{ "abstract": "Background: The rising prevalence of osteoporosis and related fractures contributes substantially to the clinical and economic burden in China, particularly in the context of an ageing population. In response, various Chinese medical specialties and organisations have developed clinical guidelines for osteoporosis management, specifically tailored to the needs of the Chinese population. This systematic review aimed to compare and evaluate the consistency and divergence among these guidelines.\n\nMethods: A systematic search of Medline, Embase, Cochrane Library, and Web of Science was conducted for English-language papers. As well, a search of Chinese databases (China National Knowledge Infrastructure and Wanfang) and Chinese government websites was conducted. The search included documents published up to 13 August 2026. Article screening and data extraction were conducted by two independent reviewers. Management guidelines for primary osteoporosis in Chinese adults were included. Exclusion criteria were guidelines for secondary osteoporosis, guidelines for osteoporotic fractures that did not address osteoporosis management, previous versions of guidelines, and management protocols specific to local hospitals, organisations, communities, or rehabilitation centres. The methodological quality of guidelines was evaluated with the Appraisal of Guidelines for Research & Evaluation II (AGREE II).\n\nResults: Our search yielded 8,100 records, from which 32 guidelines produced by over 60 professional societies across multiple medical specialties were included. While there was consensus on the definition of osteoporosis, diagnostic criteria, prevention strategies, and the inclusion of both pharmacological and non-pharmacological treatment approaches, notable differences emerged in specific treatment recommendations. These discrepancies often reflected differences in the clinical focus of individual disciplines, such as orthopaedics, endocrinology, and geriatrics, particularly regarding diagnosis, treatment or rehabilitation, and patient populations. Unlike other international guidelines, fracture liaison services and health economic considerations, including cost-effectiveness analyses, were addressed in only some of the included guidelines.\n\nConclusion: This systematic review synthesises current osteoporosis management guidelines in China and highlights important inconsistencies in recommendations. The findings underscore the need for high-quality, context-specific research and greater incorporation of health economic evidence to inform the development of more coherent and evidence-based national guidelines.\n\nSystematic review registration: https://osf.io/j83s4/ , identifier j83s4.", "abstract_shown": true, "affiliations": [ "School of Health Sciences, Faculty of Health, Western Sydney University", "Healthcare Big Data Research Institute, School of Public Health, Cheeloo College of Medicine, Shandong University", "The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales", "Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University", "School of Public Health, Harbin Medical University", "Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University", "National Health Commission Key Laboratory in Etiology and Epidemiology, Harbin Medical University", "Department of General Practice, The Second Affiliated Hospital of Harbin Medical University", "Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital", "School of Health Policy and Management, Nanjing Medical University", "Department of General Practice, School of Medicine, Western Sydney University", "Faculty of Medicine and Health, University of Sydney", "Department of Rheumatology, Westmead Hospital", "College of Public Health, Taipei Medical University", "School of Health Management, Anhui Medical University", "Translational Health Research Institute, Western Sydney University" ], "article_type": "systematic review", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Ting Wei" }, { "affs": [ 1 ], "name": "Lizheng Xu" }, { "affs": [ 2 ], "name": "Shangzhi Xiong" }, { "affs": [ 3 ], "name": "Xinyi Zhang" }, { "affs": [ 2, 3, 4, 5, 6, 7 ], "name": "Maoyi Tian" }, { "affs": [ 8 ], "name": "Minghui Yang" }, { "affs": [ 7 ], "name": "Yongcheng Wang" }, { "affs": [ 9 ], "name": "Mingsheng Chen" }, { "affs": [ 10 ], "name": "Penelope Abbott" }, { "affs": [ 11, 12 ], "name": "Peter K.K. Wong" }, { "affs": [ 0, 13 ], "name": "Gregory S. Kolt" }, { "affs": [ 0, 14, 15 ], "name": "Lei Si" } ], "bibtex": "https://research.draconitic.com/paper/7a7jt94r60syj.bib", "cited_by": 0, "doi": "10.3389/fendo.2026.1943964", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716593/?tool=EBI", "id": "7a7jt94r60syj", "issns": [ "1664-2392" ], "landing_url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1943964/full", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Systematic Review" ], [ "openalex", "2732|Bone health and osteoporosis research" ] ], "openalex": "W7222044332", "pdf_url": "https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1943964/pdf", "pmcid": "PMC13716593", "pmid": "42959116", "published": "2026-10-15", "publisher": "Frontiers Media SA", "ris": "https://research.draconitic.com/paper/7a7jt94r60syj.ris", "sources": [ { "first_seen": "2026-10-30T12:20:20Z", "native_id": "10.3389/fendo.2026.1943964", "source": "crossref", "url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1943964/full" }, { "first_seen": "2026-10-31T00:20:37Z", "native_id": "PMC:PMC13716593", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13716593" }, { "first_seen": "2026-11-01T00:20:52Z", "native_id": "MED:42959116", "source": "europepmc", "url": "https://europepmc.org/article/MED/42959116" }, { "first_seen": "2026-11-01T12:23:51Z", "native_id": "PMC13716593", "source": "pmc", "url": "https://doi.org/10.3389/fendo.2026.1943964" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2732|Bone health and osteoporosis research", "subfield": "surgery" } ], "title": "Clinical guidelines for the management of osteoporosis in China: a systematic review", "title_text": "Clinical guidelines for the management of osteoporosis in China: a systematic review", "type": "peer-reviewed", "updated_at": "2026-11-02T12:21:05Z", "url": "https://research.draconitic.com/paper/7a7jt94r60syj", "venue": "Frontiers in Endocrinology", "versions": [] }