Skip to main content

Advertisement

SpringerLink
Log in

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

  • Review Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  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 11:37

    Article  PubMed  PubMed Central  Google Scholar 

  2. Compston J, Cooper A, Cooper C et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Ballane G, Cauley J, Luckey M, Fuleihan GE-H (2017) Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 28:1531–1542

    Article  CAS  PubMed  Google Scholar 

  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 25:2359–2381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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 12:56

    Article  PubMed  Google Scholar 

  6. Wade S, Strader C, Fitzpatrick L, Anthony M, O’Malley C (2014) Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 9:182

    Article  CAS  PubMed  Google Scholar 

  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 29:2520–2526

    Article  PubMed  Google Scholar 

  8. Kling JM, Clarke BL, Sandhu NP (2014) Osteoporosis prevention, screening, and treatment: a review. J Women's Health (Larchmt) 23:563–572

    Article  Google Scholar 

  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 29:717–722

    Article  PubMed  Google Scholar 

  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 8:136

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Cooper C, Campion G, Lr M (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    Article  CAS  PubMed  Google Scholar 

  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 2012:436762

    PubMed  PubMed Central  Google Scholar 

  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 9:229

    Article  PubMed Central  Google Scholar 

  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 5:274–298

    Article  PubMed  PubMed Central  Google Scholar 

  15. (2015) IOF Regionals - 3rd Middle East & Africa osteoporosis meeting : plenary lecture abstracts. Osteoporos Int 26:S421-S425

  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. (2015) IOF Regionals - 3rd Middle East & Africa osteoporosis meeting : poster presentation abstracts. Osteoporos Int 26:S439-S486

  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 14:384–394

    Article  CAS  PubMed  Google Scholar 

  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 7:131–143

    CAS  PubMed  Google Scholar 

  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:e1000097

    Article  PubMed  PubMed Central  Google Scholar 

  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. World Health Organization. Prevention and management of osteoporosis. Geneva: WHO; 2003

  23. 2015 ISCD Official Positions – Adult. https://www.iscd.org/official-positions/2015-iscd-official-positions-adult/

  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 65:934–939

    Article  PubMed  Google Scholar 

  25. Becker DJ, Kilgore ML, Morrisey MA (2010) The societal burden of osteoporosis. Curr Rheumatol Rep 12:186–191

    Article  PubMed  Google Scholar 

  26. Chen P, Li Z, Hu Y (2016) Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health 16:1039

    Article  PubMed  PubMed Central  Google Scholar 

  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 1:57–61

    Article  PubMed  PubMed Central  Google Scholar 

  28. Middle East & Africa Guidelines. https://www.iofbonehealth.org/middle-east-africa-guidelines

  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 5:199–217

    Article  PubMed  PubMed Central  Google Scholar 

  30. Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z (2013) Prevalence of osteoporosis in Iran: a meta-analysis. J Res Med Sci 18:759–766

    PubMed  PubMed Central  Google Scholar 

  31. Alswat KA (2017) Gender Disparities in Osteoporosis. J Clin Med Res 9:382–387

    Article  PubMed  PubMed Central  Google Scholar 

  32. Heidari B, Hosseini R, Javadian Y, Bijani A, Sateri MH, Nouroddini HG (2015) Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos 10:15

    Article  PubMed  Google Scholar 

  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:e39662

    PubMed  Google Scholar 

  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 58:389–394

    PubMed  Google Scholar 

  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 8:3–10

    Article  CAS  PubMed  Google Scholar 

  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 8:170–176

    Article  CAS  PubMed  Google Scholar 

  37. Cauley JA (2015) Estrogen and bone health in men and women. Steroids 99:11–15

    Article  CAS  PubMed  Google Scholar 

  38. Manolagas SC, O’Brien CA, Almeida M (2013) The role of estrogen and androgen receptors in bone health and disease. Nat Rev Endocrinol 9:699–712

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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 47:1331–1332

    Article  CAS  PubMed  Google Scholar 

Download references

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

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

Author information

Authors and Affiliations

  1. Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran

    Mohammad Zamani

  2. Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Mohammad Zamani

  3. Vice-Chancellery for Health, Babol University of Medical Sciences, Babol, Iran

    Vahid Zamani

  4. Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Behzad Heidari

  5. Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran

    Behzad Heidari

  6. Social Determinant of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Hadi Parsian

  7. Department of Orthopedics, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran

    Seyed Mokhtar Esmaeilnejad-Ganji

  8. Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran

    Seyed Mokhtar Esmaeilnejad-Ganji

Authors
  1. Mohammad Zamani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vahid Zamani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Behzad Heidari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hadi Parsian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Seyed Mokhtar Esmaeilnejad-Ganji
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seyed Mokhtar Esmaeilnejad-Ganji.

Ethics declarations

Conflicts of interest

None.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zamani, M., Zamani, V., Heidari, B. et al. Prevalence of osteoporosis with the World Health Organization diagnostic criteria in the Eastern Mediterranean Region: a systematic review and meta-analysis. Arch Osteoporos 13, 129 (2018). https://doi.org/10.1007/s11657-018-0540-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11657-018-0540-7

Keywords

Search

Navigation