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Osteoporosis is a skeletal disorder characterized by compromised bone strength that predisposes a person to an increased risk for fracture (1). Bone strength is determined by properties that include bone mineral density (BMD), bone geometry (size and shape of bone), degree of mineralization, microarchitecture, and bone turnover. It is a common disease with serious clinical consequences. In the United States, about 44 million people have osteoporosis or osteopenia (low bone mass) that could lead to low-trauma fractures. About 50% of white women and 20% of men will have an osteoporosis-related fracture in their lifetimes. Fractures of the hip and spine may be disabling and are associated with mortality rates that are about 20% greater than that of an age-matched population. A fragility fracture (i.e., a nontraumatic fracture or one that occurs with low trauma, such as a fall from the standing position) of any type is a sentinel event that increases the risk for future fractures. To reduce the burden of osteoporotic fractures, high-risk patients must be identified, evaluated for factors contributing to skeletal fragility, and treated to reduce fracture risk. Pharmacologic agents can reduce the risk for fracture in appropriately selected patients, with a generally favorable safety profile.
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