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Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis

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Abstract  

This systematic review and meta-analysis estimated the global, regional prevalence, and risk factors of osteoporosis. Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from 8.0% in Oceania to 26.9% in Africa). Osteoporosis is a common metabolic bone disorder in the elderly, usually resulting in bone pain and an increased risk of fragility fracture, but few summarized studies have guided global strategies for the disease. Therefore, we pooled the epidemiologic data to estimate the global, regional prevalence, and potential risk factors of osteoporosis. We conducted a comprehensive literature search through PubMed, EMBASE, Web of Science, and Scopus, to identify population-based studies that reported the prevalence of osteoporosis based on the World Health Organization (WHO) criteria. Meta-regression and subgroup analyses were used to explore the sources of heterogeneity. The study was registered in the PROSPERO database (CRD42021285555). Of the 57,933 citations evaluated, 108 individual studies containing 343,704 subjects were included. The global prevalence of osteoporosis and osteopenia was 19.7% (95%CI, 18.0%–21.4%) and 40.4% (95%CI, 36.9%–43.8%). Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from Oceania 8.0% to 26.9% in Africa). The prevalence was higher in developing countries (22.1%, 95%CI, 20.1%–24.1%) than in developed countries (14.5%, 95%CI, 11.5%–17.7%). Our study indicates a considerable prevalence of osteoporosis among the general population based on WHO criteria, and the prevalence varies substantially between countries and regions. Future studies with robust evidence are required to explore risk factors to provide effective preventive strategies for the disease.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (NO. 81772384 and 81902242).

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  1. Pei-Lun Xiao, Ai-Yong Cui, and Chi-Jen Hsu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China

    P.-L. Xiao, C.-J. Hsu, R. Peng, N. Jiang, X.-H. Xu, Y.-G. Ma, D. Liu & H.-D. Lu

  2. Department of Orthopaedics, Honghui Hospital, Xi’an Jiao Tong University, Xi’an, 710000, China

    A.-Y. Cui

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Contributions

Conceptualization, Pei-Lun Xiao, Ai-Yong Cui, and Hua-Ding Lu; Data curation, Pei-Lun Xiao and Ai-Yong Cui; Formal analysis, Pei-Lun Xiao, Xiang-He Xu, Ai-Yong Cui, Chi-Jen Hsu, and Hua-Ding Lu; Investigation, Pei-Lun Xiao, Chi-Jen Hsu, and Yong-Guang Ma; Methodology, Pei-Lun Xiao, Xiang-He Xu, and Hua-Ding Lu; Project administration, Pei-Lun Xiao, Xiang-He Xu, and Hua-Ding Lu; Software, Pei-Lun Xiao, Yong-Guang Ma, and Hua-Ding Lu; Visualization, Pei-Lun Xiao, Ding-Liu, and Rong-Peng; Writing—original draft, Pei-Lun Xiao, Rong -Peng, and Hua-Ding Lu; Writing—review & editing, Pei-Lun Xiao, Xiang-He Xu, Ning-Jiang, and Hua-Ding Lu.

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Correspondence to A.-Y. Cui or H.-D. Lu.

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Pei-Lun Xiao, Ai-Yong Cui, Chi-Jen Hsu, Rong-Peng, Ning-Jiang, Xiang-He Xu, Yong-Guang Ma, Ding-Liu and Hua-Ding Lu declare that they have no conflict of interest.

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Xiao, PL., Cui, AY., Hsu, CJ. et al. Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int 33, 2137–2153 (2022). https://doi.org/10.1007/s00198-022-06454-3

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