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Objective To describe the regional and population differences in calcaneus bone mineral density (BMD) across ten regions of China. Methods We based the study on the second re-survey of China Kadoorie Biobank, in which 5% of surviving participants were interviewed during 2013-2014. After excluding those who had missing data for BMD and important variables, 24,677 participants aged 38~87 years were included in the analyses. We measured calcaneus BMD using quantitative ultrasound bone densitometer. The present study analyzed four indexes, including broadband ultrasound attenuation (BUA), speed of sound (SOS), stiffness index (SI), and T score. Results The average calcaneus BMD of the present population was: BUA 109.7±12.6 dB/MHz, SOS 1554.7±45.6 m/s, SI 88.3±18.8%, T score -0.74±1.28. Urban residents showed higher calcaneus BMD than rural ones, and men higher than women. The calcaneus BMD decreased with age, for which women had a bigger decline than men. Current smokers and postmenopausal women had lower calcaneus BMD, and those who ate milk or yogurt frequently and who were physically active had higher calcaneus BMD. Conclusion The calcaneus BMD varied greatly among the ten regions of CKB study and participants who had different demographic characteristics, lifestyle behaviors, and health conditions.

Original publication




Journal article


Chinese Journal of Epidemiology


Chinese Center for Disease Control and Prevention

Publication Date





422 - 427


quantitative ultrasound system, regional and population difference, calcaneus bone mineral density