Si, L and Winzenberg, TM and Chen, M and Jiang, Q and Palmer, AJ, Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women, Current Medical Research and Opinion, 31, (6) pp. 1149-1156. ISSN 0300-7995 (2015) [Refereed Article]
Copyright 2015 Informa UK Ltd
Objective: To determine the residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women.
Methods: A validated state-transition microsimulation model was used. Microsimulation and probabilistic sensitivity analyses were performed to address the uncertainties in the model. All parameters including fracture incidence rates and mortality rates were retrieved from published literature. Simulated subjects were run through the model until they died to estimate the residual lifetime fracture risks. A 10 year time horizon was used to determine the 10 year fracture risks. We estimated the risk of only the first osteoporotic fracture during the simulation time horizon.
Results: The residual lifetime and 10 year risks of having the first osteoporotic (hip, clinical vertebral or wrist) fracture for Chinese women aged 50 years were 40.9% (95% CI: 38.3-44.0%) and 8.2% (95% CI: 6.8-9.3%) respectively. For men, the residual lifetime and 10 year fracture risks were 8.7% (95% CI: 7.5-9.8%) and 1.2% (95% CI: 0.8-1.7%) respectively. The residual lifetime fracture risks declined with age, whilst the 10 year fracture risks increased with age until the short-term mortality risks outstripped the fracture risks. Residual lifetime and 10 year clinical vertebral fracture risks were higher than those of hip and wrist fractures in both sexes.
Conclusions: More than one third of the Chinese women and approximately one tenth of the Chinese men aged 50 years are expected to sustain a major osteoporotic fracture in their remaining lifetimes. Due to increased fracture risks and a rapidly ageing population, osteoporosis will present a great challenge to the Chinese healthcare system.
Limitations: While national data was used wherever possible, regional Chinese hip and clinical vertebral fracture incidence rates were used, wrist fracture rates were taken from a Norwegian study and calibrated to the Chinese population. Other fracture sites like tibia, humerus, ribs and pelvis were not included in the analysis, thus these risks are likely to be underestimates. Fracture risk factors other than age and sex were not included in the model. Point estimates were used for fracture incidence rates, osteoporosis prevalence and mortality rates for the general population.
|Item Type:||Refereed Article|
|Keywords:||10 year risk, absolute risk, fracture, osteoporosis, residual lifetime risk|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Skeletal System and Disorders (incl. Arthritis)|
|UTAS Author:||Si, L (Mr Lei Si)|
|UTAS Author:||Winzenberg, TM (Professor Tania Winzenberg)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|Web of Science® Times Cited:||16|
|Deposited By:||Menzies Institute for Medical Research|
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