ArticleBMC public health2025
Exploring social determinants of health in the context of metabolic and circadian influences on new hip fracture risk: longitudinal insights from CHARLS.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Associations of Social Determinants of Health Scores with Visual Impairment and Premature Death in Visually Impaired Adults: Insights from CHARLS-A Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Edentulism and incident hip fracture among middle-aged and older adults in China: evidence from the CHARLS.BMC public health · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 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.
methodsThis 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.
resultsHigher 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.
conclusionsSDHs 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.
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