Awareness of osteoporosis among 368 residents in China: a cross-sectional study

Knowledge, Attitudes, and Practices of Patients with Knee Osteoarthritis Regarding Osteoporosis and Its Prevention: A Cross-Sectional Study in China

Background

Older age and female sex are risk factors for osteoarthritis and osteoporosis (OP). This study evaluated the knowledge, attitudes, and practices of patients with knee osteoarthritis (KOA) in China regarding OP and its prevention. This cross-sectional, questionnaire-based study enrolled patients with KOA at four grade-A tertiary hospitals in Shandong Province between 1st September and 20th November 2022.

Methods

The administered questionnaire contained 55 items across four dimensions (demographic information, knowledge, attitude, and practice). Logistic regression analyses were performed to identify factors associated with an overall questionnaire score ≥70% of the maximum possible score. SPSS 26.0 was used for the analyses; P<0.05 was considered significant.

Results

The analysis included 434 participants (261 females). The median knowledge, attitude, and practice scores were 7 (interquartile range: 5-10) (possible range, 0-17 points), 44 (interquartile range: 42-49) (possible range, 11-55 points), and 43 (interquartile range: 38-47) (possible range, 13-65 points), respectively. Multivariable logistic regression indicated that female sex (odds ratio [OR], 2.421; 95% confidence interval [95% CI] 1.558-3.762; P<0.001), age 56-65 years-old (OR, 4.222; 95% CI, 1.763-10.109; P=0.001 vs ≤55 years-old), age >65 years-old (OR, 4.358; 95% CI, 1.863-10.195; P=0.001 vs ≤55 years-old), middle/high/technical secondary school education (OR, 1.853; 95% CI, 1.002-3.428; P=0.049 vs primary school or below), and having KOA for 4-5 years (OR, 2.682; 95% CI, 1.412-5.094; P=0.003 vs ≤3 years) were independently associated with a high KAP score.

Conclusion

There is room for improvement in the knowledge and practices of patients with osteoarthritis in China regarding OP. The findings of this study may facilitate the design and implementation of education programs to increase awareness about OP prevention among patients with KOA.

Gene detection of VDR BsmI locus and its approteins, genes and growthplication in rational drug use in patients with osteoporosis

Aim: This paper determines the polymorphism distribution of the VDR BsmI gene in 350 patients and provides medication recommendations for osteoporosis based on detection results. Materials & methods: Chi-square tests compared genotype and allele frequencies with other populations. Results: Genotype frequencies were 91.66 bb, 8.72 Bb and 0.21% BB, with allelic frequencies of 95.43 b and 4.57% B, adhering to Hardy-Weinberg equilibrium. These findings suggest that VDR gene polymorphisms, particularly at the BsmIlocus, play an essential role in bone health and osteoporosis treatment. Genotype-based drug selection reduced adverse reactions from 14 to two cases. Conclusion: These findings improve clinical treatment efficacy and guide rational drug use for osteoporosis patients.

A comprehensive approach for osteoporosis detection through chest CT analysis and bone turnover markers: harnessing radiomics and deep learning techniques

Purpose

The main objective of this study is to assess the possibility of using radiomics, deep learning, and transfer learning methods for the analysis of chest CT scans. An additional aim is to combine these techniques with bone turnover markers to identify and screen for osteoporosis in patients.

Method

A total of 488 patients who had undergone chest CT and bone turnover marker testing, and had known bone mineral density, were included in this study. ITK-SNAP software was used to delineate regions of interest, while radiomics features were extracted using Python. Multiple 2D and 3D deep learning models were trained to identify these regions of interest. The effectiveness of these techniques in screening for osteoporosis in patients was compared.

