Burden, trends and projections of low bone mineral density in premenopausal/postmenopausal women

Low bone mineral density (LBMD) significantly contributes to global morbidity and mortality, especially in postmenopausal women. However, its burden in premenopausal women remains underrecognized. This study evaluated the global burden, temporal trends and future projections of LBMD-related outcomes. Data were obtained from the Global Burden of Disease 2021 dataset covering 204 countries. Premenopausal and postmenopausal women from 1990 to 2021 were included. Incidence, mortality and disability-adjusted life years (DALYs) were extracted, and age-standardized rates were calculated. The study explored demographic and epidemiologic changes, applied inequality indices and employed a Bayesian Markov chain Monte Carlo model to forecast trends through 2035. Between 1990 and 2021, LBMD-related mortality rose by 27.39% (95% uncertainty interval [UI] 16.83–39.69) among premenopausal women and 138.73% (95% UI 98.45–186.25) among postmenopausal women. In 2021, the postmenopausal age-standardized rate (27.92 per 100,000) was 63.5 times higher than that of premenopausal women (0.44 per 100,000). By 2035, although rates may decline, overall deaths and DALYs will likely increase due to population growth and aging. Despite decreasing standardized rates, the absolute burden of LBMD continues to grow. Early screening and targeted prevention, especially for postmenopausal and underrecognized premenopausal women, is crucial to lessen its global impact.