title: Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women.
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.
  
  
  CONCLUSIONS
  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.
authors: Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia.
authors: Lei
authors: L
authors: Si
authors: Tania M
authors: TM
authors: Winzenberg
authors: Mingsheng
authors: M
authors: Chen
authors: Qicheng
authors: Q
authors: Jiang
authors: Andrew J
authors: AJ
authors: Palmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D012306:Risk; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000209:etiology
keywords: 10 year risk; Absolute risk; Fracture; Osteoporosis; Residual lifetime risk