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Archives of Osteoporosis

, 13:129 | Cite as

Prevalence of osteoporosis with the World Health Organization diagnostic criteria in the Eastern Mediterranean Region: a systematic review and meta-analysis

  • Mohammad Zamani
  • Vahid Zamani
  • Behzad Heidari
  • Hadi Parsian
  • Seyed Mokhtar Esmaeilnejad-GanjiEmail author
Review Article

Abstract

Summary

A systematic review and meta-analysis was conducted on the prevalence of osteoporosis in the Eastern Mediterranean Region. The overall pooled prevalence of osteoporosis was 24.4%. The prevalence has increased significantly over the recent years. The highest pooled prevalence was in Saudi Arabia (32.7%), and the lowest was in Kuwait (15.1%).

Purpose

To conduct a systematic review and meta-analysis on the prevalence of osteoporosis in the Eastern Mediterranean Region (EMR), as defined by the World Health Organization.

Methods

We included all observational studies reporting the prevalence of osteoporosis among general population. We searched literatures from the databases of PubMed, Scopus, Web of Science, and Index Medicus for the EMR published between January 2000 and December 2017 with no restriction of language. Two reviewers independently contributed in study selection and data extraction. STATA software was used for analyzing the collected data.

Results

A total of 1692 citations were retrieved. After excluding the irrelevant articles, 36 eligible studies were included. The overall pooled prevalence rate of osteoporosis in the EMR on 31,593 participants was 24.4% (95% confidence interval [CI], 20.4–28.4). Based on femoral densitometry, the prevalence of osteoporosis was 16.8% (95% CI, 9.5–24.2), and based on spinal densitometry, it was 24.3% (95% CI, 19.4–29.2). The pooled prevalence in males was 20.5% (95% CI, 10.5–30.5), compared with 24.4% (95% CI, 20.2–28.6) in females. The prevalence rate was significantly higher in 2007–2015 (32.7%; 95% CI, 25.1–40.3) than in 2000–2006 (19.8%; 95% CI, 12.5–27).

Conclusions

Our findings indicate a considerable prevalence of osteoporosis among the people of the EMR. The prevalence has increased during recent years, showing that osteoporosis is becoming a critical health problem in this region. Prevention and control measures need to be implemented by health service authorities.

Keywords

Osteoporosis Bone density Prevalence Systematic review 

Notes

Acknowledgments

We are thankful to Prof. Nicola M. Lowe, Prof. Fadoua Allali, Dr. Ambreen Kazi Kamran, Dr. Naim Maalouf, Dr. Jamal Al Saleh, Dr. Sireen Shilbayeh, and Mr. Mohsen Karamati for answering our queries about their studies.

Funding information

We thank the Vice Chancellor for Research and Technology of Babol University of Medical Sciences for the support on our study.

Compliance with ethical standards

Conflicts of interest

None.

Supplementary material

11657_2018_540_MOESM1_ESM.doc (73 kb)
Supplementary Table 1 (DOC 73 kb)
11657_2018_540_MOESM2_ESM.doc (264 kb)
Supplementary Table 2 (DOC 263 kb)
11657_2018_540_MOESM3_ESM.doc (50 kb)
Supplementary Table 3 (DOC 50 kb)
11657_2018_540_MOESM4_ESM.doc (52 kb)
Supplementary Table 4 (DOC 52 kb)

