The global, regional, and national burden attributable to low bone mineral density, 1990–2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021

Hsieh E. Bryazka D. Ong K.L. Rhinehart P.-A. Cousin E. Hagins H. Cooper C. Cross M. Culbreth G.T. Dreinhoefer K.E. Halbout P. Kopec J.A. Nicholson S.I. Prieto Alhambra D. Woolf A.D. Vos T. Abate Y.H. Abd-Elsalam S. Abdoun M. Abouzid M. Abu-Gharbieh E. Aburuz S. Adepoju A.V. Adnani Q.E.S. Ahmad A. Ahmed H. Ahmed L.A. Al Hasan S.M. Alalwan T.A. Al-amer R.M. Alemi H. Ali A. Al-Worafi Y.M. Amani R. Anil A. Arabloo J. Aravkin A.Y. Areda D. Aregawi B.B. Asghari-Jafarabadi M. Athari S.S. Azadnajafabad S. Azzam A.Y. Badiye A.D. Bagheri N. Bagherieh S. Balogun S.A. Banach M. Barati S. Bhardwaj P. Bhaskar S. Bhatti G.K. Bustanji Y. Calina D. Chattu V.K. Chekol Abebe E. Chu D.-T. Criqui M.H. Cruz-Martins N. Dadras O. Dai X. Dai Z. Darvishi Cheshmeh Soltani R. Dashti M. Dejenie T.A. Del Bo C. Denova-Gutiérrez E. Devanbu V.G.C. Dewan S.M.R. Dhulipala V.R. Ekholuenetale M. Elmonem M.A. Etaee F. Fagbamigbe A.F. Fakhradiyev I.R. Fatehizadeh A. Feizkhah A. Fekadu G. Feyisa B.R. Fischer F. Gaipov A. Galluzzo L. Gebrehiwot M. Ghadirian F. Gill T.K. Gohari K. Golchin A. Gupta B. Gupta S. Hadi N.R. Haj-Mirzaian A. Hanif A. Harlianto N.I. Hasan I. Hasnain M.S. Hassan A. Hay S.I. He J. Heidari G. Hezam K. Hiraike Y. Hoogar P. Hu C. Ibitoye S.E. Iranmehr A. Ismail N.E. Iwagami M. Jafari-Khounigh A. Jakovljevic M. Jamshidi E. Jayapal S.K. Jayaram S. Jemere D.M. Jeong G.H. Joseph N. Joshua C.E. Jürisson M. Kadashetti V. Kalra S. Khafaie M.A. Khajuria H. Khan M.A.B. Khanali J. Khanmohammadi S. Khatatbeh M.M. Khateri S. Kim M.S. Korzh O. Krishan K. Kulimbet M. Kulkarni V. Kurniasari M.D. Lahariya C. Laksono T. Landires I. Latief K. Le T.T.T. Lee M. Lee W.-C. Llanaj E. Malhotra K. Malik A.A. Martorell M. Maugeri A. Meles H.N. Merati M. Meretoja T.J. Mestrovic T. Mirahmadi A. Mohamed N.S. Mohammadian-Hafshejani A. Mokdad A.H. Monasta L. Moradi Y. Morovatdar N. Morrison S.D. Mostafavi E. Mousavi P. Mubarik S. Murray C.J.L. Muthu S. Naghavi M. Naghavi P. Natto Z.S. Nayak B.P. Nematollahi M.H. Nguyen D.H. Nguyen H.Q. Nguyen V.T. Niazi R.K. Noman E.A. Nurrika D. Okonji O.C. Ordak M. Osman W.M.S. Ostadi Y. Padron-Monedero A. Pardhan S. Parija P.P. Parikh R.R. Patel J. Petermann-Rocha F.E. Pham H.T. Prates E.J.S. Qattea I. Rahimi M. Rahimi-Movaghar V. Rahman M. Rahmati M. Raimondo I. Ramasamy S.K. Rashedi S. Rashidi M.-M. Rawaf S. Redwan E.M. Rezaei N. Saad A.M.A. Saeed U. Saghazadeh A. Saheb Sharif-Askari F. Sahebkar A. Saki M. Sakshaug J.W. Saleh M.A. Samodra Y.L. Samy A.M. Sanmarchi F. Saqib M.A.N. Schuermans A. Sethi Y. Seylani A. Shahwan M.J. Sham S. Shannawaz M. Sharfaei S. Sharma M. Shorofi S.A. Siddig E.E. Silva L.M.L.R. Singh J.A. Singh P. Soleimani H. Swain C.K. Tabatabai S. Tamuzi J.L. Tavakoli Oliaee R. Tavangar S.M. Teramoto M. Terefa D.R. Ticoalu J.H.V. Vaithinathan A.G. Vasankari T.J. Vaziri S. Wang F. Wang S. Xia J. Yonemoto N. Yu C. Zahir M. Zhao H. Zielińska M. Zitoun O.A. March L.M. Sanchez-Riera L.
