The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis

Salari, Nader; Ghasemi, Hooman; Mohammadi, Loghman; Behzadi, Mohammad hasan; Rabieenia, Elham; Shohaimi, Shamarina; Mohammadi, Masoud

doi:10.1186/s13018-021-02772-0

Journal of Orthopaedic Surgery and Research

Table 1 Summary of characteristics of included studies

From: The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis

Row number	Author	Year	Continent	Country	Diagnosis tool	Location of diagnosis	Cut-off	Study population	m	w	Age	OP
1	Hyun Koo Uoon [22]	2001	Asia	Tae-An Korea	BUA by QUS2	Calcaneus	T ≤ − 2.5	298	0	298	35–65	9
2	Sireen Shilbayeh [23]	2003	Asia	Jordan	BMD by DXA	Femoral neck, lumbar spine	T ≤ − 2.5	400	0	400	19–89	119
3	X.-P. WU [4]	2003	Asia	China	SOS	Tibial	T ≤ − 2.5	1596	0	1596	46.5	173
4	Vu Thi Thu Hien [16]	2005	Asia	Vietnam	SOS	Calcaneus	T ≤ − 3.8	2232	0	2232	≥ 20	343
5	Sarath Lekamwasam [24]	2006	Asia	Sri Lanka	BMD by DXA	Spine, femoral neck	T ≤ − 2	1642	0	1642	≥ 50	736
6	G. Chhibber [25]	2006	Asia	Dehli and Haryana (INDIA)	BMD by DXA	Forearm, hip	T ≤ − 2.5	430	0	430	60–80	265
7	Mahmoud I. El-Desouki [21]	2007	Asia	Saudi Arabia	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	429	429	0	30–90	101
8	Nan-Ping Yang [19]	2006	Asia	Taiwan	BMD by DXA	Lumbar, hip	T ≤ − 2.5	33,633	17,583	16,050	≥ 50	2109
9	Abdulbari Bener [26]	2007	Asia	Qatar	BMD by DXA	Spine, femur	T ≤ − 2.5	821	0	821	20–70	42
10	Didem Arslantas [27]	2008	Asia	Turkey	BMD by DXA	Hip	T ≤ − 1.8	1437	571	866	40–89	216
11	Montchai Chumnumnawin [28]	2008	Asia	Bangkok-Thaiwan (Priests)	BMD by DXA	Hip	T ≤ − 2.5	659	659	0	≥ 20	33
12	S. Miura [29]	2008	Asia	Philippines	SOS	Calcaneus	T ≤ − 1.79	339	0	339	40–89	67
13	P. Shokrollahi [30]	2008	Asia	IRAN, SHIRAZ	BMD by DXA	BMD		75	0	75	≥ 55	58
14	M. Fatima [31]	2009	Asia	Pakistan	BMD by SOS	Calcaneus	T ≤ − 2.5	334	0	334	20–60	43
15	Sarath Lekamwasam [32]	2009	Asia	Sri Lanka	BMD by DXA	Middle phalanx of the middle finger of the non-dominant hand	T ≤ − 2.5	1147	1147	0	50–84	66
16	Aranjan Lionel Karunanayake [33]	2010	Asia	Sri Lanka	BMD by DXA	Lumbar spine, hip	T ≤ − 2.5	700	279	421	35–64	101
17	A. Neema [34]	2010	Asia	Wardha, India	BMD by SOS	Calcaneus	T ≤ − 1.8	1122	0	1122	40–60	173
18	Shafaq Zahoor [35]	2010	Asia	Pakistan	BMD by DXA	Heel	T ≤ − 2.5	240	0	240	≥ 49	56
19	Neelam Aggarwal [36]	2011	Asia	Chandigarh, India	BMD by DXA	Lumbar spine, femoral neck, and total spine	T ≤ − 2.5	200	0	200	≥ 45	56
20	Zhifeng Sheng [37]	2011	Asia	Chine	BMD by DXA	Lumbarspine, left femoral	T ≤ − 2.5	954	0	954	50–82	376
21	Yong Jun Choi [38]	2012	Asia	Korea	BMD by DXA	Lumbar spine, total femur, femur neck	T ≤ − 2.5	4946	2095	2851	≥ 50	1169