Result

Clinical models based on gender, age, and β-cross achieved an accuracy of 0.698 and an AUC of 0.665. Radiomics models, which utilized 14 selected radiomics features, achieved a maximum accuracy of 0.750 and an AUC of 0.739. The test group yielded promising results: the 2D Deep Learning model achieved an accuracy of 0.812 and an AUC of 0.855, while the 3D Deep Learning model performed even better with an accuracy of 0.854 and an AUC of 0.906. Similarly, the 2D Transfer Learning model achieved an accuracy of 0.854 and an AUC of 0.880, whereas the 3D Transfer Learning model exhibited an accuracy of 0.740 and an AUC of 0.737. Overall, the application of 3D deep learning and 2D transfer learning techniques on chest CT scans showed excellent screening performance in the context of osteoporosis.

Conclusion

Bone turnover markers may not be necessary for osteoporosis screening, as 3D deep learning and 2D transfer learning techniques utilizing chest CT scans proved to be equally effective alternatives.

Bone health and awareness of osteoporosis in women aged 40 to 60 years in Jiaxing City, China

The objective of this study is to evaluate the pattern of bone mineral density (BMD) in native Jiaxing women, and to investigate their awareness of osteoporosis. A total of 538 native Jiaxing women aged 40 to 60 years were recruited from January 2022 to December 2023 when they had routine examinations in the physical examination center of Jiaxing Maternal and Child Health Hospital. The Chinese version of Osteoporosis Prevention and Cognition Tool was used to evaluate participants' cognitive level of osteoporosis. BMD of participants' lumbar spine (L1-L4) and left hip (Neck/Troch/Ward) was measured by dual-energy X-ray absorptiometry. The mean total score of the awareness about osteoporosis (general knowledge, complications, and prevention) was 22.08 ± 2.74, which was suboptimal. The higher the education level, the higher the score of awareness (P < .01). Medical staff had the highest awareness rate of osteoporosis and the farmer had the lowest. Lumber spine and hip BMD of all sites was significantly decreased with increasing age (P < .001). Premenopausal women had higher BMD than postmenopausal women at all lumbar spine and hip sites (P < .01). The overall frequency of osteoporosis was 10.8% in the lumbar spine, 8.6% in the total hip, and 17.7% in either site. Osteoporosis and osteopenia are highly prevalent among native Jiaxing women but their awareness of osteoporosis is inadequate. To reduce the prevalence of osteoporosis, especially among the unemployed, we should carry out effective health education through multimedia to raise their awareness of osteoporosis. In addition, menopausal hormone therapy should also be considered in menopausal women.

Knowledge, Awareness and Perception towards Osteoporosis Risk in China: A Systematic Review

Background

We aimed to evaluate the level of knowledge, awareness, and perceptions regarding osteoporosis (OP) and risk factors in China.

Methods

The databases of PubMed, Medline, Embase, Web of science, VIP, and CNKI were searched for papers published before December 2022 using Chinese and English keywords and their combinations: "knowledge", "osteoporosis", "risk factor", "bone health", "perception", "awareness". The levels of knowledge, awareness, and perception about OP, as well as risk factors, clinical symptoms, and health information sources were narratively synthesized.

Results

Sixteen papers were finally included for analysis. Participants all showed poor levels of knowledge and perception regarding osteoporosis and risk factors. Investigation of clinical symptoms was rarely involved in the included studies due to the asymptomatic features of OP. The findings also suggest a strong association between poor level of knowledge regarding OP and educational attainment, type of participant, and gender. The majority of participants are increasingly turning to the Internet and social media to access information about OP.

Conclusion

The findings of this paper provide useful information for intervention providers to prevent and control OP and encourage them to carry out health promotion campaigns to enhance knowledge and awareness of OP.

Treatment of Osteoporosis after Hip Fracture: Survey of the Korean Hip Society

Purpose

To assess current practice in the treatment of osteoporosis in patients who underwent treatment for hip fracture in South Korea.

Materials and Methods

A survey of 97 members of the Korean Hip Society, orthopedic hip surgeons who administer treatment for hip fractures in South Korea, was conducted. The survey was conducted for assessment of demographic data and perceptions regarding the management of osteoporosis in patients who have undergone treatment for hip fracture. Analysis of the data was performed using descriptive statistical methods.

