Familial risks of hospital treated osteoporosis and fractures in first-, second- and third-degree relatives - A Swedish nationwide real-world family study
- 1Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden
- 2University Clinic Primary Care, Skåne University Hospital, Region Skåne, Sweden
Abstract
Objective: Osteoporosis (OP) is a common degenerative disorder. This is the first real-world nationwide study aimed to determine the familial risks of hospital treated OP and fractures in first-, second- and third-degree relatives. Design: The Swedish Multigeneration register was linked to the National Patient Register to investigate the familial risks of OP between 1997 and 2018. Offspring born to Swedish parents were included. The adjusted familial hazard ratios (afHRs) with 95% confidence interval (CI) were determined for hospital treated OP and fractures at common osteoporotic fracture sites among twins, full-siblings, half-siblings, and cousins. There was no information about zygosity of the twins. Adjustments were made for birth year, sex, educational level, and comorbidities. Results: 6,548,562 individuals (48.77% women) were included with a mean age of 41 years (range 0−87 years) at the end of follow-up. 57,869 (0.88%) individuals were affected with hospital treated OP, and 403,660 (6.16%) individuals with fractures. The afHRs were increased for both OP and fractures in twins, full-siblings, half-siblings, and cousins. The afHR for OP were for twins 2.92 (95%CI 2.32–3.67), full-siblings 2.22 (95%CI 2.14–2.31), half-siblings 1.74 (95%CI 1.55–1.94), cousins 1.81 (95%CI 1.55–2.11). Age-stratified analysis showed age-dependent familial associations with highest afHR in young individuals (<20 years): among full-siblings afHR was 125.70 (95%CI 59.44–265.84) for OP and 2.34 (95%CI 2.28–2.39) for fractures. Conclusions: Heredity is associated with risk of hospital treated OP and fractures in the Swedish population. The familial risk of hospital treated OP or fractures is related to the genetic closeness of the affected relative(s).
Related
- Rare Novel Genetic Variants of the OFD1 Gene Associated With a Familial Form and a Sporadic Case of Long Bone Atypical Fractures
- Glucocorticoid in giant cell arteritis: real-world treatment patterns over time and associated burden in a nationwide hospital-based study within the French health insurance database
- Win ratio analysis of surgical approaches for lung cancer: a nationwide observational study using the French national hospital discharge database
- Access to hospital-based rehabilitation for people with multiple sclerosis in France: A nationwide study (2017–2023)
- Nationwide trends in dementia subtypes and in-hospital mortality among hospitalizations with type 2 diabetes in Spain, 2021–2024: A focus on sex disparities
BibTeX
@article{ankerhansen2026familial,
title = {{Familial risks of hospital treated osteoporosis and fractures in first-, second- and third-degree relatives - A Swedish nationwide real-world family study}},
author = {Christian Anker-Hansen and MirNabi Pirouzifard and Jan Sundquist and Kristina Sundquist and Bengt Zöller},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0358074},
url = {https://doi.org/10.1371/journal.pone.0358074},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Familial risks of hospital treated osteoporosis and fractures in first-, second- and third-degree relatives - A Swedish nationwide real-world family study
AU - Christian Anker-Hansen
AU - MirNabi Pirouzifard
AU - Jan Sundquist
AU - Kristina Sundquist
AU - Bengt Zöller
PY - 2026
DA - 2026/09/11
JO - PLOS One
DO - 10.1371/journal.pone.0358074
UR - https://doi.org/10.1371/journal.pone.0358074
AB - Objective: Osteoporosis (OP) is a common degenerative disorder. This is the first real-world nationwide study aimed to determine the familial risks of hospital treated OP and fractures in first-, second- and third-degree relatives. Design: The Swedish Multigeneration register was linked to the National Patient Register to investigate the familial risks of OP between 1997 and 2018. Offspring born to Swedish parents were included. The adjusted familial hazard ratios (afHRs) with 95% confidence interval (CI) were determined for hospital treated OP and fractures at common osteoporotic fracture sites among twins, full-siblings, half-siblings, and cousins. There was no information about zygosity of the twins. Adjustments were made for birth year, sex, educational level, and comorbidities. Results: 6,548,562 individuals (48.77% women) were included with a mean age of 41 years (range 0−87 years) at the end of follow-up. 57,869 (0.88%) individuals were affected with hospital treated OP, and 403,660 (6.16%) individuals with fractures. The afHRs were increased for both OP and fractures in twins, full-siblings, half-siblings, and cousins. The afHR for OP were for twins 2.92 (95%CI 2.32–3.67), full-siblings 2.22 (95%CI 2.14–2.31), half-siblings 1.74 (95%CI 1.55–1.94), cousins 1.81 (95%CI 1.55–2.11). Age-stratified analysis showed age-dependent familial associations with highest afHR in young individuals (<20 years): among full-siblings afHR was 125.70 (95%CI 59.44–265.84) for OP and 2.34 (95%CI 2.28–2.39) for fractures. Conclusions: Heredity is associated with risk of hospital treated OP and fractures in the Swedish population. The familial risk of hospital treated OP or fractures is related to the genetic closeness of the affected relative(s).
SN - 1932-6203
ER -