22	Kyae Hyung Kim [39]	2012	Asia	Korea	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	2870	0	2870	≥ 50	1122
23	Zhang Mengmeng [40]	2012	Asia	Changchun, China	BMD by DXA	Distal, forearm	T	16,019	7286	8733	20–89	4313
24	Zahra Pourhashem [41]	2012	Asia	Amirkola, Iran	BMD by DXA	Femur, spine, femoral, lumbar	T ≤ − 2.5	193	105	88	60–88	62
25	S. Tuzun [42]	2012	Asia	Turkey	BMD by DXA	Lumbar spine, proximal femur (neck, total), femoral neck	T ≤ − 2.5	1965	944	1021	≥ 50	202
26	Neeraj Kumar Agrawal [43]	2013	Asia	India	BMD by DXA	Right femur, neck, trochanter, total hip	T ≤ − 2.5	200	200	0	≥ 50	17
27	Maj Tripti Agrawal [44]	2013	Asia	India	BMD by QUS	Calcaneus (heel)	T ≤ − 2.5	158	0	158	35–64	21
28	Maninder Kaur [45]	2013	Asia	North, India	BMD by DXA	Lumbar spine	T ≤ − 2.5	250	0	250	45–80	66
29	Jongseok Lee [46]	2013	Asia	Korea	BMD by DXA	Femoral neck, lumbar spine	T ≤ − 2.5	17,205	7837	9368	10_89	4077
30	Yaşar Keskin [47]	2014	Asia	Turkey	BMD by MetriScan device	Middle phalanges of the second, third, and fourth digits of the non-dominant hand	T ≤ − 2.5	620	122	498	40–89	88
31	Kyung-Shik Lee [48]	2014	Asia	Korea	BMD by DXA	Total hip, femoral neck, total lumbar spine	T ≤ − 2.5	11,142	5355	5787	≥ 50	2557
32	Eun Jung Park [49]	2014		Korea	BMD by DXA	Lumbar spine, femoral neck, trochanter, total hip	T ≤ − 2.5	7425	3414	4011	≥ 50	1773
33	Edith Ming Chu Lau [50]	2015	Asia	China	BMD by DXA	Lumbar spine, total hip, femoral neck	T ≤ − 2.5	12,401	0	12,401	50–89	2798
34	Cathy Nga Yan Lee [13]	2015	Asia	Hong Kong	BMD by DXA	Heel	T ≤ − 2.5	80	22	58	41.6	3
35	Zahra Mohammadi [51]	2015	Asia	Kurdistan, Iran	BMD by DXA	Lumbar spine, hip, femoral neck	T ≤ − 2.5	306	403	629	≥ 50	123
36	Marzieh Saei Ghare Naz [52]	2015	Asia	Urmia, Iran	BMD by DXA	Femoral neck, lumbar spine	T ≤ − 2.5	292	0	292	≥ 50	152
37	Yan-Jiao Wang [53]	2015	Asia	China	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	316	164	152	≥ 65	78
38	Khurshid A. Bhat [54]	2018	Asia	INDIA	BMD by DXA	Lumbar, total hip, femur neck	T ≤ − 2.5	241	241	0	≥ 60	46
39	Yi-Chien Lu [55]	2016	Asia	Taiwan, China	BMD by DXA	Lumbar spine, femoral neck, both	T_usa ≤ − 2.5	3740	2028	1712	≥ 50	886
39	Yi-Chien Lu [55]	2016	Asia	Taiwan, China	BMD by DXA	Lumbar spine, femoral neck, both	T_Asia ≤ − 2.5	3740	2028	1712	≥ 50	271
40	Sung Bae Park [15]	2016	Asia	Korea	BMD by DXA	Spine, hip, or wrist	T ≤ − 2.5	51,169,141	–	–	All	2,018,236
41	Sung Bae Park [15]	2016	Asia	Korea	BMD by DXA	Spine, hip, or wrist	T ≤ − 2.5	50,908,646	–	–	All	2,018,437
42	Dana Hyassat [56]	2017	Asia	Amman, Jordan	BMD by DXA	Total, lumbar spine, left femoral neck	T ≤ − 2.5	1079	0	1079	45–84	405
