Patients with osteoporosis (OP) often suffer from a variety of diseases. In addition to general risk factors such as age, gender, race, comorbidities and related treatments can affect bone metabolism. At present, there are relatively few studies on the association between neurological disorders and OP. Therefore, this article intends to review the epidemiological characteristics, bone loss feature, related pathogenesis and progress of diagnosis and treatment, in order to provide reference for the mechanism of bone damage, OP prevention and anti-osteoporosis treatment in patients with nervous system diseases.

Secondary osteoporosis (OP) is easy to be ignored in clinical practice, especially secondary OP caused by hypertension, coronary heart disease, chronic heart failure, atrial fibrillation and other circulatory system diseases. Due to the complexity of circulatory system diseases and adverse reactions of therapeutic drugs, the risk of secondary OP is often underestimated. Early prevention and treatment of secondary OP is very important to improve the quality of life of patients. The mechanism and treatment scheme of bone metabolism imbalance caused by different types of diseases are different. This article will review the common circulatory system diseases complicated with OP from the aspects of epidemiological characteristics, related risk factors and pathogenesis, changes of bone metabolism and characteristics of bone damage, as well as the progress of diagnosis and treatment, in order to provide reference for the prevention and treatment of circulatory system diseases complicated with OP.

Secondary osteoporosis (OP) is mostly related to endocrine and metabolic diseases. The growth and development of bone is inseparable from the regulation of the endocrine system. Endocrine and metabolic diseases such as hyperthyroidism, hypogonadism, and hyperprolactinemia can break the balance between bone resorption and bone formation, and increase the risk of osteoporosis and fracture. In order to effectively manage secondary OP caused by endocrine and metabolic diseases, it is particularly important to explore its mechanism, diagnostic methods and treatment options. This article reviews the epidemiological characteristics of secondary osteoporosis in different groups of endocrine and metabolic diseases, the pathogenesis of hormone imbalance and cell signaling pathway abnormalities, the characteristics of bone damage such as bone metabolism indicators and bone mineral density, and the progress in the diagnosis and treatment of secondary osteoporosis, so as to provide reference for the prevention and treatment of secondary osteoporosis in patients with endocrine and metabolic diseases.

At present, China is faced with high prevalence of osteoporosis, low awareness rate, low treatment rate, diagnosis and treatment and follow-up management are still lack of normative problems. Osteoporosis can be secondary to multiple systemic diseases and is a multidisciplinary disease, which requires multidisciplinary medical workers to work closely together, give full play to their respective advantages, and develop a complete disease management program. In this paper, the author analyzes the status quo, difficulties and prevention and treatment measures of secondary osteoporosis (SOP), in order to provide effective inspiration for clinical workers in the standardized diagnosis and treatment of SOP.

Type 2 diabetes mellitus (T2DM), as a chronic metabolic disorder, represents a significant health threat to middle-aged and elderly populations in China and is a major risk factor for osteosarcopenia. The presence of osteosarcopenia can markedly impact the health status and quality of life of individuals with T2DM. A comprehensive examination of the epidemiological characteristics of osteosarcopenia holds substantial significance in guiding the prevention and management of osteosarcopenia among T2DM patients in China.

To conduct a systematic evaluation of the prevalence of osteosarcopeniain patients with T2DM in China.

A comprehensive search was conducted for studies on the prevalence of osteosarcopenia in Chinese patients with T2DM across multiple databases, including CNKI, Wanfang Data, VIP, SinoMed, Cochrane Library, PubMed, Web of Science, EBSCO and Embase. The search period extended from the establishment of these databases to June 2024. Two researchers independently screened the literature, extracting relevant information such as the first author, publication year, survey period, geographical region, osteosarcopenia prevalence, diagnostic criteria, assessment tools and quality evaluation information. The methodological quality of the included studies was assessed using the AHRQ tool. Data were analyzed using Stata 15.0.

