Self-report. The risk of developing osteoporotic fractures is high in Nordic countries, including Sweden. The background to this, whether genetic or environmental factors are the most influential, is not entirely clear.
With regard to those born abroad, a reduced risk of osteoporotic fractures has been observed in certain groups in Norway and Sweden, however, no comprehensive study has been conducted.
Through the patient registry, we have studied the risk of new osteoporotic fractures (lower forearm, upper arm, vertebrae and hips) in both  And others  Migrant generation, 50 years and over, during the period 1998-2012 in Sweden. We also recorded comorbidity, socio-economic factors, and the country or region of origin of people born abroad. The group of first-generation immigrants includes 2.8 million individuals and the second-generation immigrant group includes 1.4 million, of which 13 percent (7 percent for men and 18 percent for women) and 8 percent (5 percent for men). 12 percent of women) have some form of osteoporotic fracture. Statistical analyzes were performed using Cox regression to determine the risk of developing osteoporotic fractures (risk ratio, heart rate) compared to individuals born in Sweden or of parents born in Sweden.
In the study of first-generation immigrants, human resources, which were fully adjusted according to the confounding factors of age, socio-economic status, and comorbidities, for all foreign-born men were 0.75 (the 99 percent confidence interval). [99KI] 0.73-0.78) and 0.83 women (99KI 0.81–0.84), with a significantly lower risk for most regions of origin, but with an increased risk of wrist fractures in men from Asia.
In the study with second-generation immigrants, the corresponding HR rate for men was 0.96 (99KI 0.89-1.04) and for women 0.95 (99KI 0.90-1.00). For hip fractures, the risk was significantly lower in all foreign-born parents, HR 0.89 (99KI 0.81-0.98) in men and 0.86 (99KI 0.76-0.98) in women.
In general, the risk of developing osteoporotic fractures was lower for first-generation immigrants, but for second-generation immigrants on a par with individuals who had parents born in Sweden. Bone density is established up to the age of 25, and first-generation immigrants seem to have better conditions than those born in Sweden. One factor that is often mentioned is Vitamin D, as we in the Nordic countries do not get enough sunlight to keep levels high during the winter season. The vitamin D hypothesis speaks against studies showing that levels are lower in southern Europe than in northern Europe.
In summary, the results of the studies indicate that environmental rather than genetic factors explain the higher risk of osteoporotic fractures in Northern Europe.
La Cartettingen 8/2021