Patients and Methods

Postmenopausal women were recruited in Community Health Service Center, Ganquan Street, Putuo District, Shanghai from January 2017 to September 2018. According to the recommendation of the WHO, we classified BMD T-score [at the lumbar spine (L1-L4) and/or the left hip] ≥−1 as the normal group, −2.5 < T-score < −1 as the osteopenia group, and T-score ≤−2.5 as the osteoporosis group. We selected the lowest BMD value among all measured sites as the value for diagnosis in every subject. The inclusion criteria of this study were as follows: 1) menopause for more than 1 year; 2) the person lived in China for more than 10 years; 3) the person signed informed consent. The exclusion criteria of this study were as follows: 1) patients with secondary osteoporosis; 2) patients with a history of fractures; 3) patients with diseases that could affect bone metabolism; 4) patients who discontinued bisphosphonates for less than 1 year and other medications that could affect bone metabolism for less than 6 months. All subjects provided informed consent to participate in this study. The study protocol and procedures conform to the ethical guidelines of the 1975 Declaration of Helsinki. The present study was approved by the Ethics Committee of Tongji Hospital, Tongji University.