Abstract
BackgroundWe conducted a systematic review and meta-analysis to obtain a reliable estimation of the prevalence of osteoporosis in China and to characterize its epidemiology.MethodsWe identified relevant studies via a search of literature published from 2003 to October 2015 in the PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang and Weipu databases. Both Chinese and WHO criteria were considered acceptable for the diagnosis of osteoporosis. Prevalence estimates were obtained using random effects models. Meta-regression analysis was used to explore the sources of heterogeneity, and publication bias was evaluated by visually inspecting funnel plots.ResultsOverall, 69 articles were included in this study. An obvious increase in the prevalence of osteoporosis was identified over the past 12 years (prevalence of 14.94 % before 2008 and 27.96 % during the period spanning 2012–2015). The prevalence of osteoporosis was higher in females than in males (25.41 % vs. 15.33 %) and increased with age. Osteoporosis prevalence was higher in rural than in urban areas (20.87 % vs. 23.92 %) and higher in southern than in northern areas (23.17 % vs. 20.13 %). At present, the pooled prevalence of osteoporosis in people aged 50 years and older was more than twice the pooled prevalence identified in 2006 (34.65 % vs. 15.7 %). The application of different diagnostic criteria could have an impact on prevalence estimation (19.7 % vs. 29.3 %). Meta-regression suggested that study setting also influenced the estimation of point prevalence (P = 0.022).ConclusionsThe prevalence of osteoporosis in China has increased over the past 12 years, affecting more than one-third of people aged 50 years and older. The prevalence of osteoporosis increased with age and was higher in females than in males. Prevention and control measures have become all the more important given the increase in osteoporosis prevalence, and three-step prevention programmes should be implemented.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3712-7) contains supplementary material, which is available to authorized users.
Highlights
We conducted a systematic review and meta-analysis to obtain a reliable estimation of the prevalence of osteoporosis in China and to characterize its epidemiology
The preferred reporting items for this systematic review and meta-analysis are presented in Additional file 2
Of the 69 studies, 50 had been conducted in urban areas and 19 had been conducted in rural areas; 36 studies were conducted in South China and 33 were conducted in North China; 39 studies evaluated osteoporosis based on the WHO diagnostic criteria and 30 evaluated osteoporosis based on Chinese criteria; and 53 and 56 studies focused on males and females, respectively
Summary
We conducted a systematic review and meta-analysis to obtain a reliable estimation of the prevalence of osteoporosis in China and to characterize its epidemiology. Osteoporosis is a metabolic disease associated with decreased bone strength and characterized by bone mass reduction, increased skeletal fragility and bone tissue structure deterioration [1]. Osteoporosis is the most frequent cause of bone fractures in the elderly, especially spine, proximal femur (hip), distal forearm, and proximal humerus fractures [2]. Using hip fractures as an example, hip fractures have been estimated to be associated with a 10 to 20 % increase in mortality, and an estimated 25 % of people with hip fractures in the United States need longterm home nursing care [9]. The cost of each hip fracture was estimated to be $34,000 to 43,000, and the annual cost of all osteoporosis-related fractures is estimated to reach 18 billion dollars [10]
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