References

  1. 1.
    Ferrari S, Reginster J-Y, Brandi ML, Kanis JA, Devogelaer J-P, Kaufman J-M, Féron J-M, Kurth A, Rizzoli R (2016) Unmet needs and current and future approaches for osteoporotic patients at high risk of hip fracture. Arch Osteoporos 11:37CrossRefGoogle Scholar
  2. 2.
    Compston J, Cooper A, Cooper C et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43CrossRefGoogle Scholar
  3. 3.
    Ballane G, Cauley J, Luckey M, Fuleihan GE-H (2017) Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 28:1531–1542CrossRefGoogle Scholar
  4. 4.
    Cosman F, De Beur S, LeBoff M, Lewiecki E, Tanner B, Randall S, Lindsay R (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381CrossRefGoogle Scholar
  5. 5.
    Park K-Y, Hwang H-S, Park H-K (2017) Modifiable lifestyle factors associated with osteoporosis in Korean men: a case-control study. Arch Osteoporos 12:56CrossRefGoogle Scholar
  6. 6.
    Wade S, Strader C, Fitzpatrick L, Anthony M, O’Malley C (2014) Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 9:182CrossRefGoogle Scholar
  7. 7.
    Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29:2520–2526CrossRefGoogle Scholar
  8. 8.
    Kling JM, Clarke BL, Sandhu NP (2014) Osteoporosis prevention, screening, and treatment: a review. J Women's Health (Larchmt) 23:563–572CrossRefGoogle Scholar
  9. 9.
    Lewiecki EM, Wright N, Curtis J, Siris E, Gagel R, Saag K, Singer A, Steven P, Adler R (2018) Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 29:717–722CrossRefGoogle Scholar
  10. 10.
    Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos 8:136CrossRefGoogle Scholar
  11. 11.
    Cooper C, Campion G, Lr M (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefGoogle Scholar
  12. 12.
    Musaiger AO, Al-Hazzaa HM, Takruri HR, Mokhatar N (2012) Change in nutrition and lifestyle in the Eastern Mediterranean Region: health impact. J Nutr Metab 2012:436762PubMedPubMedCentralGoogle Scholar
  13. 13.
    Hwalla N, Al Dhaheri AS, Radwan H, Alfawaz HA, Fouda MA, Al-Daghri NM, Zaghloul S, Blumberg JB (2017) The prevalence of micronutrient deficiencies and inadequacies in the Middle East and approaches to interventions. Nutrients 9:229CrossRefGoogle Scholar
  14. 14.
    Bassil D, Rahme M, Hoteit M, Fuleihan GE-H (2013) Hypovitaminosis D in the Middle East and North Africa: prevalence, risk factors and impact on outcomes. Dermatoendocrinol 5:274–298CrossRefGoogle Scholar
  15. 15.
    (2015) IOF Regionals - 3rd Middle East & Africa osteoporosis meeting : plenary lecture abstracts. Osteoporos Int 26:S421-S425Google Scholar
  16. 16.
    The middle east & Africa Regional Audit. Epidemiology, costs & burden of osteoporosis in 2011. 2011. https://www.iofbonehealth.org/sites/default/files/PDFs/Audit%20Middle%20East_Africa/ME_audit-executive_summary.pdf
  17. 17.
    (2015) IOF Regionals - 3rd Middle East & Africa osteoporosis meeting : poster presentation abstracts. Osteoporos Int 26:S439-S486Google Scholar
  18. 18.
    Baddoura R, Hoteit M, Fuleihan GE-H (2011) Osteoporotic fractures, DXA, and fracture risk assessment: meeting future challenges in the eastern Mediterranean region. J Clin Densitom 14:384–394CrossRefGoogle Scholar
  19. 19.
    Maalouf G, Gannagé-Yared M, Ezzedine J, Larijani B, Badawi S, Rached A, Zakroui L, Masri B, Azar E, Saba E (2007) Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact 7:131–143PubMedGoogle Scholar
  20. 20.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097CrossRefGoogle Scholar
  21. 21.
    Prevalence of osteoporosis in the Eastern Mediterranean Region: a systematic review and meta-analysis. 2018. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=81807
  22. 22.
    World Health Organization. Prevention and management of osteoporosis. Geneva: WHO; 2003Google Scholar
