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Hip fracture rates for S’pore Chinese women fall; still higher than Malay, Indian women: Study

SINGAPORE — Chinese women in Singapore are more susceptible to hip fractures than Malay and Indian women, but rates among Chinese women have been falling, a nationwide study released on Tuesday (Oct 15) found.

Osteoporotic hip fractures in women above 50 years are eight times more common than breast cancer in Singapore.

Osteoporotic hip fractures in women above 50 years are eight times more common than breast cancer in Singapore.

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SINGAPORE — Chinese women in Singapore are more susceptible to hip fractures than Malay and Indian women, but rates among Chinese women have been falling, a nationwide study released on Tuesday (Oct 15) found.

Hip fracture rates among Chinese women are 1.4 times higher than Malay women, and 1.9 times higher than Indian women, the findings showed. 

The study's authors, including consultants from the National University Hospital (NUH), said that one possible reason why Chinese women are more susceptible to hip fractures is their lower rate of obesity. Lower obesity is associated with lower bone mineral density, thus increasing the risk of osteoporosis, where bones become weak and may break from a fall.

But in a positive development, the rate of hip fractures among Chinese women across all age groups went down while the rate among Malay and Indian women saw no decline, and even saw some signs of worsening, the authors said.

The fall in the rate among Chinese women was encouraging, because a 2001 study had predicted a rise in hip fracture rates, they added.

The study, whose authors include Professor Yong Eu Leong, senior consultant at NUH Women’s Centre, also found that women in Singapore were twice as likely to suffer hip fractures as men.

This could be attributed to women being of smaller stature than men in general, and they lose estrogen — a key hormone for bones — as they grow older, especially during menopause, Prof Yong said.

OLDER, SHORTER WOMEN AT HIGHER RISK

After looking at 50 variables, the study concluded that likely risk factors for osteoporosis in Singaporean women were: Short stature, older, thin and Chinese.

Osteoporotic hip fractures in women above 50 years are eight times more common than breast cancer in Singapore.

The study examined more than 36,000 hip fractures recorded in the Health Ministry’s Medisave database from 2000 to 2017. A second related study looked at bone mineral density among middle-aged women.

Prof Yong said that hip fractures and musculoskeletal disorders are major contributors to poor health in women globally.

INCREASE IN NUMBER OF HIP FRACTURES

The overall number of hip fracture cases in 2017 was 2,729, almost double the 1,487 figure in 2000 due to population growth and an increase in the ageing population. Women in Singapore live the longest in the world.

The study did not look into the ethnic differences among men for hip fracture rates because the overall rate was lower.

Prof Yong said that there is an emphasis on hip fractures because the injury represents 5 per cent of the cause of death. Patients who suffer from hip fractures will usually be required to undergo surgery, from which some patients never recover.

“The effects of hip fracture is based on how patients recover. Non-mobility can result in the formation of blood clots, pneumonia and stroke,” he explained.

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