{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:50:44Z","timestamp":1792011044791,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Osteopenia and osteoporosis present a significant global public health challenge. This study analyses the global, regional, and national burden of disease attributable to low bone mineral density, including both osteopenia and osteoporosis, across 204 countries and territories from 1990 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were used to quantify deaths and disability\u2010adjusted life years (DALYs) linked to osteopenia and osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, osteopenia and osteoporosis were responsible for 459,661 deaths and 17.3 million DALYs globally, with population attributable fractions of 0.7% and 0.6%, respectively. The global age\u2010standardized death rate was 5.7 per 100,000, while the age\u2010standardized DALY rate was 205 per 100,000, reflecting declines of 9.4% and 14.8%, respectively, from 1990 to 2021. The highest age\u2010standardized DALY rates were seen in Saudi Arabia and India, while the lowest were in Azerbaijan and Jamaica. Significant increases in DALY rates were noted in Lesotho and the Netherlands, whereas the largest decreases occurred in Hungary and Taiwan. DALY rates for osteopenia and osteoporosis were highest in the 95+ age group for both sexes, with females generally experiencing higher rates, particularly in older age groups. The main contributing causes varied by age, with falls being the leading cause in the 80\u201384 age group, road injuries in the 40\u201344 age group, and exposure to mechanical forces in the 50\u201354 age group. A negative correlation was observed between regional socio\u2010demographic index and age\u2010standardized DALY rates from 1990 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Addressing the global burden of osteopenia and osteoporosis requires targeted interventions, further research, and efforts to reduce regional disparities and improve healthcare access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71378","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:40:47Z","timestamp":1761198047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Global Health Effects of Osteopenia and Osteoporosis, 1990\u20132021"],"prefix":"10.1002","volume":"8","author":[{"given":"Saeid","family":"Safiri","sequence":"first","affiliation":[{"name":"Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran"},{"name":"Department of Genetics and Bioengineering Yeditepe University \u0130stanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Amiri","sequence":"additional","affiliation":[{"name":"Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Karamzad","sequence":"additional","affiliation":[{"name":"Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J. M.","family":"Sullman","sequence":"additional","affiliation":[{"name":"Department of Life and Health Sciences University of Nicosia Nicosia Cyprus"},{"name":"Department of Social Sciences University of Nicosia Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0024-1934","authenticated-orcid":false,"given":"Mohammad","family":"Rahmanian","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Student Research Committee, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Aletaha","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Mansournia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2772-2316","authenticated-orcid":false,"given":"Gary S.","family":"Collins","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre University of Oxford Oxford UK"},{"name":"NIHR Oxford Biomedical Research Centre Oxford University Hospitals NHS Foundation Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikrettin","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Genetics and Bioengineering Yeditepe University \u0130stanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali\u2010Asghar","family":"Kolahi","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1365.035"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.047"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1602599"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01622200"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-018-4704-5"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1565-2"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24146"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(99)70058-2"},{"issue":"7","key":"e_1_2_15_10_1","first-page":"1521","article-title":"Osteoporosis in Men","volume":"67","author":"Campion J. 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