Why Norwegian women are twice as likely to fracture a hip as Spanish women
May 17, 2014, Prague, Czech Republic. Press Dispensary.
Dr Daysi Duarte Sosa
A recent study into causes of bone fractures has been trying to solve a long-standing puzzle: why women in Norway have the highest registered rate of hip fractures in the world, more than double that of women in Spain ... and the researchers believe they've hit upon an answer.
The result was presented today in Prague by Daysi Duarte Sosa, of Oslo University Hospital
, speaking at the 41st European Calcified Tissue Society Congress
, held May 17-20, 2014. Dr Duarte Sosa described how earlier studies had been unable to demonstrate significant differences in bone mass or calcium metabolism between the women of Norway and the women of Spain, and was proposing that the answer might instead lie in the strength of their bone material.
To investigate this, teams from Oslo University Hospital and Hospital del Mar-IMIM of Autonomous University, Barcelona, examined 41 Norwegian and 46 Spanish women, all of whom had normal bone mineral density (BMD) values, no clinical or morphometric vertebral fractures, no detectable signs of secondary osteoporosis and no use of drugs with known influence on bone metabolism. An Osteoprobe® device was used to measure microindentation of the thick cortex of the mid tibia (following local anesthesia), with results expressed as BMS (Bone Material Strength) units.
The investigation showed that the BMS value of Norwegian women was indeed significantly lower than that of Spanish women, by an average of 3.7%. It also showed that Norwegian women had a significantly higher total BMD but analysis showed the indentation values did not vary with BMD or age.
Dr Duarte Sosa said of the findings: "It's clear that the quality of bone material in Norwegian women is impaired, in comparison to Spanish women, and this could partly explain why Norwegian women are more likely to have hip fractures than Spanish women.
She added: "This is the first demonstration of ethnical differences in bone material properties.
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Notes for editors
The European Calcified Tissue Society (ECTS) is the major organisation in Europe for researchers and clinicians working in the field of calcified tissues and related fields. ECTS acts as a forum for the dissemination of high quality research through its annual meeting, the European Symposium on Calcified Tissues, and through training courses and workshops.
Calcified tissues are central to a healthy skeleton and to bone disorders - such as osteoporosis, back pain and fractures - that make life a misery for countless people. Children can inherit some forms of bone diseases causing bone pain, shortness and deformed limbs.
The 41st European Calcified Tissue Society Congress is taking place in Prague, the Czech Republic, on May 17-20, 2014.
The ECTS Annual Congress gives delegates the opportunity to collaborate with leading international researchers and clinical colleagues. Main discussion points are the latest in high quality science and research to benefit clinical practice..
ECTS 2015 will be in Rotterdam, 25-18 April 2015.
About the study
The study, carried out by teams from team from Oslo University Hospital and Hospital del Mar-IMIM of Autonomous University, Barcelona, tested whether the difference in fracture propensity between both populations could be explained by differences in bone material quality by assessing bone material strength using microindentation in 41 Norwegian and 46 Spanish women with normal BMD-values (T-score > -1 and < ư,0), without clinical or morphometric vertebral fractures, no clinical or laboratory signs of secondary osteoporosis and without use of drugs with known influence on bone metabolism.
Bone material properties were assessed by microindentation of the thick cortex of the mid tibia following local anesthesia of the area using the Osteoprobe® device (Active Life Scientific, Sta Barbara, CA). Indentation distance was standardized against a calibration phantom of methylmethacrylate and results, as percentage of this reference value, expressed as BMS (Bone Material Strength) units.
The study found that the bone material properties reflected in the BMS value of Norwegian women was significantly inferior when compared to Spanish women (77.0 ± 7.1 % vs 80.7 ± 7.8%, p=0,02). Total hip BMD was significantly higher in Norwegian women (1,218 g/cm2 vs 0.938 g/cm2 p = <0,001, but regression analysis revealed that indentation values did not vary with BMD (r=0.03, p= 0.12) or age (r=0.04, p= 0.42).
The study concluded that Norwegian women show impaired bone material properties, when compared to Spanish women, which could partly explain the much higher propensity for fracture in Norwegian women than in Spanish women.
For further information, please contact:
Amanda Sherwood, ECTS executive director
European Calcified Tissue Society (ECTS)
Tel: + 44 (0)1454 610255
Congress site: www.ectscongress.org/2014/