Abstract
BackgroundFragility fracture is associated with bone mineral density (BMD), and most databases used in related researches are instrument-matched. Little is known about the relationship between BMD and fragility fracture risk of native Chinese, especially using local databases as reference databases.ObjectiveTo investigate relationship between BMD and risk of fragility fracture in native China.Methods3,324 cases, including 2,423 women (67.7 ± 8.9 years) and 901 men (68.4 ± 11.6 years) having radiological fragility fractures and 3,324 age- and gender-matched controls participated in the study. We measured BMD at posteroanterior spine and hip using dual-energy X-ray absorptiometry (DXA), calculated BMD measurement parameters based on our own BMD reference database.ResultsBMDs and mean T-scores were lower in case group (with clinical fragility) than in control group (without clinical fragility). In patients with fragility fractures, prevalence of lumbar osteoporosis, low bone mass, and normal BMD were 78.9 %, 19.3 %, and 1.8 %, respectively, in women, and 49.5, 44.8 %, and 5.7 %, respectively, in men. In hip, these prevalence rates were 67.2 %, 28.4 %, and 4.4 % in females, and 43.2 %, 45.9 %, and 10.9 % in males, respectively, showing differences between females and males. Multivariate Cox regression analysis showed that after adjusting age, height, weight, and body mass index, fracture hazard ratio (HR) increased by 2.7–2.8 times (95 % CI 2.5–3.1) and 3.6–4.1 times (95 %CI 3.0–5.1) for women and men respectively with decreasing BMD parameters. In both sexes, risk of fragility fracture increased approximately 1.6–1.7 times (95 % CI 1.5–1.8) for every 1 T-score reduction in BMD.ConclusionsRisk of clinical fragility fracture increases with decreasing BMD measurement parameters and anthropometric indicators in native China, and fracture HR varies from gender and site.
Highlights
Fragility fracture is associated with bone mineral density (BMD), and most databases used in related researches are instrument-matched
Risk of clinical fragility fracture increases with decreasing BMD measurement parameters and anthropometric indicators in native China, and fracture hazard ratio (HR) varies from gender and site
The average ages of women and men in case group were 67.7 ± 8.9 years and 68.4 ± 11.6 years respectively. For both men and women, BMD at different skeletal sites and mean T- scores were significantly lower in case group than in control group
Summary
Fragility fracture is associated with bone mineral density (BMD), and most databases used in related researches are instrument-matched. Little is known about the relationship between BMD and fragility fracture risk of native Chinese, especially using local databases as reference databases. The main serious consequence of osteoporosis is fragility fracture. Fifty-six million people worldwide were estimated to have sustained a fragility fracture in 2000 [1]. Epidemiological surveys have shown that bone mineral density (BMD), prevalence of osteoporosis, and incidence of fragility fractures, differs among different racial and ethnic groups and regions [10,11,12,13,14,15]. The prevalence of osteoporosis and incidence of fragility fractures are much higher in white people than in black people [10, 11]. The incidence of fragility fractures is lower in Asians than in white people [10, 12], while that of fragility fractures is much lower in Beijing than in the rest of China, Taiwan and Hong Kong [14, 15]
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