Results

The majority of participants were between the age of 41 and 50 years, and 74% were practicing in tertiary hospitals. Testing for serum vitamin D levels (82%) was the most commonly performed laboratory test. Calcium and vitamin D were prescribed for more than 80% of patients by 47% and 52% of participants, respectively. Denosumab was the most commonly used first-line treatment option for osteoporosis in hip fracture patients. Bisphosphonate was most often perceived as the cause of atypical femoral fractures, and the most appropriate time for reoperation was postoperative 12 months. Teriparatide was most preferred after cessation of bisphosphonate and only prescribing calcium and vitamin D was most common in high-risk patients for prevention of atypical femoral fracture.

Conclusion

The results of this study that surveyed orthopedic hip surgeons showed that most participants followed the current strategy for management of osteoporosis. Because the end result of osteoporosis is a bone fracture, active involvement of orthopedic surgeons is important in treating this condition.

Knowledge of osteoporosis prevention among people with endocrine disorders: A cross-sectional study

People with endocrine disorders are at an increased risk of osteoporosis, yet their knowledge of osteoporosis prevention is rarely studied. This study aimed to assess the knowledge related to osteoporosis prevention and its associated factors among people with endocrine disorders in China. A cross-sectional study was conducted in a Chinese hospital's Department of Metabolism and Endocrinology. A total of 562 people with endocrine disorders completed the Chinese version of the Osteoporosis Prevention and Awareness Tool to assess their knowledge of osteoporosis prevention. Results showed that participants had a mean knowledge of 59.36 ± 23.90 out of 100, with only 52.1% scoring above 60 points. Being female, having higher education, with comorbidities, with a recent osteoporosis diagnosis, and having received health education related to osteoporosis prevention were associated with higher knowledge of osteoporosis prevention. Our study indicates that more efforts are needed to improve the knowledge related to osteoporosis prevention among people with endocrine disorders. This may be realized by strengthening and expanding diverse education, focusing on males and those with lower education and without comorbidities.

Perception and awareness of osteoporosis and its related risk factors among women: A cross-sectional study

<b>Objectives:</b> This study was designed to assess the awareness of women of the risk factors and preventive measures of osteoporosis.<br /> <b>Methods:</b> This is a cross-sectional study that was conducted in Jordan. During the study period, a convenience sample of women were invited to participate via a survey link communicated through social media. Linear regression was used to screen independent variables affecting participants’ awareness of osteoporosis, its risk factors, and preventive measures.<br /> <b>Results:</b> 426 women agreed to participate in this study, with a median age of 38.5 years (IQR=16.0). Results showed that women have a median awareness score of 5.0 out of 9.0 (IQR=4.0) about osteoporosis risk factors, whereas women with higher educational levels (diploma or higher) and those with medical-related degrees have a higher awareness about osteoporosis risk factors compared to others (p≤0.05).<br /> Medical websites were the primary source used to obtain information about osteoporosis by the participating women (n=236, 55.4%). Also, results showed that more than 90% of the women believed that osteoporosis is a chronic silent disease that makes your bones less dense and more fragile (n=418, 98.1%), and that bone strength may increase by taking vitamin D and calcium (n=405, 95.0%).<br /> <b>Conclusion:</b> This study showed that women had an intermediate level of awareness of osteoporosis and prevention measures. The importance of medical websites and social media as sources of information was also demonstrated. More public targeted campaigns are needed to promote awareness of osteoporosis, its risk factors, prevention, and treatment.

A study on the anti-osteoporosis mechanism of isopsoralen based on network pharmacology and molecular experiments

OBJECTIVE

Osteoporosis (OP) is a disease caused by multiple factors. Studies have pointed out that isopsoralen (IPRN) is one of the most effective drugs for the treatment of OP. Based on network pharmacological and molecular experimental analysis, the molecular mechanism of IPRN in osteoporosis is clarified.

