The aim of the China Osteoporosis Prevalence Study was to describe the prevalence of osteoporosis based on BMD, vertebral fracture, and clinical fracture (defined as fracture events recalled by participants on a questionnaire) in the past 5 years among men and women in 5 age groups (40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years) and in urban and rural areas. We calculated sample weights by sampling clusters and poststratification weights based on the 2010 National Census of China,7 and we calculated the final weights as sample weights multiplied by poststratification weights to represent the general population in China.
We established a mean BMD and SD database for men and women and plotted lumbar spine, femoral neck, and total hip BMD by age and sex using Svysmooth, a smoothing procedure available in the survey package of R, version 4.0.0 (R Project for Statistical Computing).8 We diagnosed osteoporosis based on the peak BMD (SD) in young men and women aged 20 to 39 years that was established in the present study. We used the diagnostic criteria of the World Health Organization: T scores = (BMD − peak BMD of individuals of the same sex)/(SD of peak BMD of individuals of the same sex).9 (link) We defined individuals with T scores of −2.5 or less in any sites (L1 to L4, femoral neck, or total hip) as having osteoporosis. We calculated the weighted prevalence of osteoporosis by sex, age group, and urban vs rural setting. We calculated weighted prevalence of vertebral fracture (based on radiographic findings as described above) and clinical fracture in the past 5 years (based on a questionnaire) by sex, age group, and urban vs rural settings. We calculated the treatment rate among patients with T scores of −2.5 or less in any sites or with a history of fracture (vertebral fracture of grade 2 or higher based on radiographic findings or clinical fracture in the past 5 years based on a questionnaire) and current use of antiosteoporosis treatment (including bisphosphonate, calcitonin, estrogen, parathyroid hormone analogue, selective estrogen receptor modulator, or an active form of vitamin D or its analogue).
We performed multivariable linear regression to investigate factors associated with BMD in the lumbar spine, femoral neck, and total hip. We performed multivariable logistic regression to investigate factors associated with vertebral fracture of grade 2 or higher and clinical fracture in the past 5 years. We used data from all participants for whom the variables of interest were available for analysis and did not impute missing data. We adjusted all P values for multiple testing, present 95% CIs, and considered a 2-sided P < .05 as statistically significant. We performed all data analysis using SAS, version 9.3 (SAS Institute Inc).
We established a mean BMD and SD database for men and women and plotted lumbar spine, femoral neck, and total hip BMD by age and sex using Svysmooth, a smoothing procedure available in the survey package of R, version 4.0.0 (R Project for Statistical Computing).8 We diagnosed osteoporosis based on the peak BMD (SD) in young men and women aged 20 to 39 years that was established in the present study. We used the diagnostic criteria of the World Health Organization: T scores = (BMD − peak BMD of individuals of the same sex)/(SD of peak BMD of individuals of the same sex).9 (link) We defined individuals with T scores of −2.5 or less in any sites (L1 to L4, femoral neck, or total hip) as having osteoporosis. We calculated the weighted prevalence of osteoporosis by sex, age group, and urban vs rural setting. We calculated weighted prevalence of vertebral fracture (based on radiographic findings as described above) and clinical fracture in the past 5 years (based on a questionnaire) by sex, age group, and urban vs rural settings. We calculated the treatment rate among patients with T scores of −2.5 or less in any sites or with a history of fracture (vertebral fracture of grade 2 or higher based on radiographic findings or clinical fracture in the past 5 years based on a questionnaire) and current use of antiosteoporosis treatment (including bisphosphonate, calcitonin, estrogen, parathyroid hormone analogue, selective estrogen receptor modulator, or an active form of vitamin D or its analogue).
We performed multivariable linear regression to investigate factors associated with BMD in the lumbar spine, femoral neck, and total hip. We performed multivariable logistic regression to investigate factors associated with vertebral fracture of grade 2 or higher and clinical fracture in the past 5 years. We used data from all participants for whom the variables of interest were available for analysis and did not impute missing data. We adjusted all P values for multiple testing, present 95% CIs, and considered a 2-sided P < .05 as statistically significant. We performed all data analysis using SAS, version 9.3 (SAS Institute Inc).
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