Estimation of osteoporosis prevalence among a population is reasonable only after the concerned reference bone mineral density database and cutpoint T-score have been validated

Background We conducted a systematic review and meta-analysis to obtain a reliable estimation of the prevalence of osteoporosis in China and to characterize its epidemiology. Methods We identified relevant studies via a search of literature published from 2003 to October 2015 in the PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang and Weipu databases. Both Chinese and WHO criteria were considered acceptable for the diagnosis of osteoporosis. Prevalence estimates were obtained using random effects models. Meta-regression analysis was used to explore the sources of heterogeneity, and publication bias was evaluated by visually inspecting funnel plots. Results Overall, 69 articles were included in this study. An obvious increase in the prevalence of osteoporosis was identified over the past 12 years (prevalence of 14.94 % before 2008 and 27.96 % during the period spanning 2012–2015). The prevalence of osteoporosis was higher in females than in males (25.41 % vs. 15.33 %) and increased with age. Osteoporosis prevalence was higher in rural than in urban areas (20.87 % vs. 23.92 %) and higher in southern than in northern areas (23.17 % vs. 20.13 %). At present, the pooled prevalence of osteoporosis in people aged 50 years and older was more than twice the pooled prevalence identified in 2006 (34.65 % vs. 15.7 %). The application of different diagnostic criteria could have an impact on prevalence estimation (19.7 % vs. 29.3 %). Meta-regression suggested that study setting also influenced the estimation of point prevalence (P = 0.022). Conclusions The prevalence of osteoporosis in China has increased over the past 12 years, affecting more than one-third of people aged 50 years and older. The prevalence of osteoporosis increased with age and was higher in females than in males. Prevention and control measures have become all the more important given the increase in osteoporosis prevalence, and three-step prevention programmes should be implemented. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3712-7) contains supplementary material, which is available to authorized users.

For the prevention of osteoporotic fracture, adequate screening and treatment are important. However, there are few published data on diagnosis and treatment rates of osteoporosis in Asia. We used data from the fourth Korea National Health and Nutrition Examination Survey 2008-2009 to estimate the nationwide prevalence, physician diagnosis rate, and treatment rate of osteoporosis in adults aged 50 years and older. The bone mineral density (BMD) measurements of central skeletal sites (lumbar spine, femoral neck, and total hip) were obtained using dual-energy X-ray absorptiometry (DXA) (Discovery-W; Hologic Inc., Waltham, MA, USA). Diagnosis of osteopenia or osteoporosis was defined by the World Health Organization (WHO) T-score criteria. The prevalence of osteoporosis in adults aged 50 years or older was 35.5% in women and 7.5% in men. The prevalence of osteoporosis in Korea was similar to other East Asian countries but higher than that in Caucasians. Lumbar spine bone density T-scores tended to be lower than those of the femoral neck or hip. The estimated diagnosis rate was 26.2% (women 29.9%, men 5.8%) and the treatment rate was 12.8% (women 14.4%, men 4.0%). The physician diagnosis rate was significantly higher in females aged 66 to 68 years who were the beneficiaries of the national screening program than that in females of other ages (43.6% versus 28.1%, p < 0.05). The national screening program for osteoporosis may have contributed to an increased diagnosis rate in older Korean women. However, it was evident that treatment following a diagnosis of osteoporosis was still inadequate. Copyright © 2012 American Society for Bone and Mineral Research.

This systematic review and meta-analysis estimated the global, regional prevalence, and risk factors of osteoporosis. Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from 8.0% in Oceania to 26.9% in Africa). Osteoporosis is a common metabolic bone disorder in the elderly, usually resulting in bone pain and an increased risk of fragility fracture, but few summarized studies have guided global strategies for the disease. Therefore, we pooled the epidemiologic data to estimate the global, regional prevalence, and potential risk factors of osteoporosis. We conducted a comprehensive literature search through PubMed, EMBASE, Web of Science, and Scopus, to identify population-based studies that reported the prevalence of osteoporosis based on the World Health Organization (WHO) criteria. Meta-regression and subgroup analyses were used to explore the sources of heterogeneity. The study was registered in the PROSPERO database (CRD42021285555). Of the 57,933 citations evaluated, 108 individual studies containing 343,704 subjects were included. The global prevalence of osteoporosis and osteopenia was 19.7% (95%CI, 18.0%-21.4%) and 40.4% (95%CI, 36.9%-43.8%). Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from Oceania 8.0% to 26.9% in Africa). The prevalence was higher in developing countries (22.1%, 95%CI, 20.1%-24.1%) than in developed countries (14.5%, 95%CI, 11.5%-17.7%). Our study indicates a considerable prevalence of osteoporosis among the general population based on WHO criteria, and the prevalence varies substantially between countries and regions. Future studies with robust evidence are required to explore risk factors to provide effective preventive strategies for the disease.