December 2025 Elsevier Ltd

The Lancet Rheumatology
2025 #7 Issue 12 e873 - e894 pp.

Background Fractures related to osteoporosis and low bone mineral density lead to substantial morbidity, mortality, and cost to individuals and health systems. Here we present the most up-to-date global, regional, and national estimates of the contribution of low bone mineral density to the burden of fractures from falls and additional categories of injuries from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Methods The burden of low bone mineral density was estimated from 1990 to 2020 in terms of years lived with disability (YLDs), disability-adjusted life years (DALYs), and deaths, for individuals aged 40 years and older, using data from population-based studies from 48 countries or territories (169 unique sources). Mean standardised femoral neck bone mineral density values were estimated by GBD location, age, and sex by meta-regression. Based on a separate meta-analysis of population-based studies from nine countries (12 unique sources), we also estimated the pooled relative risk of fractures per unit decrease in bone mineral density (g/cm²). The population-attributable fraction for low bone mineral density was calculated by comparing the observed distributions of standardised femoral neck bone mineral density to an age-specific and sex-specific counterfactual distribution, defined as the 99th percentile of five rounds of the National Health and Nutrition Examination Survey in the USA, by 5-year age group and sex. Hospital and emergency department data were used to derive the incidence of fractures for six categories of injury (road injuries, other transport injuries, falls, non-venomous animal contact, exposure to mechanical forces, and physical interpersonal violence) using ICD codes. Deaths due to fractures were estimated as the proportion of in-hospital deaths due to the specified injury causes for which a fracture (nature of injury code) was more severe than the cause of injury code. YLDs and DALYs attributable to low bone mineral density by cause of injury were also determined according to previous GBD methods. Findings In 2020, 8·32 million (95% UI 5·58–10·84) YLDs, 17·2 million (14·1–20·2) DALYs, and 477 000 (411 000–536 000) deaths were attributable to low bone mineral density globally in individuals aged 40 years and older. Between 1990 and 2020, global YLDs, DALYs, and deaths attributable to low bone mineral density increased by 91·8% (88·5–95·1), 89·8% (81·5–99·0), and 127·1% (108·5–144·5), respectively. Over this period, the age-standardised global rates of YLDs, DALYs, and deaths attributable to low bone mineral density showed modest decreases. In 2020, falls accounted for 76·2% (95% UI 74·2–78·3) of YLDs, 65·2% (62·9–67·6) of DALYs, and 71·0% (67·4–72·8) of deaths attributable to low bone mineral density, and road injuries largely accounted for the remaining amount: 12·4% (11·1–13·6) of YLDs, 24·6% (22·5–27·1) of DALYs, and 23·1% (21·6–26·2) of deaths. As a proportion of all fall-related burden, low bone mineral density accounted for 26·6% (23·2–28·7) of YLDs, 25·6% (22·1–27·4) of DALYs, and 40·6% (35·4–44·0) of deaths in 2020. Of all road injury-related burden, 12·6% (10·8–13·5) of YLDs, 6·3% (5·4–6·9) of DALYs, and 8·9% (7·6–9·6) of deaths were attributable to low bone mineral density. In men, road injuries accounted for the largest proportion of DALYs attributable to low bone mineral density in those aged 40–59 years and the largest proportion of deaths in those aged 40–64 years. In women, road injuries were the leading cause of DALYs attributable to low bone mineral density in those aged 40–44 years and the leading cause of deaths attributable to low bone mineral density in those aged 40–54 years. In older age groups among both men and women, falls were the leading cause of the burden attributable to low bone mineral density. Interpretation Low bone mineral density is a crucial modifiable risk factor for fractures, which are an important cause of morbidity and mortality particularly in ageing populations. This analysis highlights low bone mineral density as a cause of health loss not just from falls, but also from road injuries. Funding Gates Foundation.

