How to screen for osteoporosis risk when women have higher bone density than men?

Osteoporosis is a systemic bone disease characterized by low bone mass, damage to bone tissue microstructure, increased bone fragility, and susceptibility to fractures.
The "China Osteoporosis Epidemiological Survey Report (2018)" shows that the osteoporosis prevalence rate in people over 40 years old in my country is 12.6%, including 4.4% for men and 20.9% for women, showing the characteristics of "higher for women and lower for men" and "higher in rural areas than in cities". The prevalence rate increases significantly with age, and the prevalence rate in people over 60 years old is as high as 27.4%.

What are the consequences of osteoporosis?

The most serious consequence of osteoporosis is fracture. Osteoporotic fracture is one of the main causes of disability and death in elderly patients, and hip fracture is the most serious osteoporotic fracture.

Within one year after a hip fracture, 20% of patients may die from various complications; about 50% of patients will become disabled and their quality of life will be significantly reduced. In recent years, the incidence of hip fractures in my country has shown a significant upward trend.

One minute test!

Are you at high risk for osteoporosis?

Self-assessment and understanding your own condition is one of the effective ways to prevent osteoporosis.

Take the one-minute test below. If you or your family members answer "yes" to any of the questions, you are at high risk of osteoporosis.

【One minute test】
1. Is your actual age over 60 (female) / 70 (male)?

2. Is there a history of fractures after the age of 50?

3. Are you underweight (BMI less than 19kg/m2)?

4. Has your height decreased by more than 4cm since the age of 40?

5. Does either parent have a history of hip fracture?

6. Do you have any of the following conditions: rheumatoid arthritis, digestive tract disease (inflammatory bowel disease, celiac disease), diabetes, chronic kidney disease, thyroid or parathyroid disease (hyperthyroidism), lung disease (chronic obstructive pulmonary disease), prolonged immobilization (e.g., long-term bed rest, paralysis), AIDS (HIV)?

7. Have you ever received the following medications: steroid hormones (such as continuous use of prednisone for 3 months or more), thiazolidinediones, immunosuppressants after organ transplantation, antidepressants, anticonvulsants, anti-epileptic drugs?

8. Women’s answer: Do you have any of the following: breast cancer, treatment with aromatase inhibitors for breast cancer, early menopause, abnormal amenorrhea, oophorectomy, or low estrogen levels due to hypogonadism?

9. Male answer: Do you have any of the following conditions: prostate cancer, receiving androgen deprivation therapy for prostate cancer, low testosterone (hypogonadism), excessive alcohol consumption (more than 3 units per day, equivalent to 1.5 liang of high-alcohol liquor, 2 liang of low-alcohol liquor, 2 bottles of beer, 9 liang of wine or 2 jin of highland barley wine) and/or are you currently smoking?

The above is a one-minute test from the International Osteoporosis Foundation https://riskcheck.osteoporosis.foundation/form

How is osteoporosis diagnosed?

Dual-energy X-ray (DXA) is recommended for detecting the lumbar spine, femoral neck and total hip.

Patients with any test result (T value) of the three parts less than -2.5 can be diagnosed with osteoporosis.