QJM: An International Journal of Medicine

doi: 10.1093/qjmed/hcae199pmid: 39392793

BackgroundBone mass at different life stages is instrumental for developing effective, long-term osteoporosis prevention strategies.AimWe aimed to investigate the developmental patterns of bone mass across the entire lifespan among the Chinese population and to compare these patterns with those of different racial groups, including Whites, Blacks and Mexicans in the US population.DesignA population-based study.MethodsOur study analyzed data from the China Body Composition Life-course (2013–2023) Study and the United States National Health and Nutrition Examination Survey (2005–2018). We measured bone mineral content (BMC) and density (BMD) using dual-energy X-ray absorptiometry at various anatomical sites, including the whole-body (WB), lumbar spine, total hip and femoral neck.ResultsIn the Chinese population, WB BMC and BMD increased rapidly during childhood and adolescence, with males and females achieving approximately 90.6% and 95.7% of their respective peak bone mass. Peak bone mass for WB, total hip and femoral neck BMC/BMD occurred generally between the ages of 21 and 30, whereas the lumbar spine BMD peak occurred approximately a decade later. After reaching the peak, a gradual bone loss was observed from ages 30 to 40, with an acceleration post age 40, especially in females. Comparative analyses indicated that Chinese individuals exhibited the lowest bone mass levels and accrual rates over their lifespan, followed successively by Whites, Mexicans and Blacks.ConclusionBy exploring bone mass changes and racial disparities among the Chinese and US populations, this study emphasizes the need for establishing sex- and ethnic-specific public health strategies to prioritize bone health throughout the entire life course.

doi: 10.1093/qjmed/hcae200pmid: 39418209

BackgroundPharmacogenetic-guided prescribing can be used to improve the safety and effectiveness of medicines. There are several approaches by which this intervention might be implemented in clinical practice, which will vary depending on the health system and clinical context.AimTo understand the clinical utility of panel-based pharmacogenetic testing in patients admitted acutely to hospital and to establish variables that predict if an individual might benefit from the intervention.DesignA cross-sectional study recruiting patients admitted acutely to hospital.MethodsParticipants underwent panel-based pharmacogenetic testing, and their genetic results were analysed in their context of the medicines they had been exposed to as an inpatient. The primary outcome was the proportion of patients with clinically actionable gene–drug interactions. Individual variables that predict the clinical utility of pharmacogenetic testing were established via logistic regression.ResultsGenetic and prescribing data were available for 482 inpatients (55% male; median age 61.2 years; range: 18–96), 97.9% of whom carried a pharmacogenetic result of interest. During their admission, 79.5% of patients were exposed to a medicine for which there is pharmacogenetic prescribing guidance available. Just under one in seven individuals (13.7%) had a clinically actionable gene–drug interaction. Increasing age (>50 years) was positively correlated with the likelihood (2.7-fold increased risk) of having a clinically actionable interaction.ConclusionsThese findings demonstrate the potential scale, and potential clinical utility, of pharmacogenetic testing as an intervention, highlighting the need to develop infrastructure to support healthcare professionals make use of this emerging tool.