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Section of Rheumatology, Allergy and Immunology, Yale University, New Haven, CT, United States
Rheumatology Department, VA Connecticut Healthcare System, West Haven, CT, United States
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
Institute of Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
Global Alliance for Musculoskeletal Health, Sydney, NSW, Australia
Center of Musculoskeletal Surgery, Charité Universitätsmedizin Berlin (Charité University Medical Center Berlin), Berlin, Germany
IOF International Osteoporosis Foundation, Nyon, Switzerland
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Arthritis Research Canada, Richmond, BC, Canada
Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford University, Oxford, United Kingdom
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
Osteoporosis Research Group, Lund University, Malmo, Sweden
Global Alliance for Musculoskeletal Health, Truro, United Kingdom
Department of Clinical Governance and Quality Improvement, Aleta Wondo General Hospital, Aleta Wondo, Ethiopia
Department of Tropical Medicine and Infectious Diseases, Tanta University, Tanta, Egypt
Department of Medicine, University of Setif Algeria, Sétif, Algeria
Department of Health, Sétif, Algeria
Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland
Department of Clinical Sciences, University of Sharjah, Sharjah, United Arab Emirates
Department of Biopharmaceutics and Clinical Pharmacy, University of Jordan, Amman, Jordan
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Department of HIV and Infectious Diseases, Jhpiego, Abuja, Nigeria
Department of Adolescent Research and Care, Adolescent Friendly Research Initiative and Care, Ado Ekiti, Nigeria
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College of Medicine, Shaqra University, Shaqra, Saudi Arabia
Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan
Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO, United States
Department of Biology, University of Bahrain, Zallaq, Bahrain
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School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia
Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
Department of Medical Sciences, Azal University for Human Development, Sanaa, Yemen
Department of Clinical Sciences, University of Science and Technology of Fujairah, Fujairah, United Arab Emirates
Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA, United States
Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
All India Institute of Medical Sciences, Bhubaneswar, India
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College of Art and Science, Ottawa University, Surprise, AZ, United States
School of Life Sciences, Arizona State University, Tempe, AZ, United States
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Cabrini Research, Cabrini Health, Malvern, VIC, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran
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Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
ASIDE Healthcare, Lewes, DE, United States
Faculty of Medicine, October 6 University, 6th of October City, Egypt
Department of Forensic Science, Government Institute of Forensic Science Nagpur, Nagpur, India
Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, India
Health Research Institute, University of Canberra, Canberra, ACT, Australia
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Polish Mothers Memorial Hospital Research Institute, Lodz, Poland
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Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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The Interdisciplinary Research Group on Biomedicine and Health, VNU International School (VNUIS), Hanoi, Viet Nam
Faculty of Applied Sciences, VNU International School (VNUIS), Hanoi, Viet Nam
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States
Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
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Research Center for Child Psychiatry, University of Turku, Turku, Finland
Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
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Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
Chettinad Hospital & Research Institute, Chettinad Academy of Research and Education, Chennai, India
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Pharmacology Division, Center for Life Sciences Research Bangladesh, Dhaka, Bangladesh
University of South Carolina, Columbia, SC, United States
Faculty of Science and Health, University of Portsmouth, Hampshire, United Kingdom
Department of Clinical and Chemical Pathology, Cairo University, Cairo, Egypt
Department of Internal Medicine, Yale University, New Haven, CT, United States
Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
