The role of bone turnover markers and risk factors in the assessment of osteoporosis and fracture risk

The clinical evaluation of osteoporosis in individual patients involves con firmation of the diagnosis, the investigation of secondary causes of osteop orosis and the evaluation of subsequent fracture risk. Optimum clinical ass essment involves bone mineral densitometry with the treatment thresholds mo dified by clinical risk factors for individual patients. Bone turnover mark ers and clinical risk factors can be used to identify patients at risk of o steoporotic fracture and those who have secondary osteoporosis. Risk assess ment should involve the evaluation of absolute rather than relative risk. F urther work is required to improve the integration of clinical risk factors , bone turnover markers and bone densitometry into appropriate models to en able the assessment of the absolute risk of fracture for individual patient s.