A total of 18 cross-sectional studies were included, involving 3 724 T2DM patients, of whom 623 were diagnosed with osteosarcopenia. The meta-analysis revealed that the overall prevalence of osteosarcopenia in Chinese T2DM patients was 21% (95%CI=15%-26%). Subgroup analysis showed that the prevalence after 2020 (25%) was higher than that before 2020 (19%) ; the prevalence in the elderly group (27%) was higher than in the middle-aged group (13%) ; the prevalence using the AWGS diagnostic criteria (23%) was higher than with the AWGS2 criteria (14%) ; the detection rate by BIA (22%) was higher than by DXA (17%) ; males (38%) had a higher prevalence than females (36%) ; the prevalence in patients with a T2DM duration of ≤10years (25%) was higher than in those with a duration > 10 years (20%) ; the prevalence in the western region (27%) was higher than in the central (18%) and eastern regions (16%) (P<0.05). Meta-regression analysis revealed no statistically significant results (P>0.05), and no significant sources of heterogeneity were identified.

Existing evidence suggests a relatively high prevalence of osteosarcopenia among patients with T2DM in China, with significant disparities observed across factors such as survey period, age groups, diagnostic criteria, assessment tools, gender, duration of T2DM, and regional differences. Consequently, it is imperative to enhance early screening and intervention strategies for high-risk populations, in order to effectively prevent and mitigate the progression of the disease.

Senescence-associated secretory phenotype (SASP) is an important feature of cellular senescence and plays an important role in regulating the disease microenvironment. At present, the role of SASP in intervening bone metabolism and inducing bone loss is very limited. Therefore, this paper discusses the regulatory mechanism of SASP in osteoporosis models and summarizes its regulatory characteristics: SASP is fully expressed in senescent bone cells and transmits aging effects to mesenchymal stem cells in an autocrine/paracrine manner, thereby interfering with osteogenic differentiation. SASP activates immune cells and promotes their aging, thus inducing the formation of inflammatory tissue microenvironment and aggravating bone loss. Mitochondrial homeostasis, pathologic hyperglycemia, and obesity-induced fat accumulation all promote SASP expression, thus disrupting microenvironmental homeostasis and transmitting aging effects to bone tissue. To sum up, understanding the role of SASP in osteoporosis lays a solid foundation for us to develop anti-SASP therapy for osteoporosis in the future.

With the gradual deepening of the comprehensive reform of community health services, the prevention and control of single diseases for the entire population in the community is also constantly being optimized, However, there is still a lack of appropriate evaluation methods in the community to reflect its prevention and control effectiveness evaluation.

By analyzing and exploring the cost effect of the existing whole-population prevention and control measures of osteoporosis in Fenglin community, from 2016 to 2022, this paper answers the initial results and possible problems of the whole-population prevention and control of single disease in the community.

This study conducted a cost-effectiveness analysis on 4 293 community residents who received osteoporosis prevention and treatment in Fenglin community from 2016 to 2022. Divide the research object into three states based on bone density values: healthy, low bone mass, and osteoporosis, and construct a Markov model to analyze the influencing factors of different state transitions. And based on the predicted values of the Markov model combined with quality adjusted life years (QALY) , the increment of quality adjusted life years (QALY) is calculated. All costs invested in prevention and control work from 2016 to 2022 are counted, and the effectiveness of prevention and control is evaluated by the cost/quality adjusted life year increment ratio. Quality adjusted life years (QALY) are obtained by calculating the health utility value and expected life determined through literature search.

The total cost of osteoporosis prevention and treatment in Fenglin community was 33 814 102.15 yuan. The total quality-adjusted life years of 4 293 community osteoporosis prevention and treatment population were 77 098.288 9 at the first diagnosis, the average per capita was 17.959, and the standard deviation was 9.34. At the second diagnosis, the total quality-adjusted life years were 79 616.936 1, the mean per capita was 18.546, the standard deviation was 9.342, and the difference between the two diagnoses was 2 518.647 2. The incremental cost-effectiveness ratio (ICER) is 2 132.907 0 yuan /QALY, and the incremental cost-effectiveness ratio (ICER) is less than 1 times (66 965.10 yuan) per capita GDP, indicating that the intervention scheme is fully cost-effective.

