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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/22812

Title: On epidemiology of fractures and variation with age and ethnicity
Authors: Harvey, Nicholas C.
Curtis, Elizabeth M.
van der Velde, Robert
Moon, Rebecca J.
van den Bergh, Joop P. W.
Geusens, Piet
de Vries, Frank
van Staa, Tjeerd P.
Cooper, Cyrus
Issue Date: 2016
Citation: BONE, 93, p. 230-231
Abstract: We recently demonstrated differences in fracture incidence by ethnicity in the UK population using the Clinical Practice Research Datalink (CPRD) [1]. In their letter, Harper et al. [2] draw attention to the differential age structure of the UK population by ethnicity, and suggest that the lower incidence of fractures in Asian adults over 50 years might reflect the lower proportion of very elderly individuals within this demographic compared with the white population. The relatively small number of fractures within black and South Asian ethnicities meant that presentation of fracture incidence stratified by age band was not feasible. We have thus used a Poisson model to calculate incidence rate ratios (with white ethnicity as the referent), adjusting for age and calendar year to account for any contribution of age distribution and secular change within ethnicity strata. These data are summarised in Table 1 below, and clearly demonstrate that the differences in fracture incidence by ethnicity are congruent with the raw incidence data presented in our paper, with rates highest in whites, intermediate in South Asians and lowest in blacks. In conclusion, whilst there are ethnic differences in age distribution in the UK, these do not explain the differential fracture rates; as discussed in our paper [1], variations in factors such as BMD, bone geometry and body composition may all contribute. Whatever the underlying cause, we agree with Harper et al. that our findings inform the allocation of healthcare resources to those at greatest need.
Notes: [Harvey, Nicholas C.; Curtis, Elizabeth M.; Moon, Rebecca J.; Cooper, Cyrus] Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton SO16 6YD, Hants, England. [Harvey, Nicholas C.; Cooper, Cyrus] Univ Southampton, NIHR Southampton Biomed Res Ctr, Tremona Rd, Southampton SO16 6YD, Hants, England. [Harvey, Nicholas C.; Cooper, Cyrus] Univ Hosp Southampton NHS Fdn Trust, Tremona Rd, Southampton SO16 6YD, Hants, England. [van der Velde, Robert; van den Bergh, Joop P. W.] VieCuri Med Ctr, Dept Internal Med, Venloseweg 59, NL-5971 PB Venlo, Netherlands. [Moon, Rebecca J.] Southampton Univ Hosp NHS Fdn Trust, Paediat Endocrinol, Southampton SO16 6YD, Hants, England. [van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, Maastricht, Netherlands. [Geusens, Piet] Maastricht Univ, Med Ctr, Subdiv Rheumatol, Dept Internal Med, Maastricht, Netherlands. [Geusens, Piet] Univ Hasselt, Hasselt, Belgium. [de Vries, Frank] Maastricht Univ, Med Ctr, Dept Clin Pharm & Toxicol, Maastricht, Netherlands. [van Staa, Tjeerd P.] Univ Manchester, Farr Inst Hlth Informat Res, Hlth ERes Ctr, 1-003 Vaughan House, Portsmouth M13 9PL, Hants, England. [van Staa, Tjeerd P.] Univ Utrecht, Dept Pharmacoepidemiol & Clin Pharmacol, NL-3508 TB Utrecht, Netherlands. [Cooper, Cyrus] Univ Oxford, Nuffield Orthoped Ctr, NIHR Musculoskeletal Biomed Res Unit, Oxford OX3 7HE, England.
URI: http://hdl.handle.net/1942/22812
DOI: 10.1016/j.bone.2016.07.011
ISI #: 000386987500031
ISSN: 8756-3282
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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