Background Osteoporosis is a disease which is frequently asymptomatic until fragility fractures occur. The study of risk factors in osteoporosis is continuously developing, considering that there is a tremendous geoghraphic variety in osteoporosis occurrence. We present the results of an epidemiological study of fragility fracture cases in Republic of Moldova, trying to underlie differences in fragility fracture epidemiology, based on residence region, and possibly lifestyle factors, in a female population.

Objectives The purpose of the study was to determine the incidence and prevalence of fragility fractures in women, with comparison of epidemiological indexes between urban and rural areas in Republic of Moldova.

Methods Approximately 6% of the state population was included in the study. Data regarding peripheral fragility fracture cases was collected from all specialised and primary medical institutions from the defined area. Fragility fractures of proximal humerus, distal forearm, proximal femur and distal calf, in women aged over 40 years old were collected. Using population statistics provided by the National Bureau of Statistics, epidemiological indexes regarding fracture incidence and prevalence were derived, with further comparison of derived epidemiological indexes for urban and rural areas, as well as separate epidemiological indexes for the four fracture regions.

Results A general incidence of 1033.4 peripheral fragility fractures per 1 00 000 female population >40 years was determined, with a significantly higher incidence in urban areas (1216.7 vs 980.1, p<0.05). The incidence of proximal humerus fracture was 149 per 1 00 000 female population >40 years, with a small, but significantly higher incidence in urban areas (159.5 vs 145.9, p<0,05). The incidence of distal forearm fractures was 393.4 per 1 00 000 population >40 years, significantly higher in urban areas (528.5 vs 354.1, p<0,05). The incidence of proximal femur fracture was 208.5 per 1 00 000 population >40 years, significantly higher in urban areas (227.9 vs 202.9, p<0,05). The incidence of distal calf fractures was 282.5 per 1 00 000 population >40 years, with a small, but significantly higher incidence in urban areas (300.7 vs 277.2, p<0,05).

Conclusions There was an overall higher incidence of fragility fractures in the urban female population compared to the rural one, with a similar relationship in all four fracture groups. The association between urban residence and increased incidence of fragility fractures in women, could be attributed to a less active physical lifestyle (known risk factor in osteoporosis) in urban areas. Distal forearm fractures showed a greater prevalence both in urban and in rural areas, compared to other fracture types. Moreover, the incidence difference between urban and rural areas was most prevalent in the distal forearm fracture group. The latter observation was not determined in a similar study in men, in the same population and period of time.

Disclosure of Interest None declared