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Risk Factors for Low Bone Mass: Clinical Implications

Charles W. Slemenda, MrPH
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Indiana University School of Medicine, Indianapolis, IN 46202-5200. Requests for Reprints: Charles W. Slemenda, DrPH, Indiana University School of Medicine, Riley Research Wing, RR 135, 702 Barnhill Drive, Indianapolis, IN 46202-5200.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;118(9):741-742. doi:10.7326/0003-4819-118-9-199305010-00014
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Cigarette smoking, alcohol consumption, exercise, and diet are among the risk factors examined in most studies of chronic disease. In this issue of Annals, these alterable behaviors and many other potential risk factors are examined as possible factors influencing the probability of having low bone mass. How can these data be used clinically? It has been presumed that certain risk factors can be used to identify patients with low bone mass and high risk for fracture. Although there are many factors significantly associated with bone mass in elderly women, the variability remains too great to accurately classify potential candidates for therapy to prevent further bone loss. An understanding of risk factors can, however, be used to assist in clinical decisions when uncertainty exists, to direct patients toward lifestyle changes that may improve their chances for avoiding osteoporotic fractures, and to relieve unfounded fears. Decisions about therapy to prevent osteoporosis will still be based primarily on measurements of bone mass, and perhaps other characteristics derived from these scans, but information on risk factors may enhance the ability to use these data.

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