METHODS

IPRN target genes and OP-related genes were predicted from the databases. Intersections were obtained and visualized. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on target genes, which was confirmed by experiments internal and external experiments. Molecular docking was used to verify the binding between IPRN and target proteins. Molecular dynamics (MD) simulates the binding affinity of protein targets and active compounds.

RESULTS

87 IPRN target genes and 242 disease-related targets were predicted. The protein-protein interaction (PPI) network identified 18 IPRN target proteins for the treatment of OP. GO analysis indicated that target genes were involved in biological processes. KEGG analysis showed that pathways such as PI3K/AKT/mTOR were associated with OP. Cell experiments (qPCR and WB) found that the expressions of PI3K, AKT, and mTOR in MC3T3-E1 cells at 10 μM, 20 μM, and 50 μM IPRN concentrations, especially at 20 μM IPRN treatment, were higher than those in the control group at 48 h. Animal experiments also showed that compared with the control group, 40 mg/kg/time IPRN could promote the expression of the PI3K gene in chondrocytes of SD rats.

CONCLUSIONS

This study predicted the target genes of IPRN in the treatment of OP and preliminarily verified that IPRN plays an anti-OP role through the PI3K/AKT/mTOR pathway, which provides a new drug for the treatment of OP.

A health communication campaign for prevention of osteoporosis in rural elderly women

BACKGROUND

Osteoporosis, as the most common metabolic disease and the leading cause of death among older people, affects more than 200 million women throughout the world. This study aimed to evaluate the effect of a health communication campaign on knowledge, attitude, and practice of older women towards prevention and control of osteoporosis.

METHODS

In this multi-stage mixed methods study, 30 days' health communication campaign for prevention of osteoporosis was conducted on 60- 75-year-old women, in rural areas of Fasa, Iran. Subjects were divided into two groups, control (n = 103) and intervention (n = 98). Data were collected using a researcher-made questionnaire and analyzed by SPSS 25.0. The significance level was set at < 0.05.

RESULTS

Inter-group group analysis revealed that the mean scores of knowledge, attitude, and practice were not significantly different between the two groups before the intervention, but after the intervention, unlike the behavior (P = 0.569), mean scores of knowledge (p < 0.001) and attitude (p < 0.001) of the intervention group were significantly more than the control group. Intra-group comparisons showed that, unlike the control group, the mean scores of knowledge (p < 0.001), attitudes (p < 0.001), and behavior (P < 0.001) increased significantly in the intervention group.

CONCLUSIONS

Health communication campaign is an effective way to change the knowledge and attitude and to a lesser extent the practice of the eldery toward prevention and control of osteoporosis.

The associations between bone mineral density and long-term risks of cardiovascular disease, cancer, and all-cause mortality

OBJECTIVE

We aimed to investigate the associations between bone mineral density and long-term risks of cardiovascular disease (CVD), cancer, and all-cause mortality in nationwide survey participants aged 18 and over.

METHODS

Using data from the United States National Health and Nutrition Examination Survey III (NHANES III), the associations of bone mineral density (normal bone mass, osteopenia, and osteoporosis) with CVD, cancer, and all-cause mortality were analyzed using the Cox proportional hazards model.

RESULTS

A total of 11,909 adults aged 18 and over were enrolled in this study. Compared with the participants with normal bone mass, those with osteoporosis and osteopenia were more likely to be female, of non-Hispanic white ethnicity, and older. They were also more likely to have lower calcium and vitamin D intakes, a lower body mass index (BMI), lower educational attainment, and lower family incomes. Participants with osteoporosis and osteopenia also engaged in less physical activity and were more likely to have diabetes, high blood pressure, and a history of CVD. After adjusting for confounders, osteopenia and osteoporosis were significantly associated with all-cause mortality, with the hazard ratios (95% confidence intervals) being 1.37 (1.11, 1.68) and 1.06 (0.91, 1.25), respectively, compared with normal bone mass. Age (P for interaction = 0.001) and BMI (P for interaction = 0.002) were found to modify the association between bone mineral density and all-cause mortality.

