An epidemiological analysis of the incidence of osteoporosis and osteoporosis-related fractures among the Saudi Arabian population

Osteoporosis is common in Saudi Arabia and the burden of management in an aging population will increase in coming decades. There is still no national policy nor consensus on screening for this silent disease. The objective of this analysis was to determine from the published data the prevalence of osteopenia and osteoporosis in Saudi Arabians, the prevalence of secondary osteoporosis, and the prevalence of osteoporosis-related fractures [ORF]. We also sought to determine the best age to begin and best modality for screening. Data Sources were MEDLINE [1966 to May 2011], EMBASE [1991 to May 2011], the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews [1952 to May 2011], and the Science Citation Index [1966 to May 2011], published data from the Saudi Medical Journal [1985-2011] and Annals of Saudi Medicine [1985-2011]. We selected English-language articles with at least 100 Saudi individuals. Two authors independently reviewed articles and abstracted data. The authors identified 36 potentially relevant articles, of which 24 met the inclusion criteria. Of 5160 healthy women 50 to 79 years of age [mean, SD: 56.8 [2.7]], 36.6% [6.6%] were osteopenic and 34.0% [8.5%] were osteoporotic. In three studies on males [n=822], the prevalence of osteopenia was 46.3% and osteoporosis 30.7%. Males had a significantly higher frequency of osteopenia in comparison to females [P= < .001 95% CI < -0.0333], The mean age of the patients with secondary osteoporosis was 37.4 [13.5, 18-57] years, with the osteoporosis in 46.4% and osteopenia in 34.1%. In 5 studies of ORF, the incidence of vertebral fractures was between 20%-24%.The currently available literature on Saudi Arabian population suggests that the ideal age for screening for low bone mass among the Saudi population should be earlier [55 years] than the >=65 years in Western countries. Both quatitative ultrasound and dual-energy x-ray absorptiometry could be used for screening. The relatively small number of studies on Saudi Arabians and the different machines used for diagnosis limited the authors ability make conclusions with surety.

Bone mass measurement using quantitative ultrasound in healthy Saudi women. A cross-sectional screening

To study the prevalence of osteopenia and osteoporosis in healthy Saudi women, a community-based screening was carried out. Three thousand and two hundred sixty-nine women in the young women in peak bone mass [PBM] age group and 3131 in the postmenopausal age [PMA] group were screened using Achilles Insight [GE, USA]. Subjects included in the study were healthy and residents of eastern province. The screening was conducted between January 2006 and December 2007. The study took place in King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia. In the PBM age group, 2090 [63.9%] were normal, 791 [24.2%] were osteopenic and 388 [11.9%] were osteoporotic. Osteopenia was more common in single urban women compared to those who were married and living in rural areas [p<0.01 and p<0.001]. Women with college education had significantly normal bone mass than women with less than high school education [p<0.01]. In the PMA, 948 [30.3%] were osteopenic and 720 [23%] were osteoporotic. Osteopenic was more common in women in urban areas as compared to industrial and the rural areas [p<0.01]. Those women whose education was less than primary had significantly more osteoporosis when compared to women with college education [p<0.001]. In the PBM, 11.9% were osteoporotic and in PMA group 23% were osteoporotic. Factors that influenced the risk for osteopenia and osteoporosis included level of education, number of children, and place of living

Bone mineral density among postmenopausal Saudi women

Osteoporosis is reported to be common among postmenopausal Saudi women. The reported incidence varies between 50-60%. Different machines were used to reach these conclusions. At present it is believed that dual energy x-ray absorptiometry [DEXA] is the most accurate method to diagnose osteoporosis. This study was conducted to measure bone mineral density [BMD] measurement of lumbar spine and the upper femur of Saudi postmenopausal women attending orthopedic clinic with unrelated complaints. This study comprises of 256 patients attending orthopedic clinics at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia between January 2002 and June 2003. The data gathered was age, duration of menopause, height and weight for body mass index [BMI] calculation. Women with secondary osteoporosis were excluded from the study. Patients' orthopedic complaints were also recorded in the database. Bone mineral density measurements were carried out using Hologic total body DEXA machine. The data were analyzed using SPSS package. The data of 256 patients was available for analysis. The average age of patients screened was 57.62 years [49-76] SD +/- 6.71. The BMI was 21.3-42.9 Kg/m2 [SD +/- 5.34]. The BMD of the lumbar spine was 0.785 gm/cm2 [0.527-1.023] SD +/- 0.142 and that of the hip region was 0.764 gm/cm2 [0. 500-1.069] SD +/- 0.149. As per the WHO classification 59 women [23%] were classified as normal with T score of -0.82, 78 [30.5%] as osteopenic with T score -2.5 and 119 [46.7%] as osteoporosis with T score -3.58. When the BMD of the hip was analyzed 62 [24.2%] were normal T score -1.0, 81 [31.6%] as osteopenic, T score -2.5 and 113 [44.1%] as osteoporotic, with a T score of -3.1. On the basis of analysis of the lumbar spine 190 [74.2%] had increased risk of fracture as compared to the analysis of hip 59% were at increased risk of fracture. Our results indicate that postmenopausal Saudi women suffer from osteoporosis and osteopenia higher than those from other parts of the country. Necessary steps are needed so as to avoid osteoporosis and its complications which could end up in epidemic proportions