This study combined Markov model and quality-adjusted life years (QALY) to make a preliminary evaluation of the prevention and treatment effect of osteoporosis in Fenglin community. The results showed that the intervention program of osteoporosis prevention and treatment in Fenglin community was worth investing, and provided a certain basis for the accurate prevention and treatment decision of osteoporosis in the future.

With the aging of the population, the health threat of osteoporosis (OP) has become more prominent. The prevalence of OP in postmenopausal women will further increase to three times of that in men due to the reduction of ovarian estrogen secretion. The prevalence and risk factors of OP in postmenopausal women have been widely reported and systematically summarized, however, there are few systematic reviews of relevant studies worldwide.

To systematically review the prevalence and influencing factors of OP in postmenopausal women.

PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and CBM were searched for studies on the prevalence and influencing factors of OP in postmenopausal women from 2002-11-01 to 2022-11-01; in addition to literature tracking based on the references in the included studies. Two reviewers independently conducted literature screening and information extraction, the quality was evaluated using the risk of bias assessment criteria recommended by the Agency for Healthcare Research and Quality. A Meta-analysis on the prevalence and influencing factors of OP in postmenopausal women was performed using Stata 16.0 software.

A total of 68 articles were included, with a total sample size of 112 097 cases. Meta-analysis showed that the prevalence of OP and osteopenia in postmenopausal women was 34.73% (95%CI=31.02%-38.44%) and 41.83% (95%CI=38.19%-45.47%), respectively. Subgroup analysis showed that the highest prevalence was found in the age≥80 years group (68.72%, 95%CI=59.81%-77.62%), followed by the age of 70-79 years group (57.20%, 95%CI=50.53%-63.87%) and the age of 60-69 years group (37.46%, 95%CI=28.95%-45.98%), the age of 50-59 years group (24.94%, 95%CI=15.50%-34.39%), the age of 40-49 years group (14.01%, 95%CI=6.64%-21.38%) ; the prevalence rate of <2 births (34.24%, 95%CI=24.08%-44.41%) was lower than that of ≥2 births (39.27%, 95%CI=30.10%-48.44%) ; the prevalence of age ≥10 years menopause (47.15%, 95%CI=42.27%-52.04%) was higher than that of <10 years menopause (34.18%, 95%CI=33.30%-35.06%) ; the prevalence in developing countries (35.87%, 95%CI=31.39%-40.34%) was higher than that in developed countries (30.10%, 95%CI=23.97%-36.23%). The influencing factors of OP in postmenopausal women included diabetes (OR=2.79, 95%CI=1.75-4.46, P<0.05) ; high BMI (OR=0.53, 95%CI=0.43-0.64, P<0.05) ; exercise (OR=0.43, 95%CI=0.28-0.65, P<0.05) ; number of births (OR=2.52, 95%CI=1.72-3.67, P<0.05) ; duration of menopause (OR=1.88, 95%CI=1.43-2.46, P<0.05) ; family history (OR=1.92, 95%CI=1.38-2.67, P<0.05) ; alcohol consumption (OR=1.95, 95%CI=1.54-2.47, P<0.05), menopausal hormone therapy (OR=0.34, 95%CI=0.25-0.44, P<0.05) ; non-violent fracture history (OR=3.83, 95%CI=1.88-7.98, P<0.05) ; and age (OR=1.43, 95%CI=1.29-1.59, P<0.05) .

The prevalence of OP and osteopenia in postmenopausal women is high, with about one third of postmenopausal women suffering from osteoporosis, and about half of postmenopausal women suffering from osteopenia. High BMI, regular exercise, and use of menopausal hormone therapy are protective factors for OP in postmenopausal women, while diabetes, high number of births, long years of menopause, family history of disease, alcohol consumption, non-violent fracture history, and advanced age are risk factors. The evaluation and intervention of OP should be strengthened in clinical practice, and it is also necessary to promote healthy lifestyle to postmenopausal women to improve their quality of life.

The continuous increase in numbers of people with osteoporosis, and individuals with low bone mass in the community, brings severe challenges to the prevention and treatment of osteoporosis in the community.