Research Centre for Healthcare and Community, Coventry University, Coventry, United Kingdom
Director of the Scientific and Technological Park, Kazakh National Medical University, Almaty, Kazakhstan
Department of Medicine, Korea University, Seoul, South Korea
School of Engineering, Edith Cowan University, Joondalup, WA, Australia
Department of Social Medicine and Epidemiology, Guilan University of Medical Sciences, Rasht, Iran
Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, China
Department of Pharmacy, Wollega University, Nekemte, Ethiopia
Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
Jimma University, Jimma, Ethiopia
Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
Department of Medicine, Nazarbayev University, Astana, Kazakhstan
Department of Cardiovascular, Endocrine-metabolic Diseases, and Aging, ISS - Italian National Institute of Health, Rome, Italy
Department of Environmental Health, Wollo University, Dessie, Ethiopia
School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
Department of Biostatistics, Tarbiat Modares University, Tehran, Iran
Quantitative Department, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
Department of Applied Cell Sciences, Urmia University of Medical Sciences, Urmia, Iran
Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
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Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
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Department of Pharmacy, Marwadi University, Rajkot, India
Department of Neurology, Cairo University, Cairo, Egypt
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Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
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Malaysian Academy of Pharmacy, Puchong, Malaysia
Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
The World Academy of Sciences UNESCO, Trieste, Italy
Shaanxi University of Technology, Hanzhong, China
Johns Hopkins University, Baltimore, MD, United States
Centre of Studies and Research, Ministry of Health, Muscat, Oman
Department of Biochemistry, Government Medical College, Mysuru, India
Caring Futures Institute, Flinders University, Adelaide, SA, Australia
Geumsan Public Health Center, Geumsan-gun, South Korea
College of Medicine, Gyeongsang National University, Jinju, South Korea
Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
Department of Economics, National Open University, Benin City, Nigeria
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
Department of Oral and Maxillofacial Pathology, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
Department of Endocrinology, Bharti Hospital Karnal, Karnal, India
University Centre for Research and Development, Chandigarh University, Mohali, India
Department of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Environmental Technologies Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Amity Institute of Forensic Sciences, Amity University, Noida, India
Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
Primary Care Department, NHS North West London, London, United Kingdom
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Basic Medical Sciences, Yarmouk University, Irbid, Jordan
School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Broad Institute of MIT and Harvard, Cambridge, MA, United States
Massachusetts General Hospital, Boston, MA, United States
Department of General Practice and Family Medicine, Kharkiv National Medical University, Kharkiv, Ukraine
Department of Anthropology, Panjab University, Chandigarh, India
Research and Publication Activity Division, Kazakh National Medical University, Almaty, Kazakhstan
Center of Medicine and Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Medicine, Queensland Health, Brisbane, QLD, Australia
Faculty of Medicine and Health Science, Universitas Kristen Satya Wacana, Salatiga, Indonesia
School of Nursing, Taipei Medical University, Taipei, Taiwan
Division of Evidence Synthesis, Foundation for People-centric Health Systems, New Delhi, India
Division of Lifestyle Medicine, Centre for Health: The Specialty Practice, New Delhi, India
Department of Physiotherapy, Universitas Aisyiyah Yogyakarta, Yogyakarta, Indonesia
Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
Unidad de Genética y Salud Pública, Instituto de Ciencias Médicas, Las Tablas, Panama
Ministry of Health, Hospital Joaquín Pablo Franco Sayas, Las Tablas, Panama
Centre for Family Welfare, University of Indonesia, Depok, Indonesia
Department of Global Health and Health Security, Taipei Medical University, Taipei, Taiwan
University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
Department of Medical Science, Ajou University School of Medicine, Suwon, South Korea
Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, United States
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
