The interaction of ethnicity and chronic disease as risk factors for osteoporotic fractures: a comparison in Canadian Aboriginals and non-Aboriginals

Published: June 13, 2006
Category: Bibliography > Papers
Authors: Derksen S, Leslie WD, Lix LM, Metge C, O'Neil J, Prior HJ
Countries: Canada
Language: null
Types: Population Health
Settings: Academic

Osteoporos Int 17:1358-1368.

Department of Medicine, University of Manitoba, Winnipeg, MB, Canada

INTRODUCTION: Efforts to develop global methods for absolute fracture risk prediction are currently limited by uncertainty over the validity of these models in non-White populations. Aboriginal Canadians have higher fractures rates than non-Aboriginals. This analysis examined the interaction of ethnicity with diabetes mellitus, disease comorbidity and substance abuse as possible explanatory variables.

METHODS: A retrospective, population-based matched cohort study of fracture rates was performed using Manitoba administrative health data (1984-2003). The study cohort consisted of 27,952 registered Aboriginal adults (aged 20 years or older) and 83,856 non-Aboriginal controls (matched three to one for year of birth and gender). Diabetes mellitus, number of ambulatory disease groups (ADGs), substance abuse and incident fractures were based upon validated definitions. Poisson regression analyses of fracture rates modelled the explanatory variables as main effects and two-way interactions with ethnicity.

RESULTS: Osteoporotic fracture rates were approximately twofold higher in the Aboriginal cohort (p0.0001). Diabetes, greater number of ADGs and substance abuse were all more common in the Aborigial cohort (all p0.0001). These factors were associated with increased fracture rates (all p0.0001) and significantly higher poplation attributable risk percent in th Aboriginal cohort (all p0.1 for all interaction effects).

CONCLUSION: Greater prevalence of diabetes, comorbidity and substance abuse contributes to higher rates of fracture. The relative risk of fracture for these factors is similar for both Aboriginal and non-Aboriginals despite large differences in absolute fracture risk and risk factor prevalence.

PMID: 16770522

Population Markers,High-Impact Chronic Conditions,Predictive Risk Modeling,Canada,Adult,Aged,80 and over,Canada/epidemiology,Chronic Disease/ethnology,Diabetes Mellitus/ethnology,Epidemiologic Methods,Fractures,Bone/etiology,Gender,Middle Aged,Osteoporosis/complications,Socioeconomic Factors,Substance-Related Disorders/complications,Substance-Related Disorders/ethnology

Please log in/register to access.

Log in/Register

LinkedIn Facebook Twitter

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System.
All rights reserved. Terms of Use Privacy Statement

Back to top