Wáng Yì Xiáng J, Deng Min, Griffith James F, Kwok Anthony W L, Leung Jason C S, Lam Patti M S, Yu Blanche Wai Man, Leung Ping Chung, Kwok Timothy C Y
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Quant Imaging Med Surg. 2022 Mar;12(3):2090-2105. doi: 10.21037/qims-2021-07.
For the MrOS (Hong Kong) and MsOS (Hong Kong) baseline (BL) studies, community-dwelling 2,000 Chinese men (mean age: 72.3 years) and 2,000 Chinese women (mean age: 72.5 years) were recruited from 2001 to 2003. These two studies have spanned two decades till now. This review summarizes our spine radiograph results. Senile and post-menopausal osteoporosis were associated with intervertebral disc volume reduction; and in women, menopause accelerates disc degeneration. Elderly women's osteoporotic vertebral fracture (OVF) prevalence was double of that of elderly men. For year-4 follow-up (FU), male participants with BL OVF had little increased risk for further OVF. In our study comparing OVF rates in age-matched Hong Kong Chinese women and Italian Caucasian women (mean age: 74.1 years), endplate and/or cortex fracture (ECF) prevalence was 26% for Chinese and 47% for Italian. OVF with ≥40% vertebral height loss was recorded among 9.5% of the Chinese subjects while among 26% of the Italian subjects. OVFs in Italian subjects were more likely to be multiple and generally severer. Clinical spine fractures were recorded 133 cases/100,000 person-years in MrOS (Hong Kong) participants and 273 cases/100,000 person-years in MsOS (Hong Kong) participants. Literature review suggests the clinical vertebral fracture rates among elderly Hong Kong Chinese subjects are approximately half of those of American, Australian, and Canadian subjects. Data synthesis suggests elderly Caucasians have a higher degenerative spondylolisthesis prevalence, being approximately 70% higher than that of elderly Hong Kong Chinese. Literature review of other authors' publications shows, compared with Caucasians, Chinese have a much lower incident rate of back pain. We conclude that elderly Chinese have a generally healthier spine relative to elderly Caucasians.
在MrOS（香港）和MsOS（香港）基线（BL）研究中，2001年至2003年招募了2000名居住在社区的中国男性（平均年龄：72.3岁）和2000名中国女性（平均年龄：72.5岁）。这两项研究至今已跨越了二十年。本综述总结了我们的脊柱X光片结果。老年和绝经后骨质疏松症与椎间盘体积减少有关；在女性中，绝经会加速椎间盘退变。老年女性骨质疏松性椎体骨折（OVF）的患病率是老年男性的两倍。在第4年随访（FU）时，基线时有OVF的男性参与者再次发生OVF的风险增加不多。在我们比较年龄匹配的香港中国女性和意大利白种女性（平均年龄：74.1岁）的OVF发生率的研究中，中国女性终板和/或皮质骨折（ECF）的患病率为26%，意大利女性为47%。中国受试者中9.5%的人记录到椎体高度丢失≥40%的OVF，而意大利受试者中这一比例为26%。意大利受试者的OVF更可能是多发的，且通常更严重。在MrOS（香港）参与者中，临床脊柱骨折的记录发生率为133例/100,000人年，在MsOS（香港）参与者中为273例/100,000人年。文献综述表明，香港中国老年受试者的临床椎体骨折发生率约为美国、澳大利亚和加拿大受试者的一半。数据综合表明，老年白种人退变性腰椎滑脱的患病率较高，比香港中国老年人高约70%。其他作者发表文章的文献综述显示，与白种人相比，中国人背痛的发病率要低得多。我们得出结论，相对于老年白种人，中国老年人的脊柱总体上更健康。
