Prevalence of Osteoporosis and Fracture in China: The China Osteoporosis Prevalence Study.

Importance: The aging of the population is associated with an increasing burden of fractures worldwide. However, the epidemiological features of fractures in mainland China are not well known. Objective: To assess the prevalence of and factors associated with osteoporosis, clinical fractures, and vertebral fractures in an adult population 40 years or older in mainland China. Design, Setting. and Participants: This cross-sectional study, the China Osteoporosis Prevalence Study, was conducted from December 2017 to August 2018. A random sample of individuals aged 20 years or older who represented urban and rural areas of China were enrolled, with a 99% participation rate. Main Outcomes and Measures: Weighted prevalence of osteoporosis, clinical fracture, and vertebral fracture by age, sex, and urban vs rural residence as determined by x-ray absorptiometry, questionnaire, and radiography. Results: A total of 20 416 participants were included in this study; 20 164 (98.8%; 11 443 women [56.7%]; mean [SD] age, 53 [13] years) had a qualified x-ray absorptiometry image and completed the questionnaire, and 8423 of 8800 (95.7%) had a qualified spine radiograph. The prevalence of osteoporosis among those aged 40 years or older was 5.0% (95% CI, 4.2%-5.8%) among men and 20.6% (95% CI, 19.3%-22.0%) among women. The prevalence of vertebral fracture was 10.5% (95% CI, 9.0%-12.0%) among men and 9.7% (95% CI, 8.2%-11.1%) among women. The prevalence of clinical fracture in the past 5 years was 4.1% (95% CI, 3.3%-4.9%) among men and 4.2% (95% CI, 3.6%-4.7%) among women. Among men and women, 0.3% (95% CI, 0.0%-0.7%) and 1.4% (95% CI, 0.8%-2.0%), respectively, with osteoporosis diagnosed on the basis of bone mineral density or with fracture were receiving antiosteoporosis treatment to prevent fracture. Conclusions and Relevance: In this cross-sectional study of an adult population in mainland China, the prevalence of osteoporosis and vertebral fracture were high and the prevalence of vertebral fracture and clinical fracture was similarly high in men and women. These findings suggest that current guidelines for screening and treatment of fractures among patients in China should focus equally on men and women and should emphasize the prevention of vertebral fractures.

Impact of reference point selection on DXA-based measurement of forearm bone mineral density.

Few studies have systematically evaluated the technical aspects of forearm bone mineral density (BMD) measurement. We found that BMD remained stable regardless of the reference point; however, the ROI identified was not always consistent. Our study highlights the importance of using the same reference point for serial measurements of forearm BMD. BACKGROUND: Forearm fractures are clinically important outcomes from the perspective of morbidity, health care costs, and interruption of work. BMD of the forearm, as derived by dual-energy x-ray absorptiometry (DXA), is a better predictor of fracture at the forearm compared with BMD measured at other sites. However, very few studies have evaluated the technical aspects of selecting the ROI for forearm BMD measurement. This study aimed to compare the BMD values measured at the 1/3 radius site using three different reference points: the ulnar styloid process, the radial endplate, and the bifurcation of the ulna and radius. METHODOLOGY: Healthy Chinese patients participating in the control group of an ongoing study at Zhejiang Provincial People's Hospital were recruited for this study. For each patient, a DXA scan (GE Lunar Prodigy) of the forearm was performed and BMD values were separately calculated using each of the three reference points to identify the ROI. Pearson correlation coefficients were calculated to examine the correlation between the BMD measures derived from each reference point. The F test and independent t test were applied for more robust analysis of the differences in the variances and means. RESULTS: Sixty-eight healthy Chinese volunteers agreed to participate in this study. The root mean square standard deviation (RMS-SD) percentages of BMD values measured at the 1/3 radius site were 2.19%, 2.23%, and 2.20% when using the ulnar styloid process, radial endplate, and the bifurcation of the ulna and radius as the reference points, respectively. Pearson's correlation coefficients for all pairwise comparisons among these three groups were greater than 0.99. F tests and independent t tests showed p values ranging from 0.92 to 0.99. However, we observed that among 10% of patients, choosing an ROI at the ulnar styloid process led to an inability to accurately determine the BMD at the ultra-distal radius. CONCLUSIONS: Given equal ability to determine BMD at the 1/3 radius accurately, the radial endplate or the bifurcation of the ulna and radius should be preferentially selected as the reference point for routine forearm BMD measurements in order to avoid situations in which the ultra-distal radius BMD cannot be determined.

Factors associated with low femoral neck bone mineral density in very elderly Chinese males.

OBJECTIVE: This study was designed to identify factors associated with the femoral neck bone mineral density (FNBMD) of the very elderly (aged 80 or more) Chinese males. METHODS: A total of 1177 very elderly Chinese males were recruited into the study, and subjected to FNBMD, biochemical parameters, bone turnover markers, and serum sex steroids assays. Univariate and multivariate regression analyses were performed to identify factors independently related to FNBMD. RESULTS: It was demonstrated that age (ß=-0.003, P=0.035), concomitant chronic obstructive pulmonary disease (COPD, ß=-0.027, P=0.009), serum ß-C-telopeptide of type 1 collagen (ß-CTX, ß=-0.097, P<0.001), and parathyroid hormone (PTH, ß=-0.001, P=0.004) were negatively correlated with the FNBMD, while body mass index (BMI, ß=0.009, P<0.001), and serum estradiol (ß=0.001, P=0.038) were positively related to FNBMD in very elderly Chinese males. CONCLUSION: An integrated intervention should be implemented to increase the BMD of the very elderly males, with special attention to preventing and curing COPD, reducing serum ß-CTX and PTH levels, as well as keeping a proper BMI and serum estradiol level.

