Is BMD sufficient to explain different fracture rates in Sweden and Turkey?

Osteoporosis and consequent fractures have become an important health problem all over the World. However, there are quite different fracture rates among different populations. In this study, our aim was to obtain the bone mineral density (BMD) values at calcaneus in a healthy Turkish population and compare them with Swedish population data. BMD was measured at the calcaneus using a dual X-ray and laser Calscan (Demetech AB, Stockholm, Sweden) bone densitometer. The total number of subjects was 951 consisting of 639 women and 312 men and age ranged from 15 to 79 yr. Mean BMD value for healthy young women (20-39 yr old) was 0.411+/-0.058 g/cm2 and for healthy young men was 0.504+/-0.068 g/cm2. BMD values tended to decrease with age in both genders. In comparison between the Turkish and Swedish population data, the Turkish population has about 1 standard deviation lower BMD values than the Swedish population in both genders, for all ages. Considering that Swedes have high fracture rates and Turks have the lowest fracture rates in Europe, the opposite difference in BMD values in the calcaneus seems interesting. Further research is needed to explain the difference in fracture rates among different populations.