Novel aspects of an old problem. The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS) - project description
Every year, more than 9000 Norwegians suffer a hip fracture. A decline in age-specific incidence has been observed. However, fracture burden is projected to increase due to an ageing population. The current project is organized into three work packages (WPs), intended to give novel and comprehensive information on an old public health problem that has long remained unresolved. We will use our national database of hip fractures (NORHip) in combination with health studies and registers covering the entire Norwegian population. New methodological approaches will be applied.
In WP1 we will develop a pioneer model (named Hip-IMPACT) for estimating the contribution of changes in risk factors and treatments to explain the decline in hip fracture incidence. We will also study what influence grip strength, as an indicator of biological ageing, might have had. In collaboration with the University of Liverpool this will be a further development of their IMPACT model originally developed for cardiovascular disease mortality.
The basis for WP2 is the connection between immune function and bone metabolism. However, it is unsettled if variation in immune function in the general population affects the risk of fracture. We have a unique possibility to study long-term risk of osteoporosis and hip fracture across the range
of immune responses assessed by the tuberculin skin test in a very large population-wide cohort.
In WP3 we will combine already available data on day-to-day weather conditions, climate changes, topography and air pollution with individual-level socio-demographic and fracture outcome data integrated in a Geographic Information System (GIS). This will enable us to quantify the influence of
these environmental factors on fracture incidence across Norway.
The research will be conducted by NOREPOS, a longstanding national research network comprising the four medical faculties in Norway and the Norwegian Institute of Public Health.