Zeng Wenhui, Liu Wei, Zhang Lulu, Zhang Yiping, He Yuxiang, Su Weijuan, Huang Peiying, Huang Caoxin, Lin Mingzhu, Li Xuejun, Shi Xiulin
Department of Endocrinology and Diabetes, Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, No. 55 Zhenhai Road, Xiamen, 361003, China.
School of Medicine, Xiamen University, Xiamen, China.
Arch Osteoporos. 2025 Jan 8;20(1):8. doi: 10.1007/s11657-024-01492-2.
Our study investigated trends in osteoporosis management in Xiamen from 2012 to 2021, revealing improvements in screening and treatment, although medication use remained low. Additionally, we identified factors that may influence medication use and emphasized the importance of effective osteoporosis management strategies.
The goal of the current study is to explore trends in assessment, diagnosis after fragility fractures, and osteoporosis treatment among hospitalized patients in Xiamen, China, between 2012 and 2021.
We conducted a retrospective cross-sectional study, using the Cochran-Armitage trend test to describe trends. Logistic regression was performed to identify the influencing factors of anti-osteoporosis medication (AOM) treatment. We performed a sensitivity analysis to verify the robustness of our findings.
From 2012 to 2021, the rates of dual-energy X-ray absorptiometry (DXA) scans and bone turnover marker (BTM) examinations increased from 0 to 37% and 36.5%, respectively. 29.3% of patients with fragility fractures were diagnosed with osteoporosis. The use rate of AOM was only 22.7%. There was an upward trend in the prescription of bisphosphonates, increasing from 1% in 2012 to 16.8% in 2021. The use of calcitonin ranged from 4.1% (2014) to 32.7% (2021). Calcium and vitamin D supplementation prescribing increased significantly from 5.6% in 2012 to 78.7% in 2021. Logistic regression analysis showed that old age, female sex, history of fractures, DXA scans, and osteoporosis diagnosis were significantly associated with increased AOM use. Tobacco use, hypertension, diabetes, congestive heart failure, cerebral vascular accidents, and severe liver diseases were associated with a reduced likelihood of AOM treatment.
Although assessment, diagnosis after fragility fractures, and osteoporosis treatment have increased over the past decade, there are still deficiencies in the management of osteoporosis. In the future, it will be necessary to further strengthen management of osteoporosis.
我们的研究调查了2012年至2021年厦门骨质疏松症管理的趋势，结果显示筛查和治疗有所改善，尽管药物使用情况仍然较低。此外，我们确定了可能影响药物使用的因素，并强调了有效骨质疏松症管理策略的重要性。
本研究的目的是探讨2012年至2021年期间中国厦门住院患者的评估、脆性骨折后的诊断以及骨质疏松症治疗的趋势。
我们进行了一项回顾性横断面研究，使用 Cochr an - Armitage趋势检验来描述趋势。进行逻辑回归以确定抗骨质疏松药物（AOM）治疗的影响因素。我们进行了敏感性分析以验证研究结果的稳健性。
2012年至2021年，双能X线吸收法（DXA）扫描率和骨转换标志物（BTM）检查率分别从0%增至37%和36.5%。29.3%的脆性骨折患者被诊断为骨质疏松症。AOM的使用率仅为22.7%。双膦酸盐类药物的处方呈上升趋势，从2012年的1%增至2021年的16.8%。降钙素的使用范围为4.1%（2014年）至32.7%（2021年）。钙和维生素D补充剂的处方从2012年的5.6%显著增至2021年的78.7%。逻辑回归分析表明，老年、女性、骨折史、DXA扫描以及骨质疏松症诊断与AOM使用增加显著相关。吸烟、高血压、糖尿病、充血性心力衰竭、脑血管意外和严重肝病与AOM治疗可能性降低相关。
尽管在过去十年中评估、脆性骨折后的诊断以及骨质疏松症治疗有所增加，但骨质疏松症管理仍存在不足。未来，有必要进一步加强骨质疏松症的管理。
