Background: Studies on osteoporosis awareness among the general population in China are still limited. We examined the level of osteoporosis awareness among residents in China, determined the risk factors associated with a lower level of osteoporosis awareness, and assessed the sources of their knowledge about osteoporosis. Methods: We conducted a cross-sectional study among 368 general residents aged 30 years or older from 19 provinces during January-March 2018 in China. All participants were identified and interviewed face-to-face by medical students in Jilin University using a structured questionnaire. Osteoporosis awareness scores (percent of the correct answer) were determined across several domains, including definition, diagnosis, risk factors, and prevention of osteoporosis. We used multiple linear regression models to test the relationship between risk factors and overall awareness scores. Results: The mean age of included participants was 52.9 ± 10.2 years, and 53% of them were male. Osteoporosis awareness score for definition was 77.7%, diagnosis 49.6%, risk factors 49.2%, treatment 60.5%, and prevention 69.9%. The overall awareness score was 67.8%. Lower family income and education level were significantly associated with lower overall awareness score (all p < 0.05). Television or radio health program was reported to be their main source of knowledge about osteoporosis. Conclusion: The awareness level for osteoporosis in our study is moderate; lower family income and education level were risk factors for lower awareness. Television or radio health programs had the greatest contribution to osteoporosis awareness.

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Context Bone mineral density (BMD) T-score reference may be updated when the peak BMD of the population is unclear and may need to be updated. Objective To update BMD T-score references using the peak BMD from the most recent National Health and Nutrition Examination Survey (NHANES) data. Design Cross-sectional study. Setting The NHANES 2005-2014. Participants Non-Hispanic white females between the ages 10-40 years (N=1549) were our target population to estimate peak BMD (SD). Individuals aged≥50 years (N=5523) were used to compare the percentages of osteoporosis and low bone mass based on existing and updated BMD T-score references. Main Outcome Measurements: BMD data within the age at attainment of peak BMD±5 years were used to calculate updated BMD T-score references. Results The updated average of BMD (SD) for diagnosing osteoporosis at the femoral neck and lumbar spine were 0.888 g/cm 2 (0.121 g/cm 2) and 1.065 g/cm 2 (0.122 g/cm 2), respectively. The percentages of individuals with osteoporosis at the femoral neck and low bone mass at the femoral neck and lumbar spine based on the updated BMD T-score references were higher than the percentages of people designated with these outcomes under the existing guidelines (P&lt;0.001). However, we observed the opposite pattern for lumbar spine osteoporosis (P&lt;0.001). Conclusions We calculated new BMD T-score references at the femoral neck and lumbar spine. We found significant differences in the percentages of individuals classified as having osteoporosis and low bone mass between the updated and existing BMD T-score references.

Background: Epidemiological studies examining the association between β-carotene intake and risk of fracture have reported inconsistent findings. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture. Methods: We systematically searched PubMed, EMBASE and Cochrane library databases for relevant articles that were published until December 2019. We also identified studies from reference lists of articles identified from the clinical databases. The frequentist and Bayesian random-effects model was used to synthesize data. Results: Nine studies with a total of 190,545 men and women, with an average age of 59.8 years, were included in this meta-analysis. For β-carotene intake (1.76 -14.30 mg/day), the pooled risk ratio (RR) of any fracture was 0.67 (95% Credible Interval (CrI): 0.51-0.82; heterogeneity: P = 0.66, I 2 =0.00 %) and 0.63 (95%CrI: 0.44-0. 82) for hip fracture. By study design, the pooled RRs were 0.55 (95% CrI: 0.14-0.96) for case-control studies and 0.82 (95% CrI: 0.58-0.99) for cohort studies. By geographic region, the pooled RRs were 0.58 (95% CrI: 0.28-0.89), 0.86 (95% CrI: 0.35-0.1.37), and 0.91(95% CrI: 0.75-1.00) for studies conducted in China, the United States, and Europe, respectively. By sex, the pooled RRs were 0.88 (95% CrI: 0.73-0.99) for males and 0.76 (95% CrI: 0.44-1.07) for females. There was a 95% probability that β-carotene intake reduces risk of hip fracture and any type of fracture by more than 20%. Conclusions: The present meta-analysis suggests that β-carotene intake was inversely associated with fracture risk, which was consistently observed for case-control and cohort studies. Randomized controlled trials are warranted to confirm this relationship.