Endocrine Abstracts

Background: Among the various ethnicities in the Israeli mosaic, the Ethiopian community is the most recently settled, with an immigration that started less than 40 years ago. Largely young, this 160,000-member community comprises nonetheless about 25,000 persons 50 years or older, virtually all born in Ethiopia. Despite this growing aging population, there is no knowledge regarding osteoporotic fractures in this unique East African ethnic group, not even from data originating from Ethiopia. Two isolated reports, from Ethiopia and from Israel, presented conflicting data regarding bone mineral density in this ethnic group. This study aimed to generate some preliminary data regarding the incidence of hip fractures, as a proxy for osteoporosis, in Ethiopian-born Israelis age 50 and over, between 2011-2020.

Methods: The INTR database contains reports on all injuries recorded in 21 of the 26 trauma centers in Israel. Hip fractures are the only osteoporotic fractures included in the database, as surgery within 48 hours is a nationally monitored medical quality index. Hip fracture data were retrieved from the registry, stratified by gender and age, and compared to those of the Israeli population of other ethnicity.

Results: Ethiopian-born subjects 50 yr and older comprised 0.6% of the INTR reports, while their representation in this age group in Israel was 1.24% (P<0.0001). The INTR included 966 reports on Ethiopian-born subjects in this age category, 3.9% of this stratum in the Ethiopian community, while it included reports on 7.4% of people of this age group of different ethnicity (P<0.0001). Between 2011-2020, there were 194 hip fractures among Ethiopian-born subjects age 50 or older, 20.1% of all reports for this group. While hip fractures represented 32.3% of injuries reported for other people in this age group, P<0.0001. Among Ethiopian-born subjects who suffered a hip fracture, 81/194 (41.8%) were men, compared to 16175/48130 (33.6%) among people of other origin (P<0.05). Additionally, 81/194 (41.75%) of these fractures occurred in Ehtiopian-born over the age of 85, while the corresponding figure was only 17303/48130 (35.95%) in people of different ethnicity, P=0.02.

Conclusions: Older Ethiopian-born Israelis, particularly women, appear to be less prone to hip fractures than the rest of the population. Additionally, hip fractures appear to occur more in the very old Ethiopian-born than in other ethnic groups, possibly suggesting less osteoporosis. Hip fracture being only a proxy for osteoporosis, a study linking all fragility fracture data with BMD is planned to further examine this question.