German Center for Diabetes Research (DZD), München-Neuherberg, Germany
Rama Medical College Hospital and Research Centre, Uttar Pradesh, India
Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Nutrition and Dietetics, University of Concepción, Concepción, Chile
Centre for Healthy Living, University of Concepción, Concepción, Chile
Department of Medical and Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
Department of Medical Laboratory Sciences, Adigrat University, Adigrat, Ethiopia
Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
University of Helsinki, Helsinki, Finland
University Centre Varazdin, University North, Varazdin, Croatia
Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Molecular Biology Unit, Sirius Training and Research Centre, Khartoum, Sudan
Bio-Statistical and Molecular Biology Department, Sirius Training and Research Centre, Khartoum, Sudan
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Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
Clinical Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
Division of Plastic and Reconstructive Surgery, University of Washington Medical Center, Seattle, WA, United States
Department of Medicine, Stanford University, Palo Alto, CA, United States
Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, United States
Unit of Pharmacotherapy, Epidemiology and Economics, Rijksuniversiteit Groningen (University of Groningen), Groningen, Netherlands
Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
Department of Research Methods, Orthopaedic Research Group, Coimbatore, India
Department of Biotechnology, Karpagam Academy of Higher Education (Deemed to be University), Coimbatore, India
Department of Computer Science, University of Illinois, Urbana, IL, United States
Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Health Policy and Oral Epidemiology, Harvard University, Boston, MA, United States
Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
Cardiovascular Laboratory, Methodist Hospital, Merrillville, IN, United States
Department of Allergy, Immunology and Dermatology, Hanoi Medical University, Hanoi, Viet Nam
Cardiovascular Research Department, Methodist Hospital, Merrillville, IN, United States
Tuberculosis Group, Oxford University Clinical Research Unit, Vietnam, Ho Chi Minh City, Viet Nam
Department of General Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
International Islamic University Islamabad, Islamabad, Pakistan
School of Chemical & Biomolecular Engineering, University of Sydney, Sydney, NSW, Australia
Faculty of Applied Sciences, Taiz University, Taiz, Yemen
Department of Public Health, Banten School of Health Science, South Tangerang, Indonesia
Ministry of Research, Technology and Higher Education, Higher Education Service Institutions (LL-DIKTI) Region IV, Bandung, Indonesia
School of Pharmacy, University of the Western Cape, Cape Town, South Africa
Department of Pharmacotherapy and Pharmaceutical Care, Medical University of Warsaw, Warsaw, Poland
Department of Biology, Khalifa University, Abu Dhabi, United Arab Emirates
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
National School of Public Health, Institute of Health Carlos III, Madrid, Spain
Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
Department of Community Medicine, All India Institute of Medical Sciences, Jammu, India
Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States
Global Health Governance Programme, University of Edinburgh, Edinburgh, United Kingdom
School of Dentistry, University of Leeds, Leeds, United Kingdom
Facultad de Medicina (Faculty of Medicine), Universidad Diego Portales (Diego Portales University), Santiago, Chile
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, United States
Department of Maternal-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Neonatology, Case Western Reserve University, Akron, OH, United States
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille University, Marseille, France
Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
Department of Radiology, Stanford University, Stanford, CA, United States
Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
Academic Public Health England, Public Health England, London, United Kingdom
Department of Biological Sciences, King Abdulaziz University, Jeddah, Egypt
Department of Protein Research, Research and Academic Institution, Alexandria, Egypt
Cardiovascular Department, Zagazig University, Zagazig, Egypt
Operational Research Center in Healthcare, Near East University (NEU), Nicosia Cyprus, Turkey
International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan
Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
Sharjah Institute of Medical Sciences, University of Sharjah, Sharjah, United Arab Emirates
Center for Global Health Research, Saveetha University, Chennai, India