43	Yu-Jun Kwon [57]	2017	Asia	Korea	BMD	Heel	T ≤ − 2.5	595	157	438	51–94	393
44	Gul Pinar [7]	2017	Asia	Turkey	BMD by DXA	Femoral neck, lumbar spine	T ≤ − 2.5	1792	0	1792	18–49	72
45	Limin Tian [58]	2017	Asia	Northwestern of China	BMD by DXA	Distal one-third radius of the forearm	T ≤ − 2.5	6564	3205	3359	≥ 40	583
46	Muhammad Farhan Abbas [59]	2018	Asia	Pakistan	BMD by X-rays	Questionnaire	T ≤ − 2.5	360	0	360	≥ 15	152
47	Parvin Cheraghi [60]	2018	Asia	Hamedan, Iran	BMD by DXA		T ≤ − 2.5	1779	1077	702	≥ 60	142
48	Nidhi S. Kadam [61]	2018	Asia	Pune City, India	BMD by DXA	Lumbar spine, femoral neck, total hip	T ≤ − 2.5	421	193	228	40–75	69
49	Neelam Kaushal [18]	2018	Asia	INDIA	BMD by DXA	Lumbar spine, femur neck, total femur	T ≤ − 2.5	524	306	216	20–85	36
50	Chi‐Hua Ko [20]	2018	Asia	Taiwan	BMD by DXA	Hip (total), lumbar spine, femoral neck	T ≤ − 2.5	3734	3734	0	≥ 50	362
51	P. Modagan [17]	2018	Asia	INDIA	BMD by DXA	Proximal femur (total hip, femoral neck, shaft, Ward’s triangle, trochanter), anteroposterior (AP) lumbar spine	T ≤ − 2.5	773	380	393	30–90	191
52	Nayer Seyfizadeh [62]	2016	Asia	Iran	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	990			55–92	307
53	Jung Eun Yoo [63]	2018	Asia	Korea	BMD by DXA	Femoral neck, total femur, lumbar spine	T ≤ − 2.5	6104	6104	0	≥ 30	305
54	Abdulaziz Ahmed Abdulaziz [64]	2019	Asia	SAUDI ARABIA	BMD by DXA	Lumbar spine, neck femur	T ≤ − 2.5	131	131		≥ 60	34
55	Zaheer Ahmed Mohammed [64]	2019	Asia	MAJMAAH, Saudi	BMD by DXA	Hip, spine (online questionnaire)	T ≤ − 2.5	593	110	483	≥ 20	47
56	K. Padmanabhan [65]	2019	Asia	Chennai, India	BMD by DXA	Calcaneus heel	T ≤ − 2.5	270	0	270	30–70	43
57	Hasanga Rathnayake [66]	2019	Asia	Sri Lanka	BMD by DXA	Spine, femoral neck, total hip	T ≤ − 2.5	176	0	355	≥ 50	65
58	Shriraj Shrestha [67]	2019	Asia	Hospital in Nepal	BUA and SOS by QUS	Centre of the bone	T ≤ − 2.5	464	141	323	41.02	38
59	Shaanthana Subramaniam [68]	2019	Asia	Malaysia	BMD by DXA	Lumbar spine, total hip	T ≤ − 2.5	367	182	185	≥ 40	56
60	Peizhi Wang [69]	2019	Asia	Singapore	Self-assessment tool	Self-assessment tool	High-Risk Index (female) < − 4, High-Risk Index (male) < − 6	2345	1052	1293	60–105	1218
61	Qiang Zeng [70]	2019	Asia	China	BMD by DXA	Lumbar spine, Femoral neck, Total femur	T ≤ − 2.5	41,347	40,944	34,377	≥ 50	7211
62	Kyeong Jin Kim [71]	2020	Asia	Korea	BMD by DXA	Lumbar spine, femur neck, total hip	T ≤ − 2.5	208	0	488	≥ 50	52
63	Mamatov Sagynali Murzaevich [72]	2020	Asia	Kyrgyz	BMD by ultrasound bone densitometer		T ≤ − 2.5	1200	509	691	18–79	179
64	Qian Zhang [8]	2020	Asia	Shanghai, China	BMD by DXA	Proximal femur, lumbar vertebrae	T ≤ − 2.5	565	231	334	70–95	223
