Unhealthy lifestyles are associated with the increased risk of low-energy fracture in Chinese men ≥ 50 years, a population-based survey



This study aims to investigate the incidence of low-energy fractures in men aged 50 years and older in China and to explore associated risk factors.


All the relevant data were available from the China National Fracture Survey (CNFS), which was a cross-sectional survey carried out in eight Chinese provinces (municipalities) between January and May 2015.


Through 2014, 76,687 men above 50 years participated in this study and 223 participants had low-energy fractures, indicating the incidence rate 290.8 (95%CI, 252.7–328.9)/100,000 men. Over 80% of the fractures occurred at home and on the common road. The fracture incidence rate presented a significant rising trend with advanced age (p = 0.039). Current smoking, alcohol overconsumption, insufficient sleep duration, and history of past fracture were identified as significant risk factors associated with low-energy fracture (p < 0.05).


These results will assist the decisions regarding allocation of healthcare provision to populations of greatest need and aid the design and implementation of strategies to reduce fracture incidence. Accordingly, individuals should be encouraged to reduce alcohol consumption, immediately quit smoking, and get sufficient sleep, especially in those with a history of past fracture. In addition, primary preventives especially home prevention should be emphasized.

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We are grateful to Q Zhang and H Wang of the Department of Orthopedics, and to X Zhang of the Department of statistics and epidemiology for their kind assistance.


This study was funded by the Hebei Province Medical Science Special Major Projects Research Fund.

Author information




Y Zhang conceived the idea for the study. Y Zhang, Y Zhang, YL, YZ, SL, WC, and HL and designed the study. JS, YZ and XZ performed the statistical analyses. XX, YL, YZ, and CJ prepared the figures and tables. YL, YZ, JS, SL, WC, HL, and CJ interpreted the data and contributed to preparation of the manuscript. GL, YL, and YZ contributed equally to this manuscript.

Corresponding author

Correspondence to Yingze Zhang.

Ethics declarations

The CNFS was approved by the Institutional Review Board of the 3rd Hospital of Hebei Medical University. Written informed consent was obtained from each participant before data collection.

Conflict of interest

The authors declare that they have no competing interests.

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This study is registered with the Chinese Clinical Trial Registry, number ChiCTR-EPR-15005878.

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Liu, G., Li, Y., Zhu, Y. et al. Unhealthy lifestyles are associated with the increased risk of low-energy fracture in Chinese men ≥ 50 years, a population-based survey. Arch Osteoporos 14, 57 (2019). https://doi.org/10.1007/s11657-019-0600-7

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  • Epidemiology
  • Low-energy fracture
  • Risk factor
  • Population-based