ABSTRACT
This chapter addresses risk factors for osteoporotic fractures and bone loss in adults after the time at which peak bone mass is attained. Alcohol and tobacco are two strong, modifiable lifestyle factors. Smoking has consistently been associated with an increased risk of spine and hip fractures, as addressed originally in a 2005 meta-analysis. Obesity is a modifiable risk factor for some fractures, but the relationship is complex. Endocrine predictors of fracture risk include male and female gonadal hormone levels, sex hormone-binding globulin have been shown to correlate with fracture risk to a variable degree in population studies. Vitamin D is essential for active calcium absorption in the gut, for normal skeletal mineralization, maintaining normocalcaemia and normal muscle function. The most prevalent, strong, non-modifiable risk factors for fractures in late adulthood are prior fractures and age.