To investigate the basic conditions related to the prevention and control of osteoporosis in communities, including the basic process and cost of enrolling the target population, and the prevalence and risk factors of osteoporosis in the target population, so as to provide evidence for supporting a general practice team to develop precise osteoporosis prevention and control measures.

This study selected 322 cases (including outpatient patients and older physical examinees) from Waitan Community Health Service Center, Shanghai from May to August 2021. General information, bone density test results and risk factors of osteoporosis were collected by a questionnaire.

The cost of enrolling the target population in the community was 57.344 yuan per person. Among the 322 cases, 27 (8.4%) had normal bone mass, 157 (48.8%) had low bone mass, and 138 (42.8%) had osteoporosis. The prevalence of bone density abnormalities (low bone mass and osteoporosis) reached 91.6%. There were statistically significant differences in gender ratio and BMI among normal bone mass, low bone mass and osteoporosis groups (P<0.05). The average bone mineral density (BMD) values of normal bone mass, low bone mass and osteoporosis groups were (-0.72±0.27) AU/mm³, (-1.88±0.38) AU/mm³, and (-3.17±0.53) AU/mm³, respectively. In terms of exercise habits, the prevalence of individuals doing little exercise in normal bone mass, low bone mass and osteoporosis groups was 37.0% (10/27), 49.7% (78/157) and 64.5% (89/138), respectively. In terms of exercise intensity, the prevalence of individuals exercising at moderate-intensity in normal bone mass, low bone mass and osteoporosis groups was 74.1% (20/27), 79.6% (125/157) and 80.4% (111/138), respectively. Three groups had no significant differences in the other osteoporosis risk factors, such as surgical treatment history, smoking history, allergy history and disease history. There was also no significant intergroup difference in dietary habits. Of all cases, 48.8% (157/322) never drank beer, liquor and red wine, 32.0% (103/322) drank coffee 4-6 times per week, and 31.4% (101/322) ate pickled vegetables, smoked foods, or sauces 4-6 times per week.

The community is a favorable setting for conducting prevention, treatment and clinically research programs regarding osteoporosis owing to short participant enrollment period and low cost. As the exercise and eating habits of the elderly in the community are unhealthy, the general practice team should accurately guide them to rapidly improve their dietary structure and develop a healthy exercise habit according to their own status, by which the onset and progression of osteoporosis can be proactively controlled.

Diabetes and osteoporosis are common diseases in middle-aged and elderly people. Diabetes can lead to various acute and chronic complications, but its related bone changes are often neglected. Osteoporosis is more common in postmenopausal women, and those with type 2 diabetes mellitus (T2DM) have multiple risk factors for osteoporosis. Therefore, it is particularly important to early identify risk factors of osteoporosis in these women, and to provide them with targeted interventions.

To explore the associated factors of osteoporosis in Chinese postmenopausal women with T2DM through a meta-analysis.

In July 2021, databases of China National Knowledge Infrastructure, CQVIP, WanFang Data, SinoMed, PubMed, EmBase, and the Cochrane Library were searched for literature about factors associated with osteoporosis in Chinese postmenopausal women with T2DM from inception to July 2021. Two researchers independently screened literature and extracted data. RevMan 5.4 and Stata 15.0 were used to conduct a meta-analysis on the data.

Twenty-one studies were finally included, from which 11 osteoporosis-related factors were extracted. The meta-analysis showed that age〔MD (95%CI) =6.56 (5.24, 7.88) 〕, years of postmenopause〔MD (95%CI) =5.93 (4.23, 7.62) 〕, duration of diabetes〔MD (95%CI) =1.94 (0.89, 2.98) 〕, body mass index〔MD (95%CI) =-1.99 (-2.63, -1.36) 〕, serum calcium〔MD (95%CI) =0.03 (0.01, 0.06) 〕, fasting blood glucose〔MD (95%CI) =0.49 (0.09, 0.90) 〕, glycosylated hemoglobin〔MD (95%CI) =0.37 (0.02, 0.71) 〕, and fasting insulin〔MD (95%CI) =3.65 (1.24, 6.06) 〕 were associated factors for osteoporosis in postmenopausal women with T2DM. But no significant association was found between osteoporosis and serum creatinine〔MD (95%CI) =4.02 (0.00, 8.04) 〕, serum phosphorus〔MD (95%CI) =0.00 (-0.05, 0.05) 〕, or serum alkaline phosphatase〔MD (95%CI) =1.26 (-0.06, 2.57) 〕 in these women. Sensitivity analysis revealed that the association of all the above-mentioned factors (except for serum creatinine) with osteoporosis was relatively robust.

