Iranian Multicenter Osteoporosis Studies (IMOS) during last decade: rationale, main findings, lessons learned and the way forward.

Purpose: Osteoporosis remains a major public health concern, considering its high prevalence along with its association with osteoporotic fractures. It imposes a heavy burden on the society worldwide as the population ages. This paper aims to provide a brief review on Iranian multicenter osteoporosis studies (IMOS) studies and provide some recommendations for improvement. Methods: IMOS studies were conducted to investigate the prevalence of osteoporosis and related risk factors. This paper provides a general view on the Iranian multicenter osteoporosis studies (IMOS), conducted during last decades. Results: The results showed a high prevalence of osteoporosis and vitamin D deficiency in the Iranian population. Although the study protocols were mainly similar, some differences were observed in terms of the study population and design. The protocol of IMOS-3 was modified to overcome the setbacks noted in the previous studies; however, it was implemented in two cities with noticeably different socioeconomic and geographical characteristics from five cities where the first phase was conducted, resulting in different lifestyles and habits. Although previous IMOS studies have raised major concerns regarding the high prevalence of osteoporosis and vitamin D deficiency, interpretation should be made with caution given the differences, especially in the surveyed cities. Such discrepancies cause problems in trend analysis, and nationally representative samplings are preferably needed to correctly compare the prevalence of osteoporosis and related risk factors. Conclusions: Considering the aging population and the importance of osteoporosis and its complication, developing a standard surveillance system to obtain valid and nationally representative estimates is recommended.