Dubbo Osteoporosis Epidemiology Study

骨质疏松症是一个重大且日益严重的公共健康问题。骨折，骨质疏松症的最终后果与严重的发病率、死亡率和经济成本有关。Dubbo骨质疏松症流行病学研究始于1989年，涉及2000多名女性和男性，是世界上持续时间最长的骨质疏松症流行病学研究之一。它一直处于骨质疏松症流行病学进展的前沿。它确定了骨质疏松性骨折的风险，包括低骨密度和骨丢失、肌肉无力和姿势不稳，以及男性问题的程度，以及与骨折相关的巨大成本、健康状况和死亡率。尽管在过去十年中对危险因素进行了澄清，但对骨质疏松症的认识仍然存在很大差距，特别是在准确预测骨折风险以及确定与骨折相关的死亡率和骨折后存活相关的因素方面。尽管骨密度是预测骨折风险的最佳指标之一，但它并不能完全区分哪些人会骨折，哪些人不会。虽然一些临床危险因素以及其他骨强度指标，如定量超声和几何形状，已被证明是骨折风险的独立预测因素，但这些指标是否能与骨密度相结合来改善骨折预测尚不清楚。目前这项研究的目的是开发和验证使用骨密度、其他骨强度测量和临床参数的模型，以更准确地预测老年男性和女性骨折后的骨折风险和死亡率。更准确地识别骨折高危人群和骨折后预后不良风险人群，将为制定更具成本效益的预防骨折及其相关发病率和死亡率的干预措施提供合理的基础。

Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.