Regarding the article 'low BMD is less predictive than reported falls for future limb fractures in women across Europe: results from the European Prospective Osteoporosis Study', by Kaptoge et al.

摘要

We were interested to read the article: "Low BMD is less predictive than reported falls for future limb fractures in women across Europe: Results from the European Prospective Osteoporosis study" by Kaptoge et al. After reading the article some questions remain. A retrospective study performed in Belgium in 2002 looked at the relationship of history, falls, osteoporosis and fractures. In this study, women with osteoporosis and falls had an adjusted fracture risk of 24.8 (95% CI 6.9-88.), and it is concluded that falls are indeed a major contributing factor to the occurrence of symptomatic fractures in postmenopausal women independent of the additional risk attributable to age and osteoporosis. In that study, a fracture had occurred during the last year in 0.6% of women with normal BMD without fall during last year, compared to 8.8% in women with osteoporosis and a recent fall. In a recent article by Wainwright et al. , the hip fracture risk of women "without osteoporosis" at baseline from the SOF study was assessed. These non-osteoporotic subjects were younger and less frail, and with less reported hyperthyroidism in their medical history, than the osteoporotic subjects. The reported characteristics associated with increased fracture risk were advancing age, reduced visual contrast sensitivity, falls in the previous year, prevalent vertebral fractures and a lower total hip BMD.