Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population

Jingjing Xu,^1,* Min Sun,^1,* Zhixiao Wang,^1,* Qi Fu,¹ Mengdei Cao,¹ Zhenxin Zhu,¹ Chuchen Meng,¹ Yan Yan,¹ Jia Mao,¹ Hua Tao,¹ Xiaoping Huang,¹ Zheng Lin,² Tao Yang,¹ Wei He<sup>1

1</sup>Department of Endocrinology, ²Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China

*These authors contributed equally to this work

Background: The People’s Republic of China has the largest population affected by osteoporosis in the world. However, no population-based survey of osteoporosis awareness in People’s Republic of China has been reported. This study investigated the level of basic awareness of osteoporosis in a large community in People’s Republic of China. The relationship between level of awareness and quantitative ultrasound (US) measurements at the calcaneus was also assessed.
Methods: A questionnaire was completed by 9983 men and women aged 40 years or older in Nanjing, People’s Republic of China, between June and December 2011. During this time, the study participants underwent quantitative US measurement. Data from 9049 of the subjects were included in the final analysis.
Results: The proportion of subjects who were aware of osteoporosis was very low. Only 30.7% had heard of osteoporosis, and only 18.5% had heard of osteoporotic fracture. In total, 52.9% of the subjects drank milk, 16.0% took calcium, 7.1% took vitamin D, and 47.2% were performing regular physical activity. Logistic regression showed that more highly educated older women had significantly better awareness of osteoporosis (P < 0.05). Subjects with a history of a previous osteoporotic fracture also had better awareness (P < 0.05) than subjects without such a history, except for those who drank milk. Similar to previous reports, female sex, old age, a low education level, and a personal history of osteoporotic fracture were significantly associated with a low quantitative US measurement (P < 0.001). Further, drinking milk and having not heard of osteoporosis were significantly associated with a higher quantitative US measurement (P < 0.05), while other indicators of osteoporosis awareness were not associated with quantitative US values (P > 0.05).
Conclusion: Awareness of osteoporosis in People’s Republic of China is very low. National awareness strategies should be implemented, especially for poorly educated young men.

Keywords: osteoporosis, awareness, quantitative ultrasound, Chinese