Division of Endocrinology, Clemenceau Medical Center, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Osteoporos Int. 2021 Aug;32(8):1499-1515. doi: 10.1007/s00198-021-05937-z. Epub 2021 Apr 7.
Asia is projected to account for the largest proportion of the rising burden of osteoporotic fractures worldwide. Data from the Middle East is scarce. We performed a systematic review on the epidemiology of vertebral and hip osteoporotic fractures in 22 Arab League countries, using Scopus, PubMed, and Embase. We identified 67 relevant publications, 28 on hip and 39 on vertebral fractures. The mean age of patients was 70-74 years, female to male ratio 1.2:2.1. Age-standardized incidence rates, to the UN 2010 population, were 236 to 290/100,000 for women from Kuwait and Lebanon, lower in Morocco. Risk factors for hip fractures included lower BMD or BMI, taller stature, anxiolytics, and sleeping pills. Most patients were not tested nor treated. Mortality derived from retrospective studies ranged between 10 and 20% at 1 year, and between 25 and 30% at 2-3 years. Among 39 studies on vertebral fractures, 18 described prevalence of morphometric fractures. Excluding grade 1 fractures, 13.3-20.2% of women, mean age 58-74 years, had prevalent vertebral fractures, as did 10-14% of men, mean age 62-74 years. Risk factors included age, gender, smoking, multiparity, years since menopause, low BMD, bone markers, high sclerostin, low IgF1, hypovitaminosis D, abdominal aortic calcification score, and VDR polymorphisms. Vertebral fracture incidence in women from Saudi Arabia, mean age 61, was 6.2% at 5 years, including grade 1 fractures. Prospective population-based fracture registries, prevalence studies, predictive models, fracture outcomes, and fracture liaison services from Arab countries are still lacking today. They are the pillars to closing the care gap of this morbid disease.
亚洲预计将占全球不断增加的骨质疏松性骨折负担的最大比例。中东地区的数据很少。我们在 Scopus、PubMed 和 Embase 上对 22 个阿拉伯联盟国家的椎骨和髋部骨质疏松性骨折的流行病学进行了系统综述。我们确定了 67 篇相关文献，其中 28 篇关于髋部骨折，39 篇关于椎骨骨折。患者的平均年龄为 70-74 岁，女性与男性的比例为 1.2:2.1。按联合国 2010 年人口年龄标准化发病率为，科威特和黎巴嫩的女性为 236-290/100,000，摩洛哥的发病率较低。髋部骨折的危险因素包括较低的 BMD 或 BMI、较高的身高、焦虑症和安眠药。大多数患者未接受检测和治疗。来自回顾性研究的死亡率在 1 年时为 10-20%，在 2-3 年时为 25-30%。在 39 项关于椎骨骨折的研究中，有 18 项描述了形态计量学骨折的患病率。排除 1 级骨折后，13.3-20.2%的女性（平均年龄 58-74 岁）和 10-14%的男性（平均年龄 62-74 岁）患有椎骨骨折。危险因素包括年龄、性别、吸烟、多胎妊娠、绝经后年限、低 BMD、骨标志物、高骨硬化蛋白、低 IGF1、维生素 D 缺乏、腹主动脉钙化评分和 VDR 多态性。沙特阿拉伯女性的椎骨骨折发生率为 6.2%（包括 1 级骨折），平均年龄为 61 岁，5 年时为 6.2%。目前，阿拉伯国家仍缺乏基于人群的骨折登记处、患病率研究、预测模型、骨折结果和骨折联络服务。这些是缩小这种病态疾病护理差距的支柱。
