Journal Article

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

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 Tia Zong-Sheng Li Yong Cao Li Ma

2015

Overview

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 exalnination. 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 Chinesepeople aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females （1.02% vs. 0.51%, x^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%,x^2= 5.847, P = 0.016）. Our multivariate regression analysis showed that high blood levels oftriglycerides, total cholesterol, LDL-cholesterol, and non-H DL-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 significantpublic 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.

• Publisher: Medknow Publications Pvt Ltd,Medknow Publications and Media Pvt. Ltd,Lippincott Williams & Wilkins Ovid Technologies,Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, China%Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA%Medical Clinic Ⅰ, University Hospital Würzburg, Würzburg, Germany%Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, China%Department of Epidemiology and Statistics, School of Public Health, Dalian Medical University, Dalian, Liaoning 116044, China,Orthopedic Medical Research Center, Dalian University, Dalian, Liaoning 116001, China,Medknow Publications & Media Pvt Ltd,Wolters Kluwer
• Subject: Adult / Age Distribution / Aged / Alcohol / Alcohol abuse / Asian Continental Ancestry Group / Care and treatment / China - epidemiology / Data collection / Diagnosis / Epidemiology / Female / Femur Head Necrosis - epidemiology / Hip joint / Hospitals / Humans / Logistic回归分析 / Male / Medical research / Middle Aged / NMR / Nontraumatic Osteonecrosis of the Femoral Head; Prevalence; Risk Factors / Nuclear magnetic resonance / Original / Osteonecrosis / Pain / Population / Prevalence / Prevalence studies (Epidemiology) / Public health / Questionnaires / Research centers / Risk Factors / Studies / Surveys / Traditional Chinese medicine / Young Adult / 中国人口 / 低密度脂蛋白胆固醇 / 创伤性 / 危险因素 / 患病率 / 股骨头坏死 / 调查结果