Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Arch Osteoporos. 2022 Nov 10;17(1):140. doi: 10.1007/s11657-022-01180-z.
Low bone mineral density (BMD) including low bone mass and osteoporosis is a bone state that carries the risk of fractures and the consequent burden. Since Iran has an aging population and is considered a high-risk country regarding fracture, the objective of this study was to report the low BMD attributable burden in Iran from 1990 to 2019 at national and subnational levels.
In this study, the Global Burden of Disease (GBD) study 2019 estimates of exposure value and attributable burden were used. For each risk-outcome pair, following the estimation of relative risk, exposure level, and the Theoretical Minimum Risk Exposure Level (TMREL), the Population Attributable Fractions (PAFs) and attributable burden were computed. The Summary Exposure Value (SEV) index was also computed.
Although the age-standardized DALYs and deaths decreased (- 41.0 [95% uncertainty interval: - 45.7 to - 33.2] and - 43.3 [- 48.9 to - 32.5]), attributable all age numbers in Iran increased from 1990 to 2019 (64.3 [50.6 to 89.1] and 66.8 [49.7 to 102.0]). The male gender had a higher low BMD attributed burden in Iran at national and subnational levels except for Tehran. Among low BMD-associated outcomes, motor vehicle road injuries and falls accounted for most of the low BMD-attributed burden in Iran. The SEV for low BMD remained constant from 1990 to 2019 in the country and females had higher SEVs.
Low BMD and the associated outcomes has to gain attention in Iran's health system due to an aging population. Hence, timely interventions by health systems and the population at stake might assist in reducing the burden attributed to low BMD.
低骨矿物质密度（BMD）包括低骨量和骨质疏松症，是一种存在骨折风险和随之而来负担的骨骼状态。由于伊朗人口老龄化，并且被认为是骨折高风险国家，因此本研究的目的是报告 1990 年至 2019 年伊朗在国家和次国家各级因低 BMD 造成的负担。
在这项研究中，使用了 2019 年全球疾病负担（GBD）研究的暴露值和归因负担估计值。对于每一对风险-结果，在估计相对风险、暴露水平和理论最小风险暴露水平（TMREL）之后，计算人群归因分数（PAFs）和归因负担。还计算了综合暴露值（SEV）指数。
尽管年龄标准化的 DALYs 和死亡人数有所下降（-41.0 [95%不确定区间：-45.7 至-33.2] 和-43.3 [-48.9 至-32.5]），但伊朗的归因全年龄人数从 1990 年到 2019 年有所增加（64.3 [50.6 至 89.1] 和 66.8 [49.7 至 102.0]）。除德黑兰外，伊朗在国家和次国家各级，男性的低 BMD 归因负担更高。在与低 BMD 相关的结果中，机动车道路伤害和跌倒占伊朗低 BMD 归因负担的大部分。1990 年至 2019 年，该国的低 BMD-SEV 保持不变，女性的 SEV 更高。
由于人口老龄化，伊朗的卫生系统必须关注低 BMD 及相关后果。因此，卫生系统和相关人群及时采取干预措施，可能有助于减轻低 BMD 造成的负担。
