title: Prevalence of osteoporosis in China: a meta-analysis and systematic review.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Orthopedic, Xiangya Hospital, Central South University, No.87, Xiangya Road, Kaifu District, Changsha City, Hunan Province, 410008, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Zhanzhan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Orthopedic, Xiangya Hospital, Central South University, No.87, Xiangya Road, Kaifu District, Changsha City, Hunan Province, 410008, China. yihehumed@126.com.
authors.forename: Yihe
authors.initials: Y
authors.lastname: Hu
mesh_terms: D000328:Adult; D017677:Age Distribution; D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D017594:Publication Bias; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data
keywords: China; Cross-sectional study; Meta-analysis; Osteoporosis; Prevalence