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Prevalence and risk factors of osteoporotic fracture among the elderly population in China: a multicenter cross-sectional study

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Abstract

Purpose

Prevalence of osteoporotic fracture (OPF) is increasing with ageing, resulting in a significant financial burden for healthcare. However, research on the nationwide epidemiological data of OPF in Chinese elderly is still scarce. The aim of this study was to investigate the prevalence and risk factors of OPF in Chinese population aged 60 years or order.

Methods

A cross-sectional survey was conducted in an elderly Chinese population in five centres. Questionnaire investigation and imaging examination were taken in all participants to identify OPF prevalence and risk factors. Diagnosis of OPF was determined based on imaging of vertebral fractures or history of fall-related fractures. We then used multivariate logistic regression model to analyze the associations between the potential risk factors and OPF.

Results

The overall prevalence of OPF in population aged 60 years or older was 24.7% (1,071/4,331), showing an increasing trend with age (P < 0.001). The prevalence of OPF was geographically distinct (P < 0.001), but similar between men and women (P > 0.05). Up to 96.8% of OPFs consisted of vertebral fractures, especially involving T11, T12, and L1 segments. Advanced age (≥ 80), vision loss, severe hearing loss, multiple exercise forms, chronic kidney disease, osteoarthritis, and trauma-related vertebral fractures were significantly associated with risk factors, while education level and vitamin D supplementation were associated with protective factors of OPF.

Conclusion

High prevalence of OPF is a serious threat to bone health among elderly people in China. There is an urgent need for effective strategies to diagnose, prevent, and treat OPF in elderly adults.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Key Research and Development Program of China (No. 2020YFC2004900), and the Key Research and Development Program of Sichuan (No. 2021YFS0123).

Author information

Author notes

  1. Qianhao Li, Zhouyuan Yang, and Mengli Zhu contributed equally to this work and should be regarded as first co-authors.

Authors and Affiliations

  1. Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China

    Qianhao Li, Zhouyuan Yang & Pengde Kang

  2. Research Core Facility, West China Hospital, Sichuan University, Chengdu, China

    Mengli Zhu

  3. Research Center of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, China

    Jing Li

  4. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China

    Chunyan Lu

  5. Department of Orthopaedics, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China

    Zhirui Li

  6. Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, 100053, Beijing, China

    Chao Kong

  7. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China

    Chao Kong

  8. Department of Orthopedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi, China

    Haifeng Li

  9. Department of Orthopedics, Ganzhou District People’s Hospital, Zhangye Gansu, 734000, China

    Ming Niu

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  1. Qianhao Li
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Contributions

All authors contributed to the study conception, design, material preparation, data collection and analysis. The first draft of the manuscript was written by Qianhao Li, Zhouyuan Yang, and Mengli Zhu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pengde Kang.

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This work was approved by Ethics Committee on Biomedical Research, West China Hospital of Sichuan University (NO. 2021–577).

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Li, Q., Yang, Z., Zhu, M. et al. Prevalence and risk factors of osteoporotic fracture among the elderly population in China: a multicenter cross-sectional study. International Orthopaedics (SICOT) 48, 1323–1330 (2024). https://doi.org/10.1007/s00264-024-06145-0

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