Estimations of bone mineral density defined osteoporosis prevalence and cutpoint T-score for defining osteoporosis among older Chinese population: a framework based on relative fragility fracture risks

This study estimated the bone mineral density (BMD) defined osteoporosis prevalence of Chinese women and Chinese men aged ≥50 years. The estimation was based on the 1994 WHO definition of osteoporosis and two assumptions: (I) fragility fracture (FF) risk among older Chinese is half of that of older US Caucasians; (II) FF risk among older Chinese men is half of that of older Chinese women. In addition, we also consider the FF risk among older Chinese is close to those of American Blacks. We estimated that the osteoporosis prevalence based on lumbar BMD, femoral neck BMD, total hip BMD would be 15.8%, 20.4%, and 15.2% for US Caucasian women, 6.7%, 7.8%, and 7.9% for US black women, 7.5%, 7.5%, and 6.7% for Chinese women, 1.8%, 5.7%, and 3.3% for US black men, and 2.0%, 3.8%, and 3.4% for Chinese men. To satisfy the above estimates of osteoporosis prevalence for the Chinese population, in addition to using a local reference database, we suggest that the T-score cutpoints for defining osteopenia and osteoporosis among older Chinese should be adjusted from the conventional WHO thresholds of −2.5 and −1.0. Our suggested revised cutpoint T-score for defining osteoporosis described in this article will be more in line with the original WHO definition and will allow a more meaningful international comparison of disease burden.