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Osteoporotic fractures among foreign-born individuals registered in Sweden before and after the age of 30 years

Wändell, Per LU ; Li, Xinjun LU ; Carlsson, Axel C. ; Sundquist, Jan LU and Sundquist, Kristina LU (2025) In Bone 200.
Abstract

Purpose: To analyse risk of osteoporotic fractures in foreign-born individuals migrating to Sweden at different ages, compared to Swedish-born individuals. Methods: This was a nationwide open cohort study including individuals ≥30 years of age at baseline (N = 4,715,081). Foreign-born individuals were divided as having arrived to and being registered in Sweden from the ages 0–30 years of age or >30 years of age. Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm, vertebrae, or pelvis, in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate relative risk (hazard ratios (HR) with 99 % confidence... (More)

Purpose: To analyse risk of osteoporotic fractures in foreign-born individuals migrating to Sweden at different ages, compared to Swedish-born individuals. Methods: This was a nationwide open cohort study including individuals ≥30 years of age at baseline (N = 4,715,081). Foreign-born individuals were divided as having arrived to and being registered in Sweden from the ages 0–30 years of age or >30 years of age. Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm, vertebrae, or pelvis, in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate relative risk (hazard ratios (HR) with 99 % confidence intervals (CI)) of incident osteoporotic fractures in foreign-born compared to Swedish-born individuals. Cox regression models were stratified by sex and adjusted for age, co-morbidities, and sociodemographic status. Results: Totally 304,462 fractures (men n = 82,992, and women n = 221,470) were registered, with hip fractures dominating (54.0 % among men, 42.6 % among women). Fully adjusted HRs (99 % CI) were for foreign-born men registered at the age 0–30 years 0.81 (0.78–0.85) and 0.73 (0.69–0.78) for foreign-born men above 30 years, respectively. The corresponding risk for foreign-born women registered at the age 0–30 years was 0.92 (0.90–0.95) and 0.84 (0.80–0.88) for foreign-born women registered above 30 years. Conclusions: We found slightly different risks of osteoporotic fractures among immigrants, but with no statistically significant interaction between risks for those being registered in Sweden at the age above 30 years vs those registered until this age. In this national study of osteoporotic fractures in foreign-born individuals, the fracture risk did not differ by age at immigration.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Forearm fractures, Gender, Hip fractures, Humerus fractures, Immigrants, Neighbourhood, Osteoporotic fractures, Socioeconomic status, Vertebral fractures
in
Bone
volume
200
article number
117614
publisher
Elsevier
external identifiers
  • scopus:105014271246
  • pmid:40876526
ISSN
8756-3282
DOI
10.1016/j.bone.2025.117614
language
English
LU publication?
yes
id
f31f2a21-09bf-48ab-8ad3-8d7d33e5ffea
date added to LUP
2025-10-03 14:56:01
date last changed
2025-12-12 21:47:38
@article{f31f2a21-09bf-48ab-8ad3-8d7d33e5ffea,
  abstract     = {{<p>Purpose: To analyse risk of osteoporotic fractures in foreign-born individuals migrating to Sweden at different ages, compared to Swedish-born individuals. Methods: This was a nationwide open cohort study including individuals ≥30 years of age at baseline (N = 4,715,081). Foreign-born individuals were divided as having arrived to and being registered in Sweden from the ages 0–30 years of age or &gt;30 years of age. Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm, vertebrae, or pelvis, in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate relative risk (hazard ratios (HR) with 99 % confidence intervals (CI)) of incident osteoporotic fractures in foreign-born compared to Swedish-born individuals. Cox regression models were stratified by sex and adjusted for age, co-morbidities, and sociodemographic status. Results: Totally 304,462 fractures (men n = 82,992, and women n = 221,470) were registered, with hip fractures dominating (54.0 % among men, 42.6 % among women). Fully adjusted HRs (99 % CI) were for foreign-born men registered at the age 0–30 years 0.81 (0.78–0.85) and 0.73 (0.69–0.78) for foreign-born men above 30 years, respectively. The corresponding risk for foreign-born women registered at the age 0–30 years was 0.92 (0.90–0.95) and 0.84 (0.80–0.88) for foreign-born women registered above 30 years. Conclusions: We found slightly different risks of osteoporotic fractures among immigrants, but with no statistically significant interaction between risks for those being registered in Sweden at the age above 30 years vs those registered until this age. In this national study of osteoporotic fractures in foreign-born individuals, the fracture risk did not differ by age at immigration.</p>}},
  author       = {{Wändell, Per and Li, Xinjun and Carlsson, Axel C. and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{8756-3282}},
  keywords     = {{Forearm fractures; Gender; Hip fractures; Humerus fractures; Immigrants; Neighbourhood; Osteoporotic fractures; Socioeconomic status; Vertebral fractures}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Bone}},
  title        = {{Osteoporotic fractures among foreign-born individuals registered in Sweden before and after the age of 30 years}},
  url          = {{http://dx.doi.org/10.1016/j.bone.2025.117614}},
  doi          = {{10.1016/j.bone.2025.117614}},
  volume       = {{200}},
  year         = {{2025}},
}