Older age, long years of postmenopause, long duration of T2DM, low levels of BMI and serum calcium, and high levels of fasting insulin, fasting blood glucose, and glycosylated hemoglobin are risk factors for osteoporosis in Chinese postmenopausal women with T2DM. But the effects of serum creatinine, phosphorus, and alkaline phosphatase on osteoporosis in this group need to be further verified.

As a chronic age-related disease known as "silent killer" in medical academic circle, osteoporosis is manifested by slow and insidious development, and obvious age-related physiological changes in muscle, bone and fat. There are few studies on the relationship of osteoporosis with muscle, bone, and fat indices.

To assess the relationship of osteoporosis with muscle, bone, and fat indices.

A total of 108 patients with primary osteoporosis were recruited from the Third Affiliated Hospital of Guangzhou University of Chinese Medicine according to the inclusion and exclusion criteria from July 19, 2019 to January 5, 2021. Data were collected, including general data (height, weight and BMI) , T-score, fat mass, muscle mass and bone mineral content measured by the dual-energy X-ray absorptiometry, bone formation indices, such as serum calcium, bone morphogenetic protein-2 (BMP2) and osteoproteintin (OPG) detected by ELISA. Height, weight, BMI, T-score, fat mass, muscle mass, fat percentage and bone mineral content were compared across three age groups. Fat mass, muscle mass, fat percentage, bone mineral contents and bone formation indices were compared across normal group (T-score≥-1.0, n=20) , bone loss group (-2.5<T-score<-1.0, n=38) and osteoporosis group (T-score ≤-2.5, n=50) divided by the T-score.

The T-score varied significantly in three age groups of 49-58, 59-68, and≥69 (P<0.05) , and it was the highest in the 49-58 age group (P<0.01) . Compared with the normal group, bone loss group had decreased bone mineral content, while osteoporosis group had decreased fat mass and bone mineral content (P<0.05) . Compared with the bone loss group, both the muscle mass and bone mineral content in the osteoporosis group were decreased (P<0.05) . Compared with normal group, a significant decrease was found in OPG and BMP2 in osteoporosis group, and in BMP2 in bone loss group (P<0.05) . Compared with bone loss group, a significant decrease was found in OPG and BCL2 in osteoporosis group (P<0.05) .

The abnormality in dynamic balance between muscular and skeletal systems and adipose tissue is closely related to the pathogenesis of osteoporosis. Bone mineral density decreases with age, decrease in serum BMP2, OPG and Bcl2 levels may be related to the failure of apoptosis-regulatory proteins to play a good role in anti-apoptosis and promoting bone formation, resulting in the decrease of osteoblast activity and the weakening of bone formation activity.

Exercise is one of inexpensive and effective interventions for the prevention and treatment of postmenopausal osteoporosis, but relevant pieces of evidence are wide-ranging and fragmented, and there is no standardized and comprehensive exercise guidance program on clinic.

To screen and assess the evidence of exercise interventions for postmenopausal osteoporosis, then summarize the best pieces.

