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Úr gögnum Hjartaverndar: Nokkur atriði um faraldsfræði og áhættumat beinbrota á Íslandi

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Authors
Gunnar Sigurðsson
Kristín Siggeirsdóttir
Brynjólfur Y. Jónsson
Brynjólfur Mogenssen
Elías F. Guðmundsson
Thor Aspelund
Vilmundur Guðnason
Útgáfudagur
2017-10-05

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Önnur málmynd
Review of epidemiology of fractures in the Icelandic Heart Association cohort
Citation
Læknablaðið 2017,103(10):423-428
Útdráttur
Á síðustu árum hafa birst nokkrar greinar í vísindatímaritinu Osteoporosis International um faraldsfræði beinbrota á Íslandi, byggðar á hóprannsóknum Hjartaverndar. Við höfum tekið saman nokkur atriði úr þessum vísindagreinum og fylgiskjölum þeirra með áherslu á meiriháttar beinþynningarbrot (framhandleggsbrot, upphandleggsbrot, hryggsúlubrot og mjaðmarbrot). Þessi fjögur brot eru talin valda um 90% af heildarbyrði allra beinþynningarbrota. Nýgengistölur þessara beinbrota í Hjartaverndarhópnum mynda grunn að notkun alþjóðlegs áhættureiknis, FRAX Ísland, fyrir Íslendinga 40-90 ára og spá fyrir um líkur á meiriháttar beinbroti næstu 10 árin. Þessi áhættureiknir var opnaður á veraldarvefnum árið 2013. Sérstaklega bendum við á mikilvægi fyrri beinbrotasögu þar sem tæp 40% allra meiriháttar beinþynningarbrota verða í kjölfar fyrsta brots síðar á ævinni samkvæmt gögnum Hjartaverndar. Niðurstöðurnar benda á mikilvægi tímalengdar frá broti þar sem mesta áhættan á að fá síðar brot er á fyrstu tveimur árunum eftir brot enda þótt aukin áhætta haldist næstu 20 árin. Þetta bendir því til mikilvægis forvarna strax eftir fyrsta beinbrot, sérstaklega meðal aldraðra. Rannsóknirnar gefa góða heildarsýn yfir beinbrot á Íslandi í samanburði við erlendar rannsóknir og sýna að aldursstaðlað nýgengi alvarlegustu brotanna, mjaðmarbrotanna, náði hámarki um aldamótin en lækkaði til 2008 meðal kvenna, svipað og lýst hefur verið í Svíþjóð og Danmörku.
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 comparison 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.
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http://www.laeknabladid.is/tolublod/2017/10/nr/6521
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ae974a485f413a2113503eed53cd6c53
10.17992/lbl.2017.10.154
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Icelandic Journal Articles (Peer Reviewed)

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