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1. Prevalence of Nontraumatic Osteonecrosis of the Femoral Head and its Associated Risk Factors in the Chinese Population: Results from a Nationally Representative Survey

Author

De-Wei Zhao, Mang Yu, Kai Hu, Wei Wang, Lei Yang, Ben-Jie Wang, Xiao-Hong Gao, Yong-Ming Guo, Yong-Qing Xu, Yu-Shan Wei, Si-Miao Tian, Fan Yang, Nan Wang, Shi-Bo Huang, Hui Xie, Xiao-Wei Wei, Hai-Shen Jiang, Yu-Qiang Zang, Jun Ai, Yuan-Liang Chen, Guang-Hua Lei, Yu-Jin Li, Geng Tian, Zong-Sheng Li, Yong Cao, and Li Ma

Subjects
Nontraumatic Osteonecrosis of the Femoral Head, Prevalence, Risk Factors, Medicine
Abstract

Background: Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population. Methods: A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH. Results: NONFH was diagnosed in 218 subjects (0.725%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, χ2 = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85% vs. 0.61%, χ 2 = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH. Conclusions: Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.

Published
2015
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2. Prevalence of Nontraumatic Osteonecrosis of the Femoral Head and its Associated Risk Factors in the Chinese Population: Results from a Nationally Representative Survey

Author

Yong-Ming Guo, Simiao Tian, Benjie Wang, Shibo Huang, Nan Wang, Yu-Jin Li, Xiao-Hong Gao, Zong-Sheng Li, Yu-Shan Wei, Yong-Qing Xu, Li Ma, Xiaowei Wei, Hui Xie, Wei Wang, Dewei Zhao, Fan Yang, Kai Hu, Mang Yu, Hai-Shen Jiang, Guanghua Lei, Yu-Qiang Zang, Geng Tian, Yuan-Liang Chen, Yong Cao, Jun Ai, and Lei Yang

Subjects
Adult, Male, China, medicine.medical_specialty, Population, lcsh:Medicine, Physical examination, Overweight, Logistic regression, Young Adult, Femoral head, Age Distribution, Asian People, Femur Head Necrosis, Risk Factors, Prevalence, medicine, Humans, Nontraumatic Osteonecrosis of the Femoral Head, ddc:610, Family history, education, Aged, education.field_of_study, medicine.diagnostic_test, business.industry, lcsh:R, General Medicine, Middle Aged, medicine.disease, Obesity, Chinese people, Surgery, medicine.anatomical_structure, Female, Original Article, medicine.symptom, business, Demography
Abstract

Background: Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population. Methods: A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH. Results: NONFH was diagnosed in 218 subjects (0.725%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, \(\chi^2\) = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85% vs. 0.61%, \(\chi^2\) = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH. Conclusions: Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.

Published
2015

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