Sànchez Riera, LídiaCarnahan, E.Vos, TheoVeerman, L.Norman, R.Lim, S. S.Hoy, D.Smith, E.Wilson, N.Nolla Solé, Joan MiquelChen, J. S.Macara, M.Kamalaraj, N.Li, Y.Kok, C.Santos-Hernández, C.March, Lyn2017-06-192017-06-192014-090003-4967https://hdl.handle.net/2445/112522Introduction: The Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls. Objectives: To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD. Methods: A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age- and sex-specific mean ± SD BMD values (g/cm2) were extracted from eligible studies. Comparative risk assessment methodology was used to calculate PAFs of BMD for fractures. The theoretical minimum risk exposure distribution was estimated as the age- and sex-specific 90th centile from the Third National Health and Nutrition Examination Survey (NHANES III). Relative risks of fractures were obtained from a previous meta-analysis. Hospital data were used to calculate the fraction of the health burden of falls that was due to fractures. Results: Global deaths and DALYs attributable to low BMD increased from 103 000 and 3 125 000 in 1990 to 188 000 and 5 216 000 in 2010, respectively. The percentage of low BMD in the total global burden almost doubled from 1990 (0.12%) to 2010 (0.21%). Around one-third of falls-related deaths were attributable to low BMD. Conclusions: Low BMD is responsible for a growing global health burden, only partially representative of the real burden of osteoporosis.11 p.application/pdfeng(c) BMJ Publishing Group, 2014OsteoporosiMalalties dels ossosDensitometria òssiaSalut públicaFracturesRessenyes sistemàtiques (Investigació mèdica)OsteoporosisBone diseasesBone densitometryPublic healthFracturesSystematic reviews (Medical research)info:eu-repo/semantics/article6397102017-06-19info:eu-repo/semantics/openAccess24692584