POS1342 GLOBAL PATTERN, TREND, AND CROSS-COUNTRY INEQUALITY OF LOW BONE MINERAL DENSITY FROM 1990 TO 2021:FINDINGS FROM THE GLOBAL BURDEN OF DISEASE STUDY 2021

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Background: Low bone mineral density (LBMD) is widely recognized as a major risk factor for fractures [1, 2]. It arises from a decrease in bone mass driven by increased bone resorption, reduced bone formation, or both [3]. Women face a greater risk of fracture, with estimates indicating that one in three women and one in five men over the age of fifty worldwide will experience an osteoporotic fracture [4]. Objectives: To assess the patterns, trends, and cross-country inequalities in LBMD from 1990 to 2021. Methods: Using data from the Global Burden of Disease (GBD) 2021, we compiled detailed information on the summary exposure value (SEV) for LBMD, as well as the age-standardized rates (ASR) of deaths and disability-adjusted life years (DALYs) attributable to LBMD. Temporal trends were evaluated using the average annual percentage change (AAPC). We also integrated the Socio-Demographic Index (SDI) with the inequality slope index and concentration index to assess health inequalities in the burden of LBMD. Results: Globally, the age-standardized SEV rate was 23.51 on a 0-100 scale in 2019, decreased with an AAPC of −0.16 (95% CI −0.17 to −0.15) from 1990. The age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) were 5.56 (95% UI 4.71–6.40), and 204.99 (95% UI 168.92–242.95) per 100,000 persons, decreased with an AAPC of −0.28 (95% CI −0.32 to −0.25), and −0.51 (95% CI −0.52 to −0.50) from 1990, respectively. Gender comparisons revealed that SEV values were higher among women than men (28.56 vs 18.08). However, the ASMR (6.45 vs 4.99) and ASDR (211.01 vs 196.37) were higher in males compared to females, as well as the decreasing trend was more pronounced in male compared to females (ASMR: -0.33 vs -0.28; ASDR: -0.56 vs -0.43). The inequality slope indices demonstrated increases in both mortality and DALYs rate gaps between the highest and lowest SDI countries, from -6.00 (95% CI: -7.14 to -6.48) to -6.15 (95% CI: -7.12 to -5.19) for mortality, and from -26.31 (95% CI: -59.10 to 6.48) to -53.34 (95% CI: -76.88 to -29.80) for DALYs between 1990 and 2021. The concentration indices remain relatively stable from -0.19 (95% CI: -0.22 to -0.16) to -0.19 (95% CI: -0.22 to -0.16) for mortality, and from -0.04 (95% CI: -0.07 to -0.02) to -0.06 (95% CI: -0.09 to -0.04) for DALYs over the past three decades(1990-2021) (Figure 1). Conclusion: The global burden attributable to LBMD has been observed to decrease over the past three decades. Therefore, gender-age-SDI specific strategy should be performed to decrease the incident LBMD in females and LBMD attributable disease burden and mortality in males. REFERENCES: [1] Ian R Reid et al, Osteopenia: a key target for fracture prevention, Lancet Diabetes Endocrinol. 2024 Nov;12(11):856-864. [2] Juliet E Compston et al, Osteoporosis,Lancet. 2019 Jan 26;393(10169):364-376. [3] Ian R Reid et al, Drug therapy for osteoporosis in older adults, Lancet. 2022 Mar 12;399(10329):1080-1092. [4] Roger A Lobo et, Management of menopause: a view towards prevention,Lancet Diabetes Endocrinol. 2022 Jun;10(6):457-470. Figure 1Health inequality regression curve and concentration curve of incidence for low bone mineral density Acknowledgements: We thank the staff at the Institute for Health Metrics and Evaluation and its collaborators who prepared these publicly available data. Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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