Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov 5;128(21):2843-50.
doi: 10.4103/0366-6999.168017.

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  1 , 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 Tian, Zong-Sheng Li, Yong Cao, Li Ma
Affiliations

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 et al. Chin Med J (Engl). .

Abstract

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 examination. 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 Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, χ2 = 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%, χ 2 = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-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 significant public 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age-specific prevalence of nontraumatic osteonecrosis of the femoral head in Chinese participants 15 years and over (a). Prevalence of nontraumatic osteonecrosis of the femoral head among Chinese adults 15 years and over, according to urban and rural residence (b) and North and South region (c). Error bars indicate 95% confidence interval. *P < 0.01, †P < 0.0001, ‡P < 0.05, §P < 0.001.
Figure 2
Figure 2
The percent of different causes of nontraumatic osteonecrosis of the femoral head between women and men. Error bars indicate 95% confidence interval. *P < 0.0001, †P < 0.05.
See this image and copyright information in PMC

References

    1. Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha AD, et al. Osteonecrosis of the hip: Management in the 21st century. Instr Course Lect. 2003;52:337–55. - PubMed
    1. Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am. 1995;77:459–74. - PubMed
    1. Aldridge JM, 3rd, Urbaniak JR. Avascular necrosis of the femoral head: Etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop (Belle Mead NJ) 2004;33:327–32. - PubMed
    1. Hirota Y, Hotokebuchi T, Sugioka Y. Idiopathic osteonecrosis of the femoral head: Nationwide epidemiologic studies in Japan. In: Urbaniak JR, Jones JP, editors. Osteonecrosis Etiology, Diagnosis, and Treatment. 1st ed. Chicago (III): American Academy of Orthopaedic Surgeons; 1997. p. 51.
    1. Fukushima W, Fujioka M, Kubo T, Tamakoshi A, Nagai M, Hirota Y. Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 2010;468:2715–24. - PMC - PubMed

Publication types