We systematically searched clinical practice guidelines, clinical decisions, evidence summaries, expert consensuses and systematic reviews regarding exercise interventions for postmenopausal osteoporosis in databases of BMJ Best Practice, Up To Date, DynaMed, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, webs of Registered Nurses' Association of Ontario, International Osteoporosis Foundation, Royal Osteoporosis Society, National Osteoporosis Foundation, Royal Australian College of General Practitioners, American College of Obstetricians and Gynecologists, Society of Obstetrics and Gynaecologists of Canada, Medlive, JBI, Cochrane Library, CINAHL, Web of Science, PubMed, Embase, CNKI and SinoMed from inception to January 2022. All relevant evidence was summarized and extracted according to the theme. Appraisal of Guidelines for Research and Evaluation (AGREEⅡ) was used to evaluate the quality of the guidelines, Critical Appraisal for Summaries of Evidence (CASE) was used to evaluate the quality of clinical decisions, the authenticity assessment tool of the expert consensus of the JBI Evidence-Based Health Care Center in Australia (2016 edition) was used to evaluate the quality of expert consensuses, the Australian JBI Evidence-based Health Care Centre System Evaluation Methodology Quality Evaluation Tool (2016 edition) was used to evaluate the quality of the systematic reviews.

A total of 18 studies were included, including seven guidelines, two clinical decisions, four expert consensuses and five systematic reviews. Twenty-two pieces of evidence were extracted, involving five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions.

This paper extracts the best evidence of exercise intervention for postmenopausal osteoporosis patients from five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions. To reduce the risks of falls and fractures and improve quality of life in postmenopausal women with osteoporosis, it is suggested to provide these women with rational exercise guidance developed based on the best evidence.

Osteoporosis (OP) and lumbar disc herniation (LDH) are two common orthopedic diseases encountered clinically, which are closely related and often coexisted, causing great suffering to middle-aged and elderly people along with the accelerated process of population aging.

To perform a cross-sectional survey on the prevalence and associated factors of LDH in OP in community-dwelling middle-aged and elderly people in Beijing, providing a reference for clinical prevention and treatment of this disease.

From November 2017 to July 2018, 1 540 residents with complete demographics and bone mass measurement data who lived in 10 communities in Chaoyang District and Fengtai District of Beijing were selected. A survey was conducted with the residents for understanding their data collected on-site, including demographics, fracture history, fall history, history of hereditary disease, bone mineral density, EuroQol Health Utility score, then those with OP were further selected and divided into two groups by the prevalence of LDH. Multivariate Logistic regression analysis was used to explore the influencing factors of LDH in OP.

A total of 521 cases of OP attended the survey, except for one with missing information of LDH, the other 520 cases (80 with LDH, and 440 without LDH) were included for final analysis. Multivariate Logistic regression analysis indicated that after controlling for age and BMI, falls〔OR=1.96, 95%CI (1.02, 3.78) , P=0.044〕, fracture〔OR=1.80, 95%CI (1.04, 3.12) , P=0.035〕and pain/discomfort〔OR=2.43, 95%CI (1.41, 4.18) , P=0.001〕were independently associated with LDH in OP.

The coexistence of LDH and OP was common in this population. Falls, fractures, and pain/discomfort may be influencing factors of LDH in OP.

Postmenopausal osteoporosis (PMOP) has an increasing incidence as aging advances. As the traditional Chinese medicine (TCM) constitution theory is of great significance in guiding PMOP prevention and treatment, studying the associated factors of yang-deficiency constitution, a common imbalanced constitution in PMOP patients, will contribute to the development of personalized treatment of PMOP.

To perform an analysis of the distribution of TCM constitution and associated factors of yang-deficiency constitution in PMOP patients in the community.

From November 2017 to July 2018, an interviewer-administered questionnaire survey for screening PMOP was conducted with a random sample of residents (45-80 years old) from 10 communities of Beijing's Chaoyang and Fengtai Districts. The general data collected include age, age at menopause, retirement status, types of job (mental, physical, or both) , educational level, monthly household income, height, weight, body mass index (BMI) , grip strength-weight index, history of fractures, history of falls, family history of osteoporosis, nighttime sleep duration, habits of eating leftovers, diet type (meat-based, plant-based, or meat-plant based) . TCM constitution was analyzed using the TCM Constitution Questionnaire. The associated factors of yang-deficiency constitution in PMOP cases were analyzed by multivariate Logistic regression.

