The global burden attributable to low bone mineral density

Sànchez-Riera, L., Carnahan, E., Vos, T., Veerman, L., Norman, R., Lim, S.S., Hoy, D., Smith, E., Wilson, N., Nolla, J.M., Chen, J.S., Macara, M., Kamalaraj, N., Li, Y., Kok, C., Santos-Hernańdez, C., & March, L. (2014) The global burden attributable to low bone mineral density. Annals of the Rheumatic Diseases, 73(9), pp. 1635-1645.

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Abstract

Introduction

The Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls.

Objectives

To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD.

Methods

A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age- and sex-specific mean ± SD BMD values (g/cm2) were extracted from eligible studies. Comparative risk assessment methodology was used to calculate PAFs of BMD for fractures. The theoretical minimum risk exposure distribution was estimated as the age- and sex-specific 90th centile from the Third National Health and Nutrition Examination Survey (NHANES III). Relative risks of fractures were obtained from a previous meta-analysis. Hospital data were used to calculate the fraction of the health burden of falls that was due to fractures.

Results

Global deaths and DALYs attributable to low BMD increased from 103 000 and 3 125 000 in 1990 to 188 000 and 5 216 000 in 2010, respectively. The percentage of low BMD in the total global burden almost doubled from 1990 (0.12%) to 2010 (0.21%). Around one-third of falls-related deaths were attributable to low BMD.

Conclusions

Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.

Impact and interest:

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ID Code: 80258
Item Type: Journal Article
Refereed: Yes
Keywords: low bone mineral density, global, burden of disease, attributable burden, fractures
DOI: 10.1136/annrheumdis-2013-204320
ISSN: 1468-2060
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Epidemiology (111706)
Australian and New Zealand Standard Research Classification
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 26 Jan 2015 23:34
Last Modified: 27 Jan 2015 21:52

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