Clinical Rheumatology

, Volume 28, Issue 2, pp 173–177 | Cite as

High prevalence of low bone density in young Iranian healthy individuals

  • Iraj SalehiEmail author
  • Shabnam Khazaeli
  • Seyed Reza Najafizadeh
  • Haleh Ashraf
  • Mahdi Malekpour
Original Article


With the increasing life expectancy, osteoporosis is becoming a major worldwide health problem, more particularly in the Middle East region. Bone mineral density (BMD) of the hip, lumbar spine, and forearm was measured by dual X-ray absorptiometry (Lunar) in 2085 (25% men, 75% women) healthy Iranian subjects aged 20–88 yr. The prevalence of osteoporosis and osteopenia in at least one measured site in subjects aged 50 yr and older were 36.1% and 43.9% in women, and 24.5% and 70.8% in men, respectively. Among subjects younger than 50 yr, 49.6% of women and 59.6% of men had low bone mass, respectively. In addition, more than one third of subjects showed discordance between different sites of measurement. The high incidence of low bone density in young ages requires our proper attention and planning for prevention. Measurement of BMD in all three sites seems necessary and clinicians should look for possible causes of discordance between different sites of measurement and develop an appropriate strategy approaching to these patients.


Bone mineral density Osteoporosis Osteopenia and prevalence 



The help of the BMD unit is gratefully acknowledged. The cooperation of the subjects who took part in the study is greatly appreciated. The author would like to thank the Farzan Institute for Research and Technology for technical assistance.




  1. 1.
    Watts NB, Harris ST, Genant HK et al (1990) Intermittent cyclical etidronate therapy of postmenopausal osteoporosis. N Engl J Med 323:73–79PubMedGoogle Scholar
  2. 2.
    Liberman UA, Weiss SR, Broll J et al (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Eng J Med 333:1437–1443CrossRefGoogle Scholar
  3. 3.
    Stevenson J, Cust MP, Gangar KF et al (1990) Effect of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in post-menopausal women. Lancet 335:265–269CrossRefGoogle Scholar
  4. 4.
    Evans SF, Davie MWJ (1996) Low and conventional dose transdermal oestradiol are equally effective at preventing bone loss in spine and femur at all postmenopausal ages. Clin Endocrinol 44:79–84CrossRefGoogle Scholar
  5. 5.
    Maalouf G, Gannagé-Yared MH, Ezzedine J et al (2007) Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact 7:131–143PubMedGoogle Scholar
  6. 6.
    Sandrick K (1998) DXA remains gold standard for assessing spine and femoral head. Diagn Imaging (Suppl Bone Mass):8–11Google Scholar
  7. 7.
    Mulder JE, Michaeli D, Flaster ER et al (2000) Comparison of bone mineral density of the phalanges, lumbar spine, hip, and forearm for the assessment of osteoporosis in postmenopausal women. J Clin Densitom 3:373–381PubMedCrossRefGoogle Scholar
  8. 8.
    Abrahamsen B, Stilgren LS, Hermann AP et al (2001) Discordance between changes in bone mineral density measured at different skeletal sites in perimenopausal women—implications for assessment of bone loss and response to therapy: the Danish Osteoporosis Prevention Study. J Bone Miner Res 16:1212–1219PubMedCrossRefGoogle Scholar
  9. 9.
    Hans D, Rizzoli R, Thiebaud D et al (2001) Reference data in a Swiss population. Discordance in patient classification using T-scores among calcaneum, spine, and femur. J Clin Densitom 4:291–298PubMedCrossRefGoogle Scholar
  10. 10.
    O’Gradaigh D, Debiram I, Love S et al (2003) A prospective study of discordance in diagnosis of osteoporosis using spine and proximal femur bone densitometry. Osteoporos Int 14:13–18PubMedCrossRefGoogle Scholar
  11. 11.
    Moayyeri A, Soltani A, Khaleghnejad Tabari N et al (2005) Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. BMC Endocr Disord 5:3PubMedCrossRefGoogle Scholar
  12. 12.
    Mallmin H, Ljunghall J (1994) Distal radius fracture is an early sign of general osteoporosis: Bone mass measurements in a population-based study. Osteoporos Int 4:357–361PubMedCrossRefGoogle Scholar
  13. 13.
    Larijani B, Bonjour JP, Aghai Meybodi HR et al (2007) Osteoporosis in Iran, overview and management. Iranian J Publ Health Suppl Osteoporosis:1–13Google Scholar
  14. 14.
    Larijani B, Hossein-Nezhad A, Mojtahedi A et al (2005) Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC Musculoskel Dis 6:38CrossRefGoogle Scholar
  15. 15.
    World Health Organization Study Group (1994) Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. Geneva, Switzerland: World Health Organization. WHO Technical Report Series No. 843Google Scholar
  16. 16.
    Akbarian M, Davatchi F, Salimzadeh A et al (2005) Bone mass density in normal Iranian population. APLAR J Rheumatol 8:177–183CrossRefGoogle Scholar
  17. 17.
    Looker AC, Bauer DC, Chesnut CH III et al (2000) Clinical use of biochemical markers of bone remodeling: current status and future directions. Osteoporos Int 11:467–480PubMedCrossRefGoogle Scholar
  18. 18.
    Hashemipour S, Larijani B, Adibi H, Javadi E, Sedaghat M, Pajouhi M et al (2004) Vit D deficiency and causative factors in the population of Tehran. BMC Public Health 4:38PubMedCrossRefGoogle Scholar
  19. 19.
    Abolhassani F, Mohammadi M, Soltani A (2004) Burden of osteoporosis in Iran. Iranian J Publ Health Suppl Osteoporosis:18–28Google Scholar
  20. 20.
    Jones G, Nguyen T, Sambrook PN et al (1995) A longitudinal study of the effect of spinal degenerative disease on bone density in the elderly. J Rheumatol 22:932–936PubMedGoogle Scholar
  21. 21.
    Kro¨ger H, Lunt M, Reeve J et al (1999) Bone density reduction in various measurement sites in men and women with osteoporotic fractures of spine and hip: the European Quantitation of Osteoporosis Study. Calcif Tissue Int 64:191–199CrossRefGoogle Scholar
  22. 22.
    Abrahamsen B, Hansen TB, Jensen LB et al (1997) Site of osteodensitometry in perimenopausal women: correlation and limits of agreement between anatomic regions. J Bone Miner Res 12:1471–1479PubMedCrossRefGoogle Scholar
  23. 23.
    Woodson G (2000) Dual X-ray absorptiometry T-score concordance and discordance between the hip and spine measurement sites. J Clin Densitom 3:319–324PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2008

Authors and Affiliations

  • Iraj Salehi
    • 1
    Email author
  • Shabnam Khazaeli
    • 2
  • Seyed Reza Najafizadeh
    • 3
  • Haleh Ashraf
    • 4
  • Mahdi Malekpour
    • 4
  1. 1.Rheumatology Research Center, Amir Álam HospitalTehran University of Medical SciencesTehranIran
  2. 2.General PractitionerPrivate SectorTehranIran
  3. 3.Rheumatology Research Center, Imam Khomeini HospitalTehran University of Medical SciencesTehranIran
  4. 4.Tehran University of Medical SciencesTehranIran

Personalised recommendations