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Microbiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
LMU-Munich, Munich, Germany
Institute for Employment Research, Nuremberg, Germany
College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
Benang Merah Research Center (BMRC), Minahasa Utara, Indonesia
Department of Entomology, Ain Shams University, Cairo, Egypt
Medical Ain Shams Research Institute (MASRI), Ain Shams University, Cairo, Egypt
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Primary Healthcare Department, Azienda USL di Bologna, Bologna, Italy
Research Development Coordination Section, Pakistan Health Research Council, Islamabad, Pakistan
School of Sciences, University of Management and Technology, Lahore, Pakistan
Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
Department of Medicine, Swami Vivekanand Subharti University, Meerut, India
National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, United States
Center for Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
Department of Pathology and Laboratory Medicine, Northwell Health, New York, NY, United States
Amity Institute of Public Health, Amity University, Noida, India
Department of Safety Services, Baim Institute for Clinical Research, Boston, MA, United States
Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, United States
Department of Social and Behavioral Health, University of Nevada Las Vegas, Las Vegas, NV, United States
Department of Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran
Department of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
Unit of Basic Medical Sciences, University of Khartoum, Khartoum, Sudan
Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
Sport Physical Activity and Health Research & Innovation Center (SPRINT), Polytechnic Institute of Guarda, Guarda, Portugal
CICS-UBI Health Sciences Research Center, University of Beira Interior, Covilhã, Portugal
School of Medicine, Baylor College of Medicine, Houston, TX, United States
Department of Medicine Service, US Department of Veterans Affairs (VA), Houston, TX, United States
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
Department of Analytical and Applied Economics, Utkal University, Bhubaneswar, India
Department of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Epidemiology, Stellenbosch University, Cape Town, South Africa
Department of Medicine, Northlands Medical Group, Omuthiya, Namibia
Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
Outpatient Department, Wollega University, Bedele Town, Ethiopia
Department of Public Health, Wollega University, Nekemte, Ethiopia
Faculty of Public Health, Universitas Sam Ratulangi (Sam Ratulangi University), Manado, Indonesia
College of Health and Sport Sciences, University of Bahrain, Zallaq, Bahrain
UKK Institute, Tampere, Finland
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
Department of Infectious Disease, Kermanshah University of Medical Sciences, Kermanshah, Iran
School of Public Health, Xuzhou Medical University, Xuzhou, China
Department of Neurosurgery, Capital Medical University, Beijing, China
Department of Neurosurgery, Beijing Tiantan Hospital, Beijing, China
School of Public Health, Capital Medical University, Beijing, China
Department of Biostatistics, University of Toyama, Toyama, Japan
Department of Public Health, Juntendo University, Tokyo, Japan
Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
College of Traditional Chinese Medicine, Hebei University, Baoding, China
Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, Warsaw, Poland
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
College of Medicine, Sulaiman Alrajhi University, Al Bukairiyah, Saudi Arabia
Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia
Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, Australia

Section of Rheumatology
Rheumatology Department
Institute for Health Metrics and Evaluation
Department of Health Metrics Sciences
MRC Lifecourse Epidemiology Unit
Institute of Musculoskeletal Sciences
Faculty of Medicine and Health
Global Alliance for Musculoskeletal Health
Center of Musculoskeletal Surgery
IOF International Osteoporosis Foundation
School of Population and Public Health
Arthritis Research Canada
Nuffield Department of Orthopaedics
Department of Medical Informatics
Osteoporosis Research Group
Global Alliance for Musculoskeletal Health
Department of Clinical Governance and Quality Improvement
Department of Tropical Medicine and Infectious Diseases
Department of Medicine
Department of Health
Department of Physical Pharmacy and Pharmacokinetics
Department of Clinical Sciences
Department of Biopharmaceutics and Clinical Pharmacy
Department of Pharmacology and Therapeutics
College of Pharmacy
Department of HIV and Infectious Diseases
Department of Adolescent Research and Care
Department of Public Health
College of Medicine
