Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
Department of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Osteoporos Int. 2019 May;30(5):975-983. doi: 10.1007/s00198-019-04844-8. Epub 2019 Jan 16.
Using the nationwide health insurance claims database, we found that the age-standardized hip fracture incidence rates in Japan indicated significant increase in males but no significant change in females during 2012-2015. The fracture risk in subjects aged 75-84 years indicated decrease in females but no change in males.
Nationwide registry data on hip fractures have not yet been established in Japan. Using the newly developed National Database of Health Insurance Claims (NDB), which covers the entire Japanese population, we investigated the incidence rates of hip fractures and the associated regional differences. We also assessed the frequency of osteoporosis prescriptions, bone turnover marker (BTM) level, and bone mineral density (BMD) measurements.
The annual numbers of hip fractures, osteoporosis prescriptions, and BTM level and BMD measurements by prefecture from 2012 to 2015 were obtained from NDB data. We calculated the standardized claims-data ratio (SCR) in each prefecture.
The age-standardized incidence rates from 2012 to 2015 indicated no significant change in females and significant increase in males (p value for trend; 0.920, 0.002, respectively). The fracture risk decreased in females aged 75-84 years and indicated no increase in females aged 85-89 years during 2012-2015, while the fracture risk indicated no change in males aged 75-84 years and increased in males aged 85-89 years. The frequency of osteoporosis prescriptions, BTM level measurements, and BMD measurements in the general population in the corresponding period increased with statistical or marginal significance in females and males. West-east regional differences were observed in the incidence rates; the highest SCR values in the western prefectures were approximately double the lowest values in the eastern prefectures.
The age-standardized hip fracture incidence rates indicated no significant change in females and significant increase in males in Japan from 2012 to 2015.
利用全国性健康保险索赔数据库，我们发现，2012-2015 年期间，日本男性的髋部骨折标准化发病率呈显著上升趋势，但女性无明显变化。75-84 岁人群的骨折风险在女性中呈下降趋势，而男性则无变化。
日本尚未建立全国性髋部骨折登记数据库。利用新开发的涵盖日本全体人口的国家健康保险索赔数据库（NDB），我们调查了髋部骨折的发病率和相关的地区差异。我们还评估了骨质疏松症处方、骨转换标志物（BTM）水平和骨密度（BMD）测量的频率。
从 NDB 数据中获取 2012 年至 2015 年各地区的髋部骨折、骨质疏松症处方、BTM 水平和 BMD 测量的年度数量，并计算每个地区的标准化索赔数据比（SCR）。
2012 年至 2015 年的年龄标准化发病率显示，女性无显著变化，男性显著增加（趋势检验 p 值分别为 0.920、0.002）。2012-2015 年期间，75-84 岁女性的骨折风险降低，85-89 岁女性的骨折风险无增加，而 75-84 岁男性的骨折风险无变化，85-89 岁男性的骨折风险增加。同期，女性和男性的一般人群中骨质疏松症处方、BTM 水平测量和 BMD 测量的频率均呈统计学或边缘显著增加。发病率存在东西部地区差异；西部地区的最高 SCR 值约为东部地区最低值的两倍。
2012-2015 年期间，日本女性髋部骨折标准化发病率无显著变化，男性显著增加。
