Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults

<p><strong>Importance:</strong> Reliable evidence on modifiable risk factors for hip and major osteoporotic fractures in untreated populations could inform prevention strategies for hip fracture worldwide.</p> <p><strong>Objectives:</strong> To estimate the...

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Main Authors: Yao, P, Parish, S, Bennett, D, Du, H, Yang, L, Chen, Y, Chen, Z, Clarke, R
Other Authors: China Kadoorie Biobank Collaborative Group
Format: Journal article
Language:English
Published: Wiley 2021
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author Yao, P
Parish, S
Bennett, D
Du, H
Yang, L
Chen, Y
Chen, Z
Clarke, R
author2 China Kadoorie Biobank Collaborative Group
author_facet China Kadoorie Biobank Collaborative Group
Yao, P
Parish, S
Bennett, D
Du, H
Yang, L
Chen, Y
Chen, Z
Clarke, R
author_sort Yao, P
collection OXFORD
description <p><strong>Importance:</strong> Reliable evidence on modifiable risk factors for hip and major osteoporotic fractures in untreated populations could inform prevention strategies for hip fracture worldwide.</p> <p><strong>Objectives:</strong> To estimate the age- and sex-specific incidence of hip, major osteoporotic and any fractures and examine their associated risk factors in Chinese adults.</p> <p><strong>Design, Setting, and Participants:</strong> Prospective study of 512,715 adults, aged 30-79 years, recruited for the China Kadoorie Biobank from 10 diverse areas in China in 2004-2008 and followed up for 10 years.</p> <p><strong>Exposures:</strong> Sociodemographic factors (e.g. age, sex, and education), medical history (e.g. CVD, diabetes, fracture, and rheumatoid arthritis), anthropometry (e.g. weight, waist-hip ratio) and lifestyle factors (e.g. smoking, alcohol drinking, physical activity, diet).</p> <p><strong>Main Outcomes and Measures:</strong> Age- and sex-specific incidence rates of fracture types, and adjusted hazard ratios (HR) and population attributable fractions (PAF) for individual risk factors associated with fracture types.</p> <p><strong>Results:</strong> The incidence rates of hip fracture in Chinese adults were 5.1 (95%CI 5.0- 5.3) per 10,000 person-years (2616 cases); and were higher in women than men (5.8 [5.5-6.1] vs 4.2 [3.9-4.5]) and increased by about 2 to 3-fold per 10 years older age. Among men, five risk factors for hip fracture including low education (HR=1.23; 95%CI 1.04-1.45), regular smoker (1.22, 1.03-1.45), lower weight (lowest vs other quintiles: 1.59, 1.34-1.88), alcohol drinker (1.18, 1.02-1.36), and prior fracture (1.62, 1.33-1.98) accounted for 44.3% of hip fractures. Among women, five risk factors including lower weight (lowest vs other quintiles: 1.30, 1.15-1.46), low physical activity (lowest vs other quintiles: 1.22, 1.10-1.35), diabetes (1.62, 1.41-1.86), prior fracture (1.54, 1.33-1.77), and self-rated poor health (1.29, 1.13-1.47), accounted for 24.9% of hip fractures. Associations of these risk factors with major osteoporotic (6857 cases) or any (15762 cases) fractures were weaker than those with hip fracture.</p> <p><strong>Conclusions:</strong> The age- and sex-specific incidence rates of hip fracture in Chinese adults were comparable with those in Western populations. Five potentially modifiable factors accounted for half of all hip fractures in men and one quarter in women.</p>
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spelling oxford-uuid:1c8e122f-bea9-400d-8c1a-6fa2c23139b02022-05-24T08:32:20ZGender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adultsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1c8e122f-bea9-400d-8c1a-6fa2c23139b0EnglishSymplectic ElementsWiley2021Yao, PParish, SBennett, DDu, HYang, LChen, YChen, ZClarke, RChina Kadoorie Biobank Collaborative Group<p><strong>Importance:</strong> Reliable evidence on modifiable risk factors for hip and major osteoporotic fractures in untreated populations could inform prevention strategies for hip fracture worldwide.</p> <p><strong>Objectives:</strong> To estimate the age- and sex-specific incidence of hip, major osteoporotic and any fractures and examine their associated risk factors in Chinese adults.</p> <p><strong>Design, Setting, and Participants:</strong> Prospective study of 512,715 adults, aged 30-79 years, recruited for the China Kadoorie Biobank from 10 diverse areas in China in 2004-2008 and followed up for 10 years.</p> <p><strong>Exposures:</strong> Sociodemographic factors (e.g. age, sex, and education), medical history (e.g. CVD, diabetes, fracture, and rheumatoid arthritis), anthropometry (e.g. weight, waist-hip ratio) and lifestyle factors (e.g. smoking, alcohol drinking, physical activity, diet).</p> <p><strong>Main Outcomes and Measures:</strong> Age- and sex-specific incidence rates of fracture types, and adjusted hazard ratios (HR) and population attributable fractions (PAF) for individual risk factors associated with fracture types.</p> <p><strong>Results:</strong> The incidence rates of hip fracture in Chinese adults were 5.1 (95%CI 5.0- 5.3) per 10,000 person-years (2616 cases); and were higher in women than men (5.8 [5.5-6.1] vs 4.2 [3.9-4.5]) and increased by about 2 to 3-fold per 10 years older age. Among men, five risk factors for hip fracture including low education (HR=1.23; 95%CI 1.04-1.45), regular smoker (1.22, 1.03-1.45), lower weight (lowest vs other quintiles: 1.59, 1.34-1.88), alcohol drinker (1.18, 1.02-1.36), and prior fracture (1.62, 1.33-1.98) accounted for 44.3% of hip fractures. Among women, five risk factors including lower weight (lowest vs other quintiles: 1.30, 1.15-1.46), low physical activity (lowest vs other quintiles: 1.22, 1.10-1.35), diabetes (1.62, 1.41-1.86), prior fracture (1.54, 1.33-1.77), and self-rated poor health (1.29, 1.13-1.47), accounted for 24.9% of hip fractures. Associations of these risk factors with major osteoporotic (6857 cases) or any (15762 cases) fractures were weaker than those with hip fracture.</p> <p><strong>Conclusions:</strong> The age- and sex-specific incidence rates of hip fracture in Chinese adults were comparable with those in Western populations. Five potentially modifiable factors accounted for half of all hip fractures in men and one quarter in women.</p>
spellingShingle Yao, P
Parish, S
Bennett, D
Du, H
Yang, L
Chen, Y
Chen, Z
Clarke, R
Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title_full Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title_fullStr Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title_full_unstemmed Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title_short Gender differences in modifiable risk factors for hip fracture: 10-year follow-up of a prospective study of 0.5 million Chinese adults
title_sort gender differences in modifiable risk factors for hip fracture 10 year follow up of a prospective study of 0 5 million chinese adults
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