Scholarlink

Background <p>The risk of hip fractures is closely intertwined with social determinants of health (SDHs), metabolic factors, and circadian rhythm-related variables. Understanding the combined effects of these factors, particularly in the elderly population of China, has substantial public health implications.</p> Methods <p>This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020), which included 11,928 individuals aged 45 years and older, all free from a history of hip fractures. Kaplan-Meier survival curves, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) analysis were applied to explore the associations between SDHs and hip fracture risk, stratified by metabolic syndrome (MetS) and circadian rhythm syndrome (CircS). Sensitivity analyses and receiver operating characteristic (ROC) curves were conducted to validate the findings and assess the predictive performance.</p> Results <p>Higher SDHs scores were consistently associated with a reduced risk of hip fractures, particularly among individuals with MetS and CircS. For each unit increase in SDHs, the risk of first hip fracture was reduced by 14% (HR = 0.86; 95%CI, 0.77–0.95; <i>P</i> &lt; 0.003). RCS analysis revealed a significant relationship between SDHs and the incidence of hip fractures across various metabolic and circadian rhythm subgroups (all P-values &lt; 0.05, non-linear <i>P</i> &gt; 0.05). Kaplan-Meier analysis demonstrated statistically significant differences in hip fracture incidence between SDHs groups (log-rank <i>P</i> &lt; 0.001). ROC curve analysis demonstrated superior predictive accuracy for SDHs, with an AUC of 0.723 and 0.731, particularly among individuals with MetS and CircS.</p> Conclusions <p>SDHs are independently associated with a decreased risk of hip fractures, with a particularly pronounced effect observed in individuals with MetS and CircS. These findings underscore the critical importance of addressing both social and metabolic factors in the prevention of hip fractures, especially within aging populations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Exploring social determinants of health in the context of metabolic and circadian influences on new hip fracture risk: longitudinal insights from CHARLS

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月21日

查看全文
  • Peng Hu,
  • Hongliang Du

摘要

Background

The risk of hip fractures is closely intertwined with social determinants of health (SDHs), metabolic factors, and circadian rhythm-related variables. Understanding the combined effects of these factors, particularly in the elderly population of China, has substantial public health implications.

Methods

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020), which included 11,928 individuals aged 45 years and older, all free from a history of hip fractures. Kaplan-Meier survival curves, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) analysis were applied to explore the associations between SDHs and hip fracture risk, stratified by metabolic syndrome (MetS) and circadian rhythm syndrome (CircS). Sensitivity analyses and receiver operating characteristic (ROC) curves were conducted to validate the findings and assess the predictive performance.

Results

Higher SDHs scores were consistently associated with a reduced risk of hip fractures, particularly among individuals with MetS and CircS. For each unit increase in SDHs, the risk of first hip fracture was reduced by 14% (HR = 0.86; 95%CI, 0.77–0.95; P < 0.003). RCS analysis revealed a significant relationship between SDHs and the incidence of hip fractures across various metabolic and circadian rhythm subgroups (all P-values < 0.05, non-linear P > 0.05). Kaplan-Meier analysis demonstrated statistically significant differences in hip fracture incidence between SDHs groups (log-rank P < 0.001). ROC curve analysis demonstrated superior predictive accuracy for SDHs, with an AUC of 0.723 and 0.731, particularly among individuals with MetS and CircS.

Conclusions

SDHs are independently associated with a decreased risk of hip fractures, with a particularly pronounced effect observed in individuals with MetS and CircS. These findings underscore the critical importance of addressing both social and metabolic factors in the prevention of hip fractures, especially within aging populations.