Four hundred and thirty-two cases were found with PMOP, four of them were excluded due to missing data of TCM constitution, and the other 428 cases were finally included. The residents with gentleness constitution numbered the most (n=175) . Among residents with biased constitution, those with yang-deficiency constitution numbered the most (n=107) . Through multivariate Logistic regression analysis, it was found that BMI<18.5 kg/m², frequently eating leftovers, and meat-based diet were associated with increased risk of PMOP in yang-deficiency residents (P<0.05) .

This cross-sectional survey indicates that yang-deficiency constitution may be highly prevalent in PMOP residents, and was associated with BMI<18.5 kg/m² often eating leftovers, and meat-based diet.

People with diabetes mellitus are at increased risk of developing osteoporosis (OP) , especially those with postmenopausal type 2 diabetes mellitus (T2DM) . Chronic inflammation plays an important role in the development of OP.

To explore the predictive value of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) for OP in postmenopausal patients with T2DM.

Two hundred and sixteen postmenopausal T2DM patients who were hospitalized in the Department of Endocrinology and Metabolism, the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were chosen. Clinical data were obtained, including blood routine and biochemical parameters (such as blood lipids and so on) in fasting venous blood, calculated NLR and MHR, and bone mineral density (BMD) of lumbar spine L_1-4, left femoral neck and left hip measured by dual-energy X-ray absorptiometry (DXA) . According to the BMD, the patients were divided into normal bone mass group (n=51) , osteopenia group (n=78) and OP group (n=87) . In addition, they were divided into 4 groups according to NLR quartiles (A1 to A4 group) and MHR quartiles (B1 to B4 group) , with 54 cases in each. Spearman correlation was used to analyze the association of NLR and MHR with BMD at lumbar spine L_1-4, left femoral neck and left hip. Multivariate Logistic regression analysis was applied to explore the influencing factors of OP. Receiver operating curve (ROC) analysis was performed to evaluate the value of NLR, MHR and their combination in predicting OP.

NLR and MHR were increased in the osteopenia group than the normal bone mass group (P<0.05) . Compared with the normal bone mass group and the osteopenia group, NLR and MHR in the OP group were statistically significant increased (P<0.05) . Compared with A1 group, A3 group had decreased BMD at lumbar spine L_1-4, left femoral neck and left hip, so did A4 group (P<0.05) . A4 group had decreased BMD at lumbar spine L_1-4, and left hip than A2 group (P<0.05) . B1 group had higher BMD at lumbar spine L_1-4, left femoral neck and left hip than did B2, B3, and B4 groups (P<0.05) . B4 group had decreased BMD at lumbar spine L_1-4, left femoral neck and left hip than did B2 group (P<0.05) . B4 group also had decreased BMD at lumbar spine L_1-4 did B3 group (P<0.05) . Spearman correlation analysis showed that both NLR and MHR were negatively correlated with BMD at lumbar spine L_1-4, left femoral neck and left hip (P<0.001) . Multivariate Logistic regression analysis showed that long menopausal duration〔OR=1.092, 95%CI (1.005, 1.186) 〕, increased NLR〔OR=2.341, 95%CI (1.453, 3.770) 〕and increased MHR〔OR=329.250, 95%CI (21.421, 5 060.810) 〕were independently associated with elevated risk of OP, while high BMI〔OR=0.806, 95%CI (0.718, 0.903) 〕was associated with decreased risk of OP (P<0.05) . ROC analysis demonstrated that in predicting OP, the area under the curve (AUC) of NLR was 0.722, with 65.5% sensitivity and 72.1% specificity, and that of MHR was 0.709 with 52.9% sensitivity and 79.8% specificity, and that of NLR with MHR was 0.787, with 81.6% sensitivity and 67.4% specificity. The AUC of NLR with MHR was greater than that of NLR or MHR alone (Z=2.418, P<0.05; Z=2.893, P<0.05) .

Either NLR or MHR could be used as a predictor of OP in postmenopausal T2DM patients, and the predictive efficiency and sensitivity of the combination of them would be higher.

