The Prevalence And Influencing Factors Of Osteoporosis In Rural Adults Of Henan

ObjectiveOsteoporosis has become an important public health problem along with an increased ageing population and longer life expectancy.However,there are still few reports on the prevalence and influencing factors of osteoporosis in rural areas.The aims of this study are to understand the prevalence rate and influencing factors of osteopenia and osteoporosis in Henan rural population,and to compare the prevalence with other rural areas of China,so as to provide scientific basis for the prevention and treatment of osteoporosis.MethodsA total of 8033 participants(18-79 years)were obtained from the Henan Rural Cohort Study,which used a multi-stage cluster sampling method to investigate rural areas in five counties(Yuzhou,Suiping,Tongxu,Xinxiang,Yima)of Henan Province from July 2015 to September 2017.The information was collected through a face-to-face interview by trained research staff using a standardized questionnaire.Bone mineral density(BMD)of the calcaneus was measured three times by the same investigator using an ultrasonic bone density apparatus(Hologic Sahara,America),and the average of the three readings was taken for analysis.Measurement indicators include BMD value and T-value.Logistic regression models were used to examine the association of different factors with osteopenia and osteoporosis,and the strength of the association was expressed by odds ratio(OR)and 95%confidence intervals(CI).A meta-analysis of prevalence of osteoporosis was also performed to compare the findings with our study.Restricted cubic splines were conducted to assess the dose-response relationship between cardiovascular metabolic influencing factors and osteoporosis.Results1.Distribution of BMD:The mean of BMD were 0.41 g/cm2 and 0.29 g/cm2 for participants with osteopenia and osteoporosis.Overall,the mean of BMD for men(0.466±0.11 g/cm2)was greater than that for women(0.43±0.12 g/cm2),with a statistically significant difference(P<0.001).With the increase of age,the mean of BMD for men,women and the general population showed a downward trend(all Ptrend<0.001).2.The prevalence of osteopenia and osteoporosis:The crude prevalence of osteopenia and osteoporosis were 50.24%and 20.37%,and the corresponding age-standardized rates were 50.05%and 14.57%,respectively.The crude prevalence of osteopenia in men was 55.75%,which was significantly higher than that in women(46.96%)(P<0.001).However,the crude prevalence of osteoporosis in men(14.56%)was significantly lower than that in women(23.83%)(P<0.001),With the increase of age,the prevalence of osteopenia increased first and then decreased(Ptrend<0.001),and the prevalence of osteoporosis showed increasing trend(Ptrend<0.001),especially after the age of 50 years in women and 60 years in men.Meta-analysis showed that the overall prevalence of osteoporosis in rural China from 1999 to 2016 was 17.7%(slightly lower than the results of this study),and the prevalence in men(7.8%)was lower than that in women(23.2%).3.Influencing factor of osteopenia and osteoporosis:Higher age,female,widowed(single/divorced/separation),smoker,drinker,underweight,hypertension and hypercholesterolemia were all positively associated with osteopenia and osteoporosis,while higher education level,high fat diet,more vegetable and fruit intake,hypertriglyceridemia,and overweight/obesity were negatively associated with osteopenia and osteoporosis.4.Dose-response relationship between cardiovascular metabolic influencing factors and osteoporosis:With the increase of body mass index and triglyceride,the OR of osteoporosis decreased gradually,while with the increase of total cholesterol,the OR of osteoporosis increased gradually(all P<0.05).Conclusions1.Nearly half of adults in Henan rural areas were in a state of osteopenia,and one in six suffered from osteoporosis.2.With the increase of age,the prevalence of osteoporosis showed increasing trend,especially after the age of 50 years in women and 60 years in men,and women had higher prevalence than men did.3.Higher age,female,widowed(single/divorced/separation),smoker,drinker,underweight,hypertension and hypercholesterolemia were all positively associated with osteopenia and osteoporosis,while higher education level,high fat diet,more vegetable and fruit intake,hypertriglyceridemia,and overweight/obesity were negatively associated with osteopenia and osteoporosis.