CONCLUSIONS

In a nationally representative cohort, osteoporosis was associated with an increased risk of all-cause mortality, and this association was stronger in participants who were older and had a lower BMI.

Osteoporosis awareness among patients in Singapore (OASIS)-a community hospital perspective

This study examines factors associated with osteoporosis awareness and knowledge using Osteoporosis Prevention and Awareness Tool (OPAAT). Of 410 patients, majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 111.5; p < 0.001) and diabetic patients (OR: 1.67; p = 0.003) were associated with lower OPAAT scores.

INTRODUCTION

Lack of osteoporosis awareness forms a critical barrier to osteoporosis care and has been linked with increased institutionalization, healthcare expenditures, and decreased quality of life. This study aims to identify factors associated with osteoporosis awareness and knowledge among female Singaporeans.

METHODOLOGY

A cross-sectional study was conducted among adult female patients (aged 40 to 90 years old) who were admitted into Outram Community Hospital from April to October 2020. Osteoporosis awareness and knowledge were assessed using interviewer-administered Osteoporosis Prevention and Awareness Tool (OPAAT). High knowledge was defined as a OPAAT score ≥ 24. Multivariate logistical regression analyses were used to identify predictors of low OPAAT scores.

RESULTS

Of 410 patients recruited, their mean age was 71.9 ± 9.5 years old and majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Patients with lower OPAAT scores tended to be older (72.5 ± 9.2 vs 67.5 ± 10.1, p < 0.001), attained lower education level (p < 0.001), and were more likely to live in public housing (92.5% vs 81.5%, p = 0.009). The prevalence of diabetes mellitus was higher in patients with low OPAAT scores (39.2% vs 18.8%, p = 0.006). After adjustment for covariates, lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 11.5; p < 0.05) and patients with diabetes mellitus (OR: 1.67; p = 0.03) were associated with lower OPAAT knowledge scores.

CONCLUSION

Elderly female patients in community hospital have inadequate osteoporosis awareness despite being at risk of fractures. There is a need to address the knowledge gap in osteoporosis, especially among diabetic patients or patients with lower education.

Health Literacy of Osteoporosis Risks among Caregivers Serving in Disability Care Facilities

Osteoporosis is a global public health issue and its consequent effects are a growing concern worldwide. Caregivers generally experience occupational physical ailments and they have less of a tendency to engage in preventive health behaviors, leading them to be in a higher risk group for osteoporosis. This study aims to present a general profile of health literacy related to osteoporosis risks and identify its associated factors among disability institutional caregivers. A cross-sectional study with a structured questionnaire was used to collect information on 465 caregivers from seven disability care institutions regarding their awareness of the health literacy related to osteoporosis risks. The results indicate that the average literacy score related to osteoporosis risks among the respondents was 60 points (full score is 80 points), with 50–59 being the most common range (51.9%), followed by 60–69 points (43.5%), and 4.4% of cases had more than 70 points. A multivariate logistic regression model revealed that respondents’ age (40–49 vs. 18–29; odds ratio (OR) = 2.53, 95% confidence interval (CI) = 1.31–4.87), education level (senior high vs. primary and junior high, OR = 2.00, 95% CI = 1.03–3.89; college and above vs. primary and junior high, OR = 3.66, 95% CI = 1.84–7.31), experience in undergoing a bone density test (OR = 1.94, 95% CI = 1.28–2.93), and poor physical fitness status (OR = 0.64, 95% CI = 0.43–0.95) were the significant predictors of the osteoporosis health literacy level. The osteoporosis health literacy of institutional caregivers is moderate, and there are many items that are worthy of attention in future health promotion programs. This study highlights risk factors related to a lower level of osteoporosis healthy literacy such as older age, less education, no experience of bone density test, and poor physical fitness that highlight the need to raise further awareness in order to improve caregivers’ bone health.