Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ministry of Public Health, Beirut, Lebanon.
Osteoporos Int. 2020 Sep;31(9):1769-1777. doi: 10.1007/s00198-020-05433-w. Epub 2020 May 6.
Osteoporosis is more common than most feared non-communicable diseases in the Middle East. This justifies the need to place osteoporosis as a health priority in the region.
Osteoporosis is a common disease associated with severe debilitating consequences. The objective of this study is To evaluate and compare disease burden from osteoporosis and other non-communicable diseases (NCDs) in Lebanon.
We assessed the prevalence of osteoporosis and other NCDs, such as obesity, diabetes, hypertension, dyslipidemia, and cardiovascular diseases, based on a published population-based study of Lebanese ≥ 65 years. We compared incidence rates of hip fractures and major osteoporotic fractures (MOF) (spine, hip, humerus, and forearm) to the five commonest cancers in women ≥ 50 years. Rates were based on the national hip fracture and cancer registry data, provided by the Lebanese Ministry of Public Health. MOF incidence rates were derived from national hip fracture incidence rates and MOF/hip fractures incidence rate ratios from the literature.
Over 70% of elderly Lebanese had osteoporosis defined by densitometric criteria or prevalent morphometric vertebral fractures. This by far exceeded the prevalence of other NCDs, such as hypertension (53%), diabetes (21%), dyslipidemia (31%), and cardiovascular diseases (30%). Morphometric vertebral fractures (grades 2 and 3) were present in 19% of women and 12% of men. The incidence rates for MOF were 1.6 times greater than those for breast cancer, and 7.4-9.9 folds higher than those for the next commonest cancers of the lungs, colon, and ovaries. Hip fracture incidence rates were lower than those of breast cancer but were 2.1-2.8 folds higher than those of the above-mentioned cancers.
This first of its kind study in the Middle East demonstrates that osteoporosis is a common disease, more common than most feared NCDs. Our findings are comparable to those in western populations and justify placing osteoporosis on the top of NCDs' priority list in our country and possibly the region.
评估和比较骨质疏松症和黎巴嫩其他非传染性疾病（NCDs）的疾病负担。
我们根据一项针对黎巴嫩≥65 岁人群的已发表的基于人群的研究，评估了骨质疏松症和其他 NCD 的患病率，如肥胖、糖尿病、高血压、血脂异常和心血管疾病。我们将髋部骨折和主要骨质疏松性骨折（MOF）（脊柱、髋部、肱骨和前臂）的发病率与≥50 岁女性中最常见的五种癌症进行了比较。这些数据是基于黎巴嫩公共卫生部提供的国家髋部骨折和癌症登记数据和文献中 MOF/髋部骨折发病率比值计算得出的。
超过 70%的黎巴嫩老年人存在骨质疏松症，其定义为骨密度仪标准或普遍存在的形态学椎体骨折。这远远超过了其他 NCD 的患病率，如高血压（53%）、糖尿病（21%）、血脂异常（31%）和心血管疾病（30%）。形态学椎体骨折（2 级和 3 级）在 19%的女性和 12%的男性中存在。MOF 的发病率是乳腺癌的 1.6 倍，是肺癌、结肠癌和卵巢癌的 7.4-9.9 倍。髋部骨折的发病率低于乳腺癌，但是上述癌症的 2.1-2.8 倍。
这是中东地区首例此类研究，表明骨质疏松症是一种常见疾病，比大多数人担心的非传染性疾病更为普遍。我们的研究结果与西方人群相似，有理由将骨质疏松症置于我国乃至该地区 NCD 优先事项的首位。