Department of Biosciences
Institute of Public Health
Division of Public Health Sciences
Department of Biology
School of Nursing
School of Nursing and Midwifery
Hematology
Department of Zoology
Department of Medical Sciences
Department of Clinical Sciences
Interdisciplinary Graduate Program in Human Toxicology
Holden Comprehensive Cancer Center
Department of Pharmacology
All India Institute of Medical Sciences
Health Management and Economics Research Center
Department of Applied Mathematics
College of Art and Science
School of Life Sciences
College of Medicine and Health Sciences
Cabrini Research
School of Public Health and Preventive Medicine
Department of Immunology
Department of Surgery
Leeds Institute of Rheumatic and Musculoskeletal Medicine
ASIDE Healthcare
Faculty of Medicine
Department of Forensic Science
Rashtrasant Tukadoji Maharaj Nagpur University
Health Research Institute
School of Medicine
Goldfields University Department of Rural Health
Department of Hypertension
Polish Mothers Memorial Hospital Research Institute
Department of Anatomy
Department of Community Medicine and Family Medicine
School of Public Health
Global Health Neurology Lab
Division of Cerebrovascular Medicine and Neurology
Department of Medical Lab Technology
School of Pharmacy
Department of Basic Biomedical Sciences
Department of Clinical Pharmacy
Temerty Faculty of Medicine
Department of Community Medicine
Department of Medical Biochemistry
The Interdisciplinary Research Group on Biomedicine and Health
Faculty of Applied Sciences
Department of Family Medicine and Public Health
Life and Health Sciences Research Institute (ICVS)
Institute for Research and Innovation in Health (i3S)
Research Center for Child Psychiatry
Iranian Research Center for HIV/AIDS (IRCHA)
School of Population Health
School of Pharmacy and Charles Perkins Centre
Department of Environmental Health
Immunology Research Center
Department of Medical Biochemistry
Department of Food
Center for Nutrition and Health Research
Chettinad Hospital & Research Institute
Department of Pharmacy
Pharmacology Division
University of South Carolina
Faculty of Science and Health
Department of Clinical and Chemical Pathology
Department of Internal Medicine
Department of Epidemiology and Medical Statistics
Research Centre for Healthcare and Community
Director of the Scientific and Technological Park
Department of Medicine
School of Engineering
Department of Social Medicine and Epidemiology
Department of Infectious Diseases and Public Health
Department of Pharmacy
Institute of Health Sciences
Jimma University
Institute of Public Health
Department of Medicine
Department of Cardiovascular
Department of Environmental Health
School of Nursing and Midwifery
Adelaide Medical School
Department of Biostatistics
Quantitative Department
Department of Applied Cell Sciences
Cellular and Molecular Medicine Institute
Department of Public Health
Department of Toxicology
Department of Clinical Pharmacology and Medicine
Department of Radiology
Obesity Research Center
Sakarya University
Faculty of Medicine
Department of Radiology
Department of Pharmaceutical Technology
Department of Pharmacy
Department of Neurology
Independent Consultant
Department of Microbiology
School of Medicine
Graduate School of Medicine
School of Social Sciences
Department of Psychology
Department of Health Promotion and Education
Department of Neurosurgery
Department of Clinical Pharmacy & Pharmacy Practice
Malaysian Academy of Pharmacy
Department of Health Services Research
Department of Non-Communicable Disease Epidemiology
Road Traffic Injury Research Center
The World Academy of Sciences UNESCO
Shaanxi University of Technology
Johns Hopkins University
Centre of Studies and Research
Department of Biochemistry
Caring Futures Institute
Geumsan Public Health Center
College of Medicine
Department of Community Medicine
Department of Economics
Institute of Family Medicine and Public Health
Department of Oral and Maxillofacial Pathology
Department of Endocrinology
University Centre for Research and Development
Department of Public Health
Environmental Technologies Research Center
Amity Institute of Forensic Sciences
Family Medicine Department
Primary Care Department
Social Determinants of Health Research Center
Non-communicable Diseases Research Center
Department of Epidemiology
School of Medicine
Department of Basic Medical Sciences
School of Medicine
Broad Institute of MIT and Harvard
Massachusetts General Hospital
Department of General Practice and Family Medicine
Department of Anthropology
Research and Publication Activity Division
Center of Medicine and Public Health
Department of Medicine
Faculty of Medicine and Health Science
School of Nursing
Division of Evidence Synthesis
Division of Lifestyle Medicine
Department of Physiotherapy
Institute of Allied Health Sciences
Unidad de Genética y Salud Pública
