TY  - JOUR
PY  - 2014//
TI  - The global burden attributable to low bone mineral density
JO  - Annals of the rheumatic diseases
A1  - Sànchez-Riera, L.
A1  - Carnahan, E.
A1  - Vos, T.
A1  - Veerman, L.
A1  - Norman, R.
A1  - Lim, S. S.
A1  - Hoy, D.
A1  - Smith, E.
A1  - Wilson, N.
A1  - Nolla, J. M.
A1  - Chen, J. S.
A1  - Macara, M.
A1  - Kamalaraj, N.
A1  - Li, Yun
A1  - Kok, C.
A1  - Santos-Hernández, C.
A1  - March, L.
SP  - 1635
EP  - 1645
VL  - 73
IS  - 9
N2  - 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. <br><br>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. <br><br>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/cm(2)) 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. <br><br>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. <br><br>CONCLUSIONS: Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4967
UR  - http://dx.doi.org/10.1136/annrheumdis-2013-204320
ID  - ref1
ER  -