  23. 23.
  24. 24.
    Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65:934–939CrossRefGoogle Scholar
  25. 25.
    Becker DJ, Kilgore ML, Morrisey MA (2010) The societal burden of osteoporosis. Curr Rheumatol Rep 12:186–191CrossRefGoogle Scholar
  26. 26.
    Chen P, Li Z, Hu Y (2016) Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health 16:1039CrossRefGoogle Scholar
  27. 27.
    Bayati M, Akbarian R, Kavosi Z (2013) Determinants of life expectancy in Eastern Mediterranean region: a health production function. Int J Health Policy Manag 1:57–61CrossRefGoogle Scholar
  28. 28.
  29. 29.
    Musaiger AO, Al-Hazzaa HM (2012) Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region. Int J Gen Med 5:199–217CrossRefGoogle Scholar
  30. 30.
    Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z (2013) Prevalence of osteoporosis in Iran: a meta-analysis. J Res Med Sci 18:759–766PubMedPubMedCentralGoogle Scholar
  31. 31.
    Alswat KA (2017) Gender Disparities in Osteoporosis. J Clin Med Res 9:382–387CrossRefGoogle Scholar
  32. 32.
    Heidari B, Hosseini R, Javadian Y, Bijani A, Sateri MH, Nouroddini HG (2015) Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos 10:15CrossRefGoogle Scholar
  33. 33.
    Heidari B, Muhammadi A, Javadian Y, Bijani A, Hosseini R, Babaei M (2017) Associated factors of bone mineral density and osteoporosis in elderly males. Int J Endocrinol Metab 15:e39662PubMedGoogle Scholar
  34. 34.
    Heidari B, Heidari P, Nourooddini HG, Hajian-Tilaki KO (2013) Relationship between parity and bone mass in postmenopausal women according to number of parities and age. J Reprod Med 58:389–394PubMedGoogle Scholar
  35. 35.
    Hajian-Tilaki K, Heidari B (2007) Prevalence of obesity, central obesity and the associated factors in urban population aged 20–70 years, in the north of Iran: a population-based study and regression approach. Obes Rev 8:3–10CrossRefGoogle Scholar
  36. 36.
    Hajian-Tilaki K, Heidari B, Firouzjahi A, Bagherzadeh M, Hajian-Tilaki A, Halalkhor S (2014) Prevalence of metabolic syndrome and the association with socio-demographic characteristics and physical activity in urban population of Iranian adults: a population-based study. Diabetes Metab Syndr 8:170–176CrossRefGoogle Scholar
  37. 37.
    Cauley JA (2015) Estrogen and bone health in men and women. Steroids 99:11–15CrossRefGoogle Scholar
  38. 38.
    Manolagas SC, O’Brien CA, Almeida M (2013) The role of estrogen and androgen receptors in bone health and disease. Nat Rev Endocrinol 9:699–712CrossRefGoogle Scholar
  39. 39.
    Zamani M, Derakhshan M, Zamani V, Shokri-Shirvani J (2018) The prevalence of Helicobacter pylori infection worldwide—knowns and unknowns. Authors’ reply. Aliment Pharmacol Ther 47:1331–1332CrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Mohammad Zamani
    • 1
    • 2
  • Vahid Zamani
    • 3
  • Behzad Heidari
    • 4
    • 5
  • Hadi Parsian
    • 6
  • Seyed Mokhtar Esmaeilnejad-Ganji
    • 7
    • 8
    Email author
  1. 1.Student Research Committee, School of MedicineBabol University of Medical SciencesBabolIran
  2. 2.Cancer Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  3. 3.Vice-Chancellery for HealthBabol University of Medical SciencesBabolIran
  4. 4.Mobility Impairment Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  5. 5.Clinical Research Development Unit of Rouhani HospitalBabol University of Medical SciencesBabolIran
  6. 6.Social Determinant of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  7. 7.Department of Orthopedics, Shahid Beheshti HospitalBabol University of Medical SciencesBabolIran
  8. 8.Clinical Research Development Center, Shahid Beheshti HospitalBabol University of Medical SciencesBabolIran

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