Ministry of Health
Centre for Family Welfare
Department of Global Health and Health Security
University of Medicine and Pharmacy at Ho Chi Minh City
Department of Medical Science
Department of Family Medicine
Department of Molecular Epidemiology
German Center for Diabetes Research (DZD)
Rama Medical College Hospital and Research Centre
Institute of Applied Health Research
Rabigh Faculty of Medicine
Department of Nutrition and Dietetics
Centre for Healthy Living
Department of Medical and Surgical Sciences and Advanced Technologies GF Ingrassia
Department of Medical Laboratory Sciences
Comprehensive Cancer Center
University of Helsinki
University Centre Varazdin
Department of Orthopedics
Molecular Biology Unit
Bio-Statistical and Molecular Biology Department
Modeling in Health Research Center
Clinical Epidemiology and Public Health Research Unit
Department of Epidemiology and Biostatistics
Clinical Research Development Unit
Division of Plastic and Reconstructive Surgery
Department of Medicine
Stanford Cardiovascular Institute
Unit of Pharmacotherapy
Department of Epidemiology and Biostatistics
Department of Research Methods
Department of Biotechnology
Department of Computer Science
Department of Dental Public Health
Department of Health Policy and Oral Epidemiology
Applied Cellular and Molecular Research Center
Cardiovascular Laboratory
Department of Allergy
Cardiovascular Research Department
Tuberculosis Group
Department of General Medicine
International Islamic University Islamabad
School of Chemical & Biomolecular Engineering
Faculty of Applied Sciences
Department of Public Health
Ministry of Research
School of Pharmacy
Department of Pharmacotherapy and Pharmaceutical Care
Department of Biology
School of Medicine
National School of Public Health
Vision and Eye Research Institute
Department of Community Medicine
Division of Health Policy and Management
Global Health Governance Programme
School of Dentistry
Facultad de Medicina (Faculty of Medicine)
School of Cardiovascular and Metabolic Health
Department of Internal Medicine
Department of Maternal-Child Nursing and Public Health
Department of Neonatology
Cardiovascular Research Center
Sina Trauma and Surgery Research Center
Department of Population Science and Human Resource Development
Health Service Research and Quality of Life Center (CEReSS)
Department of Medical
Gynecology and Breast Care Center
Department of Radiology
Brigham and Womens Hospital
Department of Primary Care and Public Health
Academic Public Health England
Department of Biological Sciences
Department of Protein Research
Cardiovascular Department
Operational Research Center in Healthcare
International Center of Medical Sciences Research (ICMSR)
Research Center for Immunodeficiencies
Sharjah Institute of Medical Sciences
Center for Global Health Research
Biotechnology Research Center
Department of Microbiology
LMU-Munich
Institute for Employment Research
College of Medicine
Faculty of Pharmacy
Institute of Epidemiology and Preventive Medicine
Benang Merah Research Center (BMRC)
Department of Entomology
Medical Ain Shams Research Institute (MASRI)
Department of Biomedical and Neuromotor Sciences
Primary Healthcare Department
Research Development Coordination Section
School of Sciences
Faculty of Medicine
Department of Cardiovascular Sciences
Department of Medicine
National Heart
Center for Medical and Bio-Allied Health Sciences Research
Department of Pathology and Laboratory Medicine
Amity Institute of Public Health
Department of Safety Services
Beth Israel Deaconess Medical Center
Department of Social and Behavioral Health
Department of Medical-Surgical Nursing
Department of Nursing and Health Sciences
Unit of Basic Medical Sciences
Department of Medical Microbiology and Infectious Diseases
Sport Physical Activity and Health Research & Innovation Center (SPRINT)
CICS-UBI Health Sciences Research Center
School of Medicine
Department of Medicine Service
Department of Radiodiagnosis
Department of Analytical and Applied Economics
Department of Medical Education
Department of Epidemiology
Department of Medicine
Basic Sciences in Infectious Diseases Research Center
Department of Pathology
Department of Preventive Medicine
Outpatient Department
Department of Public Health
Faculty of Public Health
College of Health and Sport Sciences
UKK Institute
Faculty of Medicine and Health Technology
Department of Infectious Disease
School of Public Health
Department of Neurosurgery
Department of Neurosurgery
School of Public Health
Department of Biostatistics
Department of Public Health
Norris Comprehensive Cancer Center
College of Traditional Chinese Medicine
Department of Biochemistry and Pharmacogenomics
School of Public Health Sciences
College of Medicine
Department of Rheumatology
Institute of Bone and Joint Research

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