Endocrine Abstracts

Osteoporosis constitutes a major public health problem through its association with age-related fractures. These fractures typically occur at the hip, spine and wrist. Our research into osteoporosis at the MRC Lifecourse Epidemiology Unit over three decades has characterised the epidemiology of these fractures, and contributed to the generation of preventive strategies against them throughout the lifecourse. Around 1 in 2 women and 1 in 5 men in the UK will sustain an osteoporotic fracture from age 50 years onwards. Incidence rates rise with age, and rates in women are around double those in men above age 50 years (in large part due to the accelerated bone loss after the menopause among women). Rates are generally higher in Caucasian than in Asian and Afro-Caribbean populations. Life expectancy is increasing around the globe and the number of elderly individuals is rising in every geographic region. Assuming constant age-specific incidence rates for fracture, the number of hip fractures occurring worldwide among people aged 65 years and over will rise from 1.7 million in 1990 to 6.3 million in 2050. In this review of major research findings in the last twelve months, we shall review: (a) key developments in risk assessment of future fracture risk, including approaches to estimating “very high” or “imminent” fracture risk; (b) risks and benefits of currently available antiresorptive and formation stimulating osteoporosis therapies; (c) effectiveness of primary and secondary preventive strategies against fracture; (d) developmental contributors to fracture risk and the role of interventions during intrauterine and early postnatal life; and (e) characterisation of the osteoporosis treatment gap, and measures to try and close this.