Fragility fracture prevalence among elderly Chinese is no more than half of that of elderly Caucasians

Section: A B a Bsupporting

confidence: 57%

An update of our understanding of radiographic diagnostics for prevalent osteoporotic vertebral fracture in elderly women

Wáng

2022

“…It has been recognized that the fragility fracture prevalence among older Chinese is no more than half that of Caucasians, both for men and women. Some literature reports have been discussed in a recent article (3). Hereby we summarize a number of additional evidence.…”

Section: Ethical Statementmentioning

confidence: 85%

“…Understandably, cutpoint T-scores for defining osteopenia and osteoporosis also depend on the quality and size of databases. In addition to the requirement for , based on the US and Canadian Caucasian data and also those of femoral neck results, the osteoporosis prevalence for Chinese women ≥ 50 years old is assumed to be 6.7%, which could be an aggressive estimation (i.e., the real prevalence could be even lower), as some studies showed hip fragility fracture prevalence of older Chinese women is close to 40% of that of Caucasians (3) . ¶ , assuming Chinese women have an osteopenia prevalence of 29% (see Table 5), the osteopenia prevalence for Chinese men ≥50 years old is assumed to be approximately half of the rate of Chinese women.…”

mentioning

confidence: 99%

Estimations of bone mineral density defined osteoporosis prevalence and cutpoint T-score for defining osteoporosis among older Chinese population: a framework based on relative fragility fracture risks

Wáng¹,

Xiao²

2022

Self Cite

The clinical significance of osteoporosis lies in the fractures which occur, and the most important fracture is hip fracture. According to the WHO criteria, T-score is defined as: (BMD patient -BMD young normal mean )/SD young normal population , where BMD is bone mineral density and SD is the standard deviation. In adult women, the cutpoint value of patient BMD 2.5 SD below BMD young normal mean satisfies that, when the femoral neck is measured, osteoporosis prevalence is about 16.2% for those aged ≥50 years, the same as the lifetime risk of hip fragility fracture (FF) (1,2). If other sites are also considered, this cutpoint value identifies approximately 30% of postmenopausal women as having osteoporosis, which is approximately equivalent to the lifetime risk of FF at the spine, hip, or forearm. It is commonly considered that this osteoporotic portion of the population has a faster bone mass loss, and interventions

“…However, these results are likely due to methodological imperfections. Recent evidence suggests that, compared with Caucasians, the relative prevalence of OVF follows the same pattern as other clinical fractures (46).…”

Section: Comparatively Lower Ovf Prevalence Among Elderly Chinese Men and Womenmentioning

confidence: 94%

“…It has been well documented that the prevalence of clinical fractures is substantially lower among elderly East Asians compared to Caucasians, both for men and women (46). For example, Ho et al (47) examined the hospital discharge data for hip fracture in Hong Kong and in the USA for 1988 through 1989.…”

Section: Comparatively Lower Ovf Prevalence Among Elderly Chinese Men and Womenmentioning

confidence: 99%

‘Healthier Chinese spine’: an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies

Wáng¹,

Deng²,

Griffith³

et al. 2022

Self Cite

For the MrOS (Hong Kong) and MsOS (Hong Kong) baseline (BL) studies, community-dwelling 2,000 Chinese men (mean age: 72.3 years) and 2,000 Chinese women (mean age: 72.5 years) were recruited from 2001 to 2003. These two studies have spanned two decades till now. This review summarizes our spine radiograph results. Senile and post-menopausal osteoporosis were associated with intervertebral disc volume reduction; and in women, menopause accelerates disc degeneration. Elderly women's osteoporotic vertebral fracture (OVF) prevalence was double of that of elderly men. For year-4 follow-up (FU), male participants with BL OVF had little increased risk for further OVF. In our study comparing OVF rates in age-matched Hong Kong Chinese women and Italian Caucasian women (mean age: 74.1 years), endplate and/or cortex fracture (ECF) prevalence was 26% for Chinese and 47% for Italian. OVF with ≥40% vertebral height loss was recorded among 9.5% of the Chinese subjects while among 26% of the Italian subjects. OVFs in Italian subjects were more likely to be multiple and generally severer. Clinical spine fractures were recorded 133 cases/100,000 person-years in MrOS (Hong Kong) participants and 273 cases/100,000 person-years in MsOS (Hong Kong) participants. Literature review suggests the clinical vertebral fracture rates among elderly Hong Kong Chinese subjects are approximately half of those of American, Australian, and Canadian subjects. Data synthesis suggests elderly Caucasians have a higher degenerative spondylolisthesis prevalence, being approximately 70% higher than that of elderly Hong Kong Chinese. Literature review of other authors' publications shows, compared with Caucasians, Chinese have a much lower incident rate of back pain. We conclude that elderly Chinese have a generally healthier spine relative to elderly Caucasians.