Bone mass, rates of osteoporotic fractures, and prevention of fractures: are there differences between China and Western countries?

Fractures are one of the most common causes of disability in older women. The quantity and density of bone decreases with age. Most types of fractures increase as bone density declines. But most of the knowledge about causes and prevention of fractures comes from studies performed in Western countries. Asian women appear to have similar or slightly lower bone density that may be a result of their smaller size. They appear to have a lower risk of hip fracture than Whites, which may be a result of their shorter hip axis. The risks of other types of fractures in Chinese women is less well defined and reasons for differences in the rates of osteoporotic fractures between China and Western countries remain to be explored. A study is underway in Beijing to describe the risks and potential causes of fractures among older women in urban China. Randomized trials in Western countries have demonstrated that calcium and vitamin D, estrogen, calcitonin, or bisphosphonates can reduce the rate of fractures. increased intake of calcium and vitamin D may be the most effective approach to preventing fractures in China, but this should be tested in a randomized trial.