65	Florent Richy [73]	2004	Europe	Belgium	BMD by DXA	Total femur, femoral neck, lumbar spine	T ≤ − 2.5	311	311	0	30–91	63
66	Eric Lespessailles [74]	2009	Europe	France	BMD by DXA	Hip, spine, wrist by face-to-face interviews	T ≤ − 2.5	2613	0	2613	≥ 45	254
67	Henrik G Ahlborg [75]	2010	Europe	Malmö, Sweden	BMD by single-photon	Distal radius, forearm	T ≤ − 2.5	459	0	459	≥ 50	69
68	Patrizia D’Amelio [76]	2013	Europe	Italy	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	995	0	995	45–92	335
69	E. J. Marjanovic [77]	2013	Europe	UK	BMD by DXA	Proximal femur, lumbar spine	T ≤ − 2.5	380	0	380	45–65	98
70	Marıa-Jesus Gómez-de-Tejada Romero [78]	2013	Europe	Spain	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	1229	0	1229	≥ 50	383
71	Loredana Cavalli [79]	2016	Europe	Italy	BMD by QUS	Heel	T ≤ − 2.5	7305	1191	6114	17–97	1212
72	Marie-Therese Puth [80]	2018	Europe	Germany	telephone survey	Self-reported		10,660	4961	5699	≥ 50	911
73	B. R. Nielsen [81]	2020	Europe	Denmark	BMD by DXA	Spine and hip	T ≤ − 2.5	529	232	297	≥ 65	101
74	Alexandre Faisal-Cury [6]	2007	America	Sao Paulo	BMD	Femur, hip	T ≤ − 2.5	999	0	999	50–96	320
75	Julie Robitaille [82]	2008	America	U.S.	By a physician in the household	Household interview	By a physician	8073	0	8073	≥ 20	442
76	H. Cheng [14]	2009	America	AMERICA	BMD by DXA	Medicare data		911,327	359,733	551,594	≥ 65	270,907
77	Arthur Swislocki [83]	2010	America	Nursing Home, United States	BMD by DXA	Lumbar spine, total hip, femoral neck	T ≤ − 2.5	106	106	0	≥ 50	33
78	John Londono [84]	2013	America	Colombia	BMD by DXA	Lumbar vertebrae, femur neck	T ≤ − 2.5	795	0	795	35–53	38
79	Robert Ferrari [85]	2015	America	Canada	BMD by DXA	Hip, lumbar spine	T ≤ − 2.5	557	557	0	65–75	6
80	Carlos Mautalen [86]	2016	America	Buenos Aires, Argentina	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	5448	0	5448	≥ 50	1021
81	Sabrina E. Noel [87]	2018	America	USA	BMD by DXA	Femoral neck, lumbar spine	T ≤ − 2.5	953	273	680	47–79	100
82	Ricardo M. Lima [88]	2019	America	Brezil	BMD by DXA	Lumbar spine, femoral neck	T ≤ − 2.5	234	0	234	68.3	37
83	T. O. Alonge [89]	2017	Africa	Nigeria	BMD by DXA	Right wrist	T ≤ − 2.5	2401	964	1437	≥ 60	1366
84	P. O. Ezeonu [90]	2017	Africa	South-East Nigeria	BMD	Right calcaneal bone	T ≤ − 2.5	327	0	327	18–44	119
85	Fred Chuma Sitati [91]	2020	Africa	Kenya, African	BMD by DXA	Lumbar spine, hip	T ≤ − 2.5	254	0	254	50–95	67
86	E. P. Boschitsch [92]	2017	Australia	Australia	BMD by DXA	Hip, the distal forearm, vertebrae	T ≤ − 2.5	99,399	0	99,399	≥ 40	13,444

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