Top

Published in:

01-12-2020 | Osteoporosis | Original Article

Estimation and projection about the standardized prevalence of osteoporosis in mainland China

Authors: Zhiyong Cui, Xiangyu Meng, Hui Feng, Siying Zhuang, Zhaorui Liu, Tengjiao Zhu, Kaifeng Ye, Yong Xing, Chuan Sun, Fang Zhou, Yun Tian

Published in: Archives of Osteoporosis | Issue 1/2020

Abstract

Summary

We performed a systematic analysis of the standardized prevalence of osteoporosis in mainland China from 1990 to 2050.

Introduction

Osteoporosis is the most common bone disease. We aimed to investigate the standardized prevalence of osteoporosis in mainland China at the national and regional levels, with projections until 2050.

Methods

A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed. We constructed resample sets to calculate the standardized prevalence in each study. Multilevel mixed-effects logistic regression was used to estimate the age-specific and sex-specific prevalence. The United Nations Population Division (UNPD) data and regional population data from the fifth and sixth censuses in mainland China were used to estimate and project the national and regional prevalence of osteoporosis.

Results

The standardized prevalence of osteoporosis ranged from 5.04% (2.12~11.34%) to 7.46% (3.13~16.32%) in males aged ≥ 50 years and from 26.28% (15.38~40.40%) to 39.19% (25.74~53.95%) in females aged ≥ 50 years from 1990 to 2050. Moreover, we did not find a significant difference in the standardized prevalence among three geographic regions (Central China, West China, and East China).

Conclusion

We found that osteoporosis is a serious public health challenge in mainland China. The findings in our study add insight into the epidemiology of osteoporosis and would be beneficial for the prevention and treatment of osteoporosis in mainland China.

Available only for authorised users

Lorentzon M, Cummings SR (2015) Osteoporosis: the evolution of a diagnosis. J Intern Med277(6):650-661. https://doi.org/10.1111/joim.12369

Teitelbaum SL (2000) Bone resorption by osteoclasts. Science 289(5484):1504–1508CrossRef

Dimitriou R, Jones E, McGonagle D et al (2011) Bone regeneration: current concepts and future directions. BMC Med 9:66. https://doi.org/10.1186/1741-7015-9-66CrossRefPubMedPubMedCentral

Seeman E (2002) Pathogenesis of bone fragility in women and men. Lancet 359(9320):1841–1850. https://doi.org/10.1016/S0140-6736(02)08706-8CrossRefPubMed

Shanbhogue VV, Brixen K, Hansen S (2016) Age- and sex-related changes in bone microarchitecture and estimated strength: A three-year prospective study using HRpQCT. J Bone Miner Res 31(8):1541–1549. https://doi.org/10.1002/jbmr.2817CrossRefPubMed

Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R, National Osteoporosis Foundation (2014) Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int 25(10):2359–2381. https://doi.org/10.1007/s00198-014-2794-2CrossRefPubMedPubMedCentral

Harvey N, Dennison E, Cooper C (2010) Osteoporosis: impact on health and economics. Nat Rev Rheumatol 6(2):99–105. https://doi.org/10.1038/nrrheum.2009.260CrossRefPubMed

Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1CrossRefPubMedPubMedCentral

Wade SW, Strader C, Fitzpatrick LA et al (2014) Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 9:182. https://doi.org/10.1007/s11657-014-0182-3CrossRefPubMed

10.

Looker AC, Sarafrazi Isfahani N, Fan B, Shepherd JA (2017) Trends in osteoporosis and low bone mass in older US adults, 2005–2006 through 2013–2014. Osteoporos Int 28(6):1979–1988. https://doi.org/10.1007/s00198-017-3996-1CrossRefPubMed

11.

Zhu H, Fang J, Luo X, Yu W, Zhao Y, Li X, du J, Lu Y (2010) A survey of bone mineral density of healthy Han adults in China. Osteoporos Int 21(5):765–772. https://doi.org/10.1007/s00198-009-1010-2CrossRefPubMed

12.

Chen P, Li ZZ, Hu Y (2016) Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health 16(1):1039. https://doi.org/10.1186/s12889-016-3712-7CrossRefPubMedPubMedCentral

13.

Hofbauer LC, Hamann C, Ebeling PR (2010) Approach to the patient with secondary osteoporosis. Eur J Endocrinol 162(6):1009–1020. https://doi.org/10.1530/EJE-10-0015CrossRefPubMed

14.

Kanis JA, Melton LJ 3rd, Christiansen C et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9(8):1137–1141. https://doi.org/10.1002/jbmr.5650090802CrossRefPubMed

15.

Kanis JA, Adachi JD, Cooper C (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764. https://doi.org/10.1007/s00198-013-2413-7CrossRefPubMedPubMedCentral

16.

Looker AC, Wahner HW, Dunn WL (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8(5):468–489CrossRef

17.

Genant H, Grampp S, Glüer C et al (1994) Universal standardization for dual x-ray absorptiometry : patient and phantom cross-calibration results. J Bone Miner Res 9:1503(10)–15031514

18.

National Bureau of Statistics (2002) Tabulation on the 2000 population census of the People's Republic of China. China Statistics Press, Beijing Available: http://www.stats.gov.cn/tjsj/pcsj/. Accessed: May 2019

19.

National Bureau of Statistics (2012) Tabulation on the 2010 population census of the People's Republic of China. China Statistics Press, Beijing Available: http://www.stats.gov.cn/tjsj/pcsj/. Accessed: May 2019

20.

Fowkes FG, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott M, Norman PE, Sampson UK, Williams LJ, Mensah GA, Criqui MH (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 382(9901):1329–1340. https://doi.org/10.1016/S0140-6736(13)61249-0CrossRefPubMed

21.

