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Title: Osteoporotic hip and vertebral fractures in the Arab region: a systematic review
Authors: Barake, M
El Eid, R
Ajjour, S
Chakhtoura, M
Meho, L
Mahmoud, Tala
Atieh, J
Sibai, A M
El-Hajj Fuleihan, G
Affiliations: Faculty of Medicine 
Keywords: Epidemiology
Fracture prediction
Osteoporotic fracture
Issue Date: 2021
Publisher: Springer
Part of: Osteoporosis international
Volume: 32
Issue: 8
Start page: 1499
End page: 1515
Asia is projected to account for the largest proportion of the rising burden of osteoporotic fractures worldwide. Data from the Middle East is scarce. We performed a systematic review on the epidemiology of vertebral and hip osteoporotic fractures in 22 Arab League countries, using Scopus, PubMed, and Embase. We identified 67 relevant publications, 28 on hip and 39 on vertebral fractures. The mean age of patients was 70-74 years, female to male ratio 1.2:2.1. Age-standardized incidence rates, to the UN 2010 population, were 236 to 290/100,000 for women from Kuwait and Lebanon, lower in Morocco. Risk factors for hip fractures included lower BMD or BMI, taller stature, anxiolytics, and sleeping pills. Most patients were not tested nor treated. Mortality derived from retrospective studies ranged between 10 and 20% at 1 year, and between 25 and 30% at 2-3 years. Among 39 studies on vertebral fractures, 18 described prevalence of morphometric fractures. Excluding grade 1 fractures, 13.3-20.2% of women, mean age 58-74 years, had prevalent vertebral fractures, as did 10-14% of men, mean age 62-74 years. Risk factors included age, gender, smoking, multiparity, years since menopause, low BMD, bone markers, high sclerostin, low IgF1, hypovitaminosis D, abdominal aortic calcification score, and VDR polymorphisms. Vertebral fracture incidence in women from Saudi Arabia, mean age 61, was 6.2% at 5 years, including grade 1 fractures. Prospective population-based fracture registries, prevalence studies, predictive models, fracture outcomes, and fracture liaison services from Arab countries are still lacking today. They are the pillars to closing the care gap of this morbid disease.
ISSN: 0937941X
DOI: 10.1007/s00198-021-05937-z
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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