Summary

There are geographic variations in hip fracture incidence rates across Norway, with a lower incidence in the coastal areas of the southwest and in the Arctic north, contrary to what may be expected with regard to vitamin D exposure from sunlight. The regional differences have become smaller in recent years.

Introduction

To investigate geographic variation in hip fracture incidence within Norway and regional differences in time trends.

Methods

All hip fractures treated in Norwegian hospitals 2002–2013 were included, and demographic information was obtained from Statistics Norway. Age-standardized incidence rates were calculated separately for 19 counties. Incidence rate ratios with 95% confidence intervals for county differences and time trends were estimated using Poisson regression.

Results

Age-standardized number of hip fractures per 10,000 person-years varied between counties from 69 to 84 in women and from 34 to 41 in men. The highest rates were observed in the southeastern capital city of Oslo, while rates were low in the four northernmost counties. There was an east-west gradient, with lower incidence in the coastal southwest compared with the southeast. Women showed a statistically significant decline during 2002–2013 in almost all counties (up to 31%). In men, only a few counties showed a decline. In both genders, hip fracture rates at age 80 in the combined five counties with the highest rates were significantly higher than in the combined five counties with the lowest rates across the period, although the trends converged over time.

Conclusions

In Norway, the hip fracture incidence was lower in the north compared with the south. In addition, we observed an east-west gradient with the highest incidence in the southeast and lower incidence in the coastal southwest. While there has been an overall declining trend in hip fracture incidence over time, regional differences are still apparent.

中文翻译：

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延伸到北极的高风险国家髋部骨折发生率的地理差异：NOREPOS 研究。

概括

整个挪威的髋部骨折发病率存在地域差异，西南沿海地区和北极北部的发病率较低，这与阳光下维生素 D 暴露的预期相反。近年来，地区差异越来越小。

介绍

调查挪威髋部骨折发生率的地理差异和时间趋势的区域差异。

方法

包括 2002-2013 年在挪威医院治疗的所有髋部骨折，人口统计信息来自挪威统计局。分别计算了 19 个县的年龄标准化发病率。使用泊松回归估计了县差异和时间趋势的 95% 置信区间的发生率比率。

结果

每 10,000 人年髋部骨折的年龄标准化数量在不同县之间有所不同，女性为 69 至 84 人，男性为 34 至 41 人。东南部首府城市奥斯陆的发病率最高，而最北端的四个县的发病率较低。呈东西向梯度，西南沿海发病率低于东南部。2002 年至 2013 年期间，几乎所有县的女性都出现了统计学上的显着下降（高达 31%）。在男性中，只有少数几个县出现下降。在两种性别中，80 岁时髋部骨折发生率最高的 5 个县明显高于同期发生率最低的 5 个县，尽管趋势会随着时间的推移而趋同。

结论

在挪威，北部的髋部骨折发生率低于南部。此外，我们观察到东南部发病率最高，西南沿海发病率较低的东西梯度。虽然随着时间的推移，髋部骨折发生率总体呈下降趋势，但区域差异仍然很明显。