Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women

Lei Si, Tania M. Winzenberg, Mingsheng Chen, Qicheng Jiang, Andrew J. Palmer

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

LanguageEnglish
Pages1149-1156
Number of pages8
JournalCurrent Medical Research and Opinion
Volume31
Issue number6
DOIs
Publication statusPublished - 1 Jun 2015
Externally publishedYes

Fingerprint

Osteoporotic Fractures
Wrist
Osteoporosis
Mortality
Hip
Incidence
Population
Humerus
Hip Fractures
Ribs
Pelvis
Tibia
Uncertainty

Keywords

  • 10 year risk
  • Absolute risk
  • Fracture
  • Osteoporosis
  • Residual lifetime risk

Cite this

Si, Lei ; Winzenberg, Tania M. ; Chen, Mingsheng ; Jiang, Qicheng ; Palmer, Andrew J. / Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. In: Current Medical Research and Opinion. 2015 ; Vol. 31, No. 6. pp. 1149-1156.
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abstract = "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.",
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Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. / Si, Lei; Winzenberg, Tania M.; Chen, Mingsheng; Jiang, Qicheng; Palmer, Andrew J.

In: Current Medical Research and Opinion, Vol. 31, No. 6, 01.06.2015, p. 1149-1156.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women

AU - Si, Lei

AU - Winzenberg, Tania M.

AU - Chen, Mingsheng

AU - Jiang, Qicheng

AU - Palmer, Andrew J.

PY - 2015/6/1

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N2 - 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.

AB - 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.

KW - 10 year risk

KW - Absolute risk

KW - Fracture

KW - Osteoporosis

KW - Residual lifetime risk

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