China is seeing increasingly osteoporosis prevalence as ageing marches on. However, the specific etiology and pathogenesis of osteoporosis are still unclear, and there are still limitations in its prevention and treatment.

To investigate osteoporosis prevalence and associated factors in older Chinese patients with stable chronic conditions.

Three hundred and two elderly inpatients with stable chronic conditions who underwent a reexamination in Department of Geriatrics, Yunnan First People's Hospital from November 2020 to September 2021 were recruited. Dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine and hip bone mineral density (BMD) . T value ≤-2.5 was defined as osteoporosis. Demographic data were collected. Comprehensive geriatric assessment was conducted via a self-developed online platform named Comprehensive Geriatric Assessment. Fasting venous blood samples were collected and measured for serum biomarkers.

Among the patients, 126 (41.7%) were found with osteoporosis, and other 176 (58.3%) without. Binary Logistic regression analysis indicated that insomnia〔OR=2.180, 95%CI (1.080, 4.443) 〕, multiple chronic conditions〔OR=1.223, 95%CI (1.101, 1.358) 〕, elevated homocysteine〔OR=1.043, 95%CI (1.000, 1.088) 〕 were associated with increased risk of osteoporosis (P<0.05) , while elevated serum uric acid level〔OR=0.996, 95%CI (0.993, 0.999) 〕 was associated with decreased risk of osteoporosis (P<0.05) .

The prevalence of osteoporosis in these older patients with stable chronic conditions was 41.7%. The probability of osteoporosis may be decreased with elevated serum uric acid level, and increased with elevated homocysteine, insomnia and multiple chronic conditions.

As life expectancy increases, the number of elderly patients with osteoporosis rises as well. Many factors affect the development of osteoporosis, and good physical fitness may contribute to having better social adaptability in older people. So it is very important to pay attention to osteoporosis and ensure physical fitness in this group.

To explore the factors associated with osteoporosis, and analyze physical fitness in elderly men, providing a theoretical basis for preventing osteoporosis, improving physical fitness and developing health management programs for this group.

This study was conducted from January 2018 to December 2020. A total of 250 elderly men who underwent bone mineral density (BMD) examination were selected from Health Management Center, Inner Mongolia People's Hospital, and divided into normal BMD, osteopenia and osteoporosis groups by BMD examination results. Data were collected, including baseline information, laboratory results, physical fitness test results〔 including muscular strength (number of elbow bending within 30 seconds, 30-second sit-to-stand test results) , flexibility (shoulder and arm stretches, sitting flexion test) , balance (stand on one foot with eyes closed) , aerobic capacity (2-minute step test) , agility/mobility (timed up go test with a minimal space of 2.5 meters) 〕.

Of the 250 subjects, 76 (30.4%) had normal BMD, 123 (49.2%) had osteopenia, and 51 (20.4%) had osteoporosis. Multivariate Logistic regression analysis demonstrated that abdomen circumference〔OR=0.710, 95%CI (0.566, 0.891) 〕, body mass index 〔OR=0.685, 95%CI (0.474, 0.990) 〕, high-density lipoprotein cholesterol〔OR=74.182, 95%CI (3.738, 1 472.125) 〕, 25 (OH) D₃〔OR=0.745, 95%CI (0.619, 0.897) 〕, and estradiol〔OR=0.784, 95%CI (0.665, 0.924) 〕were associated with osteoporosis in elderly men (P<0.05) . All the subjects successfully completed physical fitness tests, without adverse events. The number of repetitions of sit-to-stands within 30 seconds, results of shoulder and arm stretches, sitting flexion test, and 2-minute step test, duration for stand on one foot with eyes closed, as well as time used for timed up go test with a minimal space of 2.5 meters differed significantly across normal BMD, osteopenia and osteoporosis groups (P<0.05) . The number of elbow bending within 30 seconds showed no significant differences across the three groups (P>0.05) .

In elderly men, abdomen circumference, body mass index, high-density lipoprotein cholesterol, 25 (OH) D₃, and estradiol may independently associated with osteoporosis. Physical fitness indices varied significantly by BMD, especially flexibility, balance, aerobic capacity and agility/mobility.