Archives of Osteoporosis

, 13:129 | Cite as

Prevalence of osteoporosis with the World Health Organization diagnostic criteria in the Eastern Mediterranean Region: a systematic review and meta-analysis

  • Mohammad Zamani
  • Vahid Zamani
  • Behzad Heidari
  • Hadi Parsian
  • Seyed Mokhtar Esmaeilnejad-GanjiEmail author
Review Article



A systematic review and meta-analysis was conducted on the prevalence of osteoporosis in the Eastern Mediterranean Region. The overall pooled prevalence of osteoporosis was 24.4%. The prevalence has increased significantly over the recent years. The highest pooled prevalence was in Saudi Arabia (32.7%), and the lowest was in Kuwait (15.1%).


To conduct a systematic review and meta-analysis on the prevalence of osteoporosis in the Eastern Mediterranean Region (EMR), as defined by the World Health Organization.


We included all observational studies reporting the prevalence of osteoporosis among general population. We searched literatures from the databases of PubMed, Scopus, Web of Science, and Index Medicus for the EMR published between January 2000 and December 2017 with no restriction of language. Two reviewers independently contributed in study selection and data extraction. STATA software was used for analyzing the collected data.


A total of 1692 citations were retrieved. After excluding the irrelevant articles, 36 eligible studies were included. The overall pooled prevalence rate of osteoporosis in the EMR on 31,593 participants was 24.4% (95% confidence interval [CI], 20.4–28.4). Based on femoral densitometry, the prevalence of osteoporosis was 16.8% (95% CI, 9.5–24.2), and based on spinal densitometry, it was 24.3% (95% CI, 19.4–29.2). The pooled prevalence in males was 20.5% (95% CI, 10.5–30.5), compared with 24.4% (95% CI, 20.2–28.6) in females. The prevalence rate was significantly higher in 2007–2015 (32.7%; 95% CI, 25.1–40.3) than in 2000–2006 (19.8%; 95% CI, 12.5–27).


Our findings indicate a considerable prevalence of osteoporosis among the people of the EMR. The prevalence has increased during recent years, showing that osteoporosis is becoming a critical health problem in this region. Prevention and control measures need to be implemented by health service authorities.


Osteoporosis Bone density Prevalence Systematic review 



We are thankful to Prof. Nicola M. Lowe, Prof. Fadoua Allali, Dr. Ambreen Kazi Kamran, Dr. Naim Maalouf, Dr. Jamal Al Saleh, Dr. Sireen Shilbayeh, and Mr. Mohsen Karamati for answering our queries about their studies.

Funding information

We thank the Vice Chancellor for Research and Technology of Babol University of Medical Sciences for the support on our study.

Compliance with ethical standards

Conflicts of interest


Supplementary material

11657_2018_540_MOESM1_ESM.doc (73 kb)
Supplementary Table 1 (DOC 73 kb)
11657_2018_540_MOESM2_ESM.doc (264 kb)
Supplementary Table 2 (DOC 263 kb)
11657_2018_540_MOESM3_ESM.doc (50 kb)
Supplementary Table 3 (DOC 50 kb)
11657_2018_540_MOESM4_ESM.doc (52 kb)
Supplementary Table 4 (DOC 52 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Mohammad Zamani
    • 1
    • 2
  • Vahid Zamani
    • 3
  • Behzad Heidari
    • 4
    • 5
  • Hadi Parsian
    • 6
  • Seyed Mokhtar Esmaeilnejad-Ganji
    • 7
    • 8
    Email author
  1. 1.Student Research Committee, School of MedicineBabol University of Medical SciencesBabolIran
  2. 2.Cancer Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  3. 3.Vice-Chancellery for HealthBabol University of Medical SciencesBabolIran
  4. 4.Mobility Impairment Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  5. 5.Clinical Research Development Unit of Rouhani HospitalBabol University of Medical SciencesBabolIran
  6. 6.Social Determinant of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  7. 7.Department of Orthopedics, Shahid Beheshti HospitalBabol University of Medical SciencesBabolIran
  8. 8.Clinical Research Development Center, Shahid Beheshti HospitalBabol University of Medical SciencesBabolIran

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