Association between duration of playing video games and bone mineral density in Chinese adolescents.

The aim of the study was to investigate the association between duration of playing video games and bone mineral density (BMD) in Chinese adolescents. Three hundred eighty-four Chinese adolescents aged 14-18 yr (148 males and 236 females) were analyzed. Anthropometric measurements were obtained using standard procedures. Total body and regional BMD were measured using dual-energy X-ray absorptiometry. Duration of playing video games, defined as hours per day, was measured by a self-report questionnaire. We examined the association between duration of playing video games and BMD using multiple linear regression analysis. After adjustment for age, sex, pubertal stage, parental education, body mass index, adolescents with longer video game duration were more likely to have lower legs, trunk, pelvic, spine, and total BMD (p < 0.05). We concluded that duration of video game was negatively associated with BMD in Chinese adolescents. These findings provide support for reducing duration of playing video games as a possible means to increase BMD in adolescents. Future research is needed to elucidate the underlined mechanisms linking playing video games and osteoporosis.

Associations of fat mass and fat distribution with bone mineral density in Chinese obese population.

The purpose of the study was to investigate the associations of fat mass (FM) and fat distribution with bone mineral density (BMD) in Chinese obese population. Three hundred and forty-seven Chinese obese females and 339 males aged 20-39 years were analyzed. Lean mass (LM), FM, percent body fat (%BF), android FM, gynoid FM, and total and regional BMD were measured using dual-energy X-ray absorptiometry. Fat distribution was assessed by android-to-gynoid FM ratio (AOI). As a result, increased central body fat had an inverse association with total and leg BMD in females but not in males. Increased FM and %BF were positively associated with arm, trunk, and pelvic BMD in Chinese obese females. Increased FM was positively associated with total, rib, and trunk BMD in Chinese obese males. The results remained almost unchanged after adjusting for LM, and LM was significantly positively associated with spine BMD in female group. FM was positively associated with trunk BMD in male group after adjusting for LM. AOI was inversely associated with total and leg BMD, and %BF was positively associated with arm, trunk, and pelvic BMD when replacing FM with %BF in female group. The results remained almost unchanged after adjusting for LM. There is no significant association in male group when replacing FM with %BF. In conclusion, our findings demonstrate that there are different associations of FM and fat distribution with BMD, and AOI has a negative association with BMD.

[Effects of statins upon bone mineral density in postmenopausal women with hypercholesterolemia].

OBJECTIVE: To explore the effects of statins upon bone mineral density (BMD) and bone metabolic markers in postmenopausal women with hypercholesterolemia. METHODS: A prospective study was conducted for 100 women receiving treatment from January 2011 to August 2012 and meeting the inclusion criteria of osteopenia or osteoporosis with hypercholesterolemia postmenopausal. They were randomly divided into treatment group on atorvastatin 10 mg once daily and control group. The parameters of lumbar BMD, bone resorption markers of type I collagen cross-linked C-telopeptide (CTX) , bone synthesis markers procollagen type I N-terminal peptide (PINP) were compared between two groups after half a year and one year. RESULTS: There was an upward trend of lumbar spine BMD and PINP in the treatment group at half a year and one year compared with the control group. And two groups had significant difference (P < 0.05). Although two groups had no significant difference in all parameters at half a year, the values of lumbar spine BMD and PINP were higher in the treatment group at one year than the control group. Two groups had significant difference (P < 0.05). CONCLUSIONS: Statins can help maintain or increase bone mass of hypercholesterolemic menopausal women through promoting bone synthesis.

Dual-energy X-ray absorptiometry (DEXA): a novel approach for the evaluation of abdominal liposuction results.

BACKGROUND: It is difficult to measure exactly the amount of adipose tissue by which the body is reduced after liposuction. Dual-energy X-ray absorptiometry (DEXA) has been widely used in not only the diagnosis of osteoporosis but also the analysis of body composition such as the amount of bone mineral, adipose tissue, and other soft tissue. With this technique we can determine the exact amount of adipose tissue removed by liposuction. METHODS: Twenty-eight subjects who underwent abdominal liposuction were enrolled in the study. DEXA scans were performed before and 2-3 months after liposuction. Data were collected and statistical analysis was performed. CONCLUSION: DEXA is a feasible alternative for the evaluation of liposuction results.

[A new species of the genus Phenylobacterium for the degradation of LAS (linear alkylbenzene sulfonate)].

A strain GZ6 that can biodegrade LAS (Linear Alkylbenzene Sulphonate) is identified. It is aerobic gram-negative rod or short-rod (0.5 to 0.8 by 1.0 to 2.0 Mm). It is mobile with a single polar flagellum. Optimum growth occurred at 30 degrees C and pH7.0. It is catalase positive, urease positive, and arginine decarboxylase positive. All the other physiological and biochemical tests performed were negative. It utilizes the xenobiotic compounds chloridazon, antipyrin and LAS as sole carbon sources. Most sugars, alcohols, and carboxylic acids are not utilized. It has Q-10 as the major quinone. The main cell fatty acids are Sum7, C16:0 and Sum4. The DNA G + C mol % content is 70.10. A phylogenic tree was constructed on the basis of 16S rDNA sequences. It showed that the previously known member of the genus Phenylobacterium, Phenylobacterium mobile DSM1986T, is the nearest neighbor to strain GZ6. The level of binary sequence similarity between them is 97.49%. And the DNA-DNA relatedness is 40%. These genetic analysis and their morphological difference show that they are different species of Phenylobacterium. A new species, Phenylobacterium mobile sp. nov., has been proposed.