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The burden of fracture in China from 1990 to 2019

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Abstract

Purpose

Osteoporosis is one of the most common clinical problems among the elderly population. China is one of the countries most threatened by osteoporosis and fragility fracture, because of its large population and aging population trends during recent decades. We aimed to estimate the disease burden of fracture from 1990 to 2019 in China.

Methods

We performed a secondary analysis of fractures using detailed information for China from the Global Burden of Disease Study 2019. Fracture incidence and prevalence, rate of years lost to disability from fractures, and term secular trends in China from 1990 to 2019 were compared by sex, age, cause, and nature of fracture.

Results

The numbers for incidence and prevalence of fracture and years lived with disability (YLDs) from fractures in China increased from 12.54 million, 28.35 million, and 1.71 million in 1990 to 21.27 million, 67.85 million, and 3.79 million in 2019, respectively, increases of 70%, 139%, and 122%, respectively. In 2019, falls was the leading cause of fractures, with an age-standardized incidence rate (ASIR) of 762 per 100 000 (95% uncertainty interval [UI] 629–906), an age-standardized prevalence rate (ASPR) of 1863 per 100 000 (95% UI 1663–2094), and an age-standardized YLD rate (ASYR) of 103 per 100 000 (95% UI 69–147). Fall-associated deaths and disability-adjusted life-years (DALYs) from low bone mineral density increased greatly during the most recent three decades. Fracture of patella, tibia or fibula, and ankle were the most frequent fracture types, with an ASYR of 116 per 100 000 (95% UI 75–169). Hip fracture had more incident cases in adults ≥ 60 years old, and was more frequent for females.

Conclusions

The burden from fractures has increased significantly since 1990 in China. Falls and road injuries are the main causes of the increase. The fall-associated health burden from osteoporosis needs to be prioritized, with longer-term commitment to its reduction required.

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Data availability

The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding authors.

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Acknowledgements

The estimates used in this manuscript are based on the GBD data and methodologies. We appreciate the visionary global health leadership of the Institute for Health Metrics and Evaluation (IHME) in Seattle, Washington, and the contribution of all anonymous collaborators, without whom this report would not be possible.

Funding

This work was supported by grants from the National Natural Science Foundation of China [grant number 81870564 to P-FS].

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

    Zhiang Zhu, Tianyue Zhang, Yuyan Shen & Peng-Fei Shan

  2. Binjing Institute of Zhejiang University, Hangzhou, China

    Peng-Fei Shan

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  1. Zhiang Zhu
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  2. Tianyue Zhang
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Contributions

ZZ conceived the study, collected data, performed the statistical analysis, and participated in writing and preparation of the report. TZ and YS were involved in the data collection, interpretation of the data and preparation of the report. P-FS designed and coordinated the study, acquired funding, performed the statistical analysis, and participated in writing and editing the final report. P-FS assumes full responsibility for the overall content of this report. All authors contributed to the article and approved the submitted version.

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Correspondence to Peng-Fei Shan.

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Zhu, Z., Zhang, T., Shen, Y. et al. The burden of fracture in China from 1990 to 2019. Arch Osteoporos 19, 1 (2024). https://doi.org/10.1007/s11657-023-01353-4

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