Song P, Wang H, Theodoratou E et al (2018) The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 8(1):10804. https://doi.org/10.7189/jogh.08-010804CrossRef

22.

United Nations, Department of Economic and Social Affairs, Population Division (2015) World Population Prospects, the 2015 Revision. Available: https://esa.un.org/unpd/wpp/. Accessed: May 2019

23.

Zeng Q, Li N, Wang QQ et al (2019) The prevalence of osteoporosis in China, a nationwide, multicenter DXA survey. J Bone Miner Res 34(10):1789–1797. https://doi.org/10.1002/jbmr.3757CrossRefPubMed

24.

Zengin A, Pye SR, Cook MJ, Adams JE, Wu FC, O'Neill TW, Ward KA (2016) Ethnic differences in bone geometry between White, Black and South Asian men in the UK. Bone 91:180–185. https://doi.org/10.1016/j.bone.2016.07.018CrossRefPubMedPubMedCentral

25.

Cauley JA, Lui LY, Ensrud KE, Zmuda JM, Stone KL, Hochberg MC, Cummings SR (2005) Bone mineral density and the risk of incident nonspinal fractures in black and white women. JAMA 293(17):2102–2108. https://doi.org/10.1001/jama.293.17.2102CrossRefPubMed

26.

Nam HS, Kweon SS, Choi JS, Zmuda JM, Leung PC, Lui LY, Hill DD, Patrick AL, Cauley JA (2013) Racial/ethnic differences in bone mineral density among older women. J Bone Miner Metab 31(2):190–198. https://doi.org/10.1007/s00774-012-0402-0CrossRefPubMed

27.

Horber FF, Gruber B, Thomi F, Jensen EX, Jaeger P (1997) Effect of sex and age on bone mass, body composition and fuel metabolism in humans. Nutrition 13(6):524–534CrossRef

28.

Levis S, Lagari VS (2012) The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep 10(4):296–302. https://doi.org/10.1007/s11914-012-0119-yCrossRefPubMed

29.

Palermo A, Tuccinardi D, D'Onofrio L, Watanabe M, Maggi D, Maurizi AR, Greto V, Buzzetti R, Napoli N, Pozzilli P, Manfrini S (2017) Vitamin K and osteoporosis: Myth or reality? Metabolism 70:57–71. https://doi.org/10.1016/j.metabol.2017.01.032CrossRefPubMed

30.

Gennari L, Merlotti D, De Paola V et al (2005) Estrogen receptor gene polymorphisms and the genetics of osteoporosis: a HuGE review. Am J Epidemiol 161(4):307–320. https://doi.org/10.1093/aje/kwi055CrossRefPubMed

31.

Zheng HF, Forgetta V, Hsu YH et al (2015) Whole-genome sequencing identifies EN1 as a determinant of bone density and fracture. Nature 526(7571):112–117. https://doi.org/10.1038/nature14878CrossRefPubMedPubMedCentral

32.

Luo D, Liu Y, Zhou Y et al (2015) Association between dietary phytoestrogen intake and bone mineral density varied with estrogen receptor alpha gene polymorphisms in southern Chinese postmenopausal women. Food Funct 6(6):1977–1983. https://doi.org/10.1039/c5fo00295hCrossRefPubMed

33.

Binkley N (2009) A perspective on male osteoporosis. Best Pract Res Clin Rheumatol 23(6):755–768. https://doi.org/10.1016/j.berh.2009.10.001CrossRefPubMed

34.

Watts NB, Adler RA, Bilezikian JP et al (2012) Osteoporosis in men: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 97(6):1802–1822. https://doi.org/10.1210/jc.2011-3045CrossRefPubMed

35.

Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRef

36.

Cadarette SM, Katz JN, Brookhart MA et al (2008) Trends in drug prescribing for osteoporosis after hip fracture, 1995-2004. J Rheumatol 35(2):319–326PubMed

37.

Solomon DH, Avorn J, Katz JN, Finkelstein JS, Arnold M, Polinski JM, Brookhart MA (2005) Compliance with osteoporosis medications. Arch Intern Med 165(20):2414–2419. https://doi.org/10.1001/archinte.165.20.2414CrossRefPubMed

38.

Gu W, Rennie KL, Lin X et al (2007) Differences in bone mineral status between urban and rural Chinese men and women. Bone 41(3):393–399. https://doi.org/10.1016/j.bone.2007.05.010CrossRefPubMed

Title: Estimation and projection about the standardized prevalence of osteoporosis in mainland China
Authors: Zhiyong Cui
Xiangyu Meng
Hui Feng
Siying Zhuang
Zhaorui Liu
Tengjiao Zhu
Kaifeng Ye
Yong Xing
Chuan Sun
Fang Zhou
Yun Tian
Publication date: 01-12-2020
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2020
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-019-0670-6

At a glance: The STEP trials

Springer Medicine

Estimation and projection about the standardized prevalence of osteoporosis in mainland China

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Bisphosphonate and denosumab initiation in older adults in Ontario, Canada: a population-based cohort study

Loss in DXA-estimated total body lean mass but not fat mass predicts incident major osteoporotic fracture and hip fracture independently from FRAX: a registry-based cohort study

Research trends in osteoporosis in Asian countries and regions in the last 20 years

Successful implementation of a Fracture Liaison Service through effective change management: a qualitative study

Initiation of anti-osteoporotic drugs in high-risk female patients starting glucocorticoid treatment: a population study in Norway

No impact of anti-Rank ligand and PTH analogs on cardiovascular risk in postmenopausal osteoporosis: a systematic literature review and meta-analysis