.95 vs 5.37 per 1000 person-years; p = 0.337), and the proportions of different fractures also varied between cohorts (p < 0.001). Hip fracture was the most common UK fracture (accounting for 56.8% fractures in men and 52.6% in women), while wrist fracture was most common in HK (42.9% in men and 57.9% in women). The major contributor to total fracture risk in multivariable regression models of both cohorts and sexes, was age; with BMI also an important contributor to fracture risk HK men and UK women. The distribution of factors relevant to fracture risk, and the rates of different fractures, varied significantly between UK and HK cohorts. However, the importance of each factor in contributing to fracture risk was similar between the cohorts. The differences in fracture rates suggest targeted approaches may be required when developing interventions and public health recommendations to reduce the burden of osteoporosis in these two countries.

Item Type: Article
Additional Information: Funding Information: The EPIC-Norfolk study received grants from the Medical Research Council (G9502233) and Cancer Research UK (SP2024-0201 and SP2024-0204). The work was supported by grants from the Research Grants Council of Hong Kong (CUHK 4101/02 M); and the Hong Kong Jockey Club Charities Trust. Publisher Copyright: © 2021, The Author(s).
Uncontrolled Keywords: epidemiology,fractures,nutrition,osteoporosis,endocrinology,endocrinology, diabetes and metabolism,orthopedics and sports medicine,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/1300/1310
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School

Faculty of Medicine and Health Sciences
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Depositing User: LivePure Connector
Date Deposited: 10 Jun 2021 00:08
Last Modified: 12 Oct 2021 01:19
URI: https://ueaeprints.uea.ac.uk/id/eprint/80245
DOI: 10.1007/s00223-021-00870-z

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