Metabolic syndrome is defined as a cluster of risk factors that are associated with diabetes, central obesity, and increased risk of cardiovascular disease. The 2001 National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition requires the presence of at least 3 of 5 of the following categorically defined risk factors: abdominal obesity (waist circumference greater than 102 cm in men or greater than 88 cm in women), high triglycerides (150 mg/dl or greater), low HDL cholesterol (less than 40 mg/dL in men or less than 50 mg/dL in women), hypertension (130/85 mm Hg or greater), and hyperglycemia (110 mg/dL or greater). Metabolic syndrome is associated with cardiovascular disease morbidity. The association between each of these risk factors and osteoporosis has been previouly studied, with contradictory results. A recent study [1] used multivariate regression models to examine the cross-sectional associations of MS defined by NCEP-ATP III criteria with bone mineral density (BMD) and osteoporosis, and the longitudinal association of MS with fractures in 420 men and 676 women from the Rancho Bernardo Study.

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Low bone mass is a determinant of fractures in healthy children. Small studies provide limited evidence on the association between ethnicity, birth weight, family size, socioeconomic status, dietary calcium intake, or physical activity and fracture incidence. Whether these determinants of fracture risk act through affecting bone mass or through other mechanisms is not known. The aim of this study [1] was to use a population-based birth cohort to confirm which variables are determinants of fracture risk and to further study which of these risk factors act independently of bone mass. Children were followed up from birth to 11 y of age. Maternal self-reported data were collected contemporaneously on early life factors, diet, puberty, and physical activity. These were linked to reported fractures between 9 and 11 y of age. Multivariable logistic regression techniques were used to assess whether these potential determinants were independent of, or worked through, estimated volumetric bone mineral density or estimated bone size relative to body size measured by total body DXA scan at 9.9 y of age.

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This study [1] was undertaken to assess the effect of strontium ranelate on nonvertebral and vertebral fractures in postmenopausal women with osteoporosis in a 5-year, double-blind, placebo-controlled trial. A total of 5091 postmenopausal women with osteoporosis were randomized to receive either strontium ranelate at 2 g/day or placebo for 5 years. The main efficacy criterion was the incidence of nonvertebral fractures. In addition, incidence of hip fractures was assessed in the subset of 1128 patients who were at high risk of fractures (age 74 years or older with lumbar spine and femoral neck bone mineral density T scores <-2.4 or less). The incidence of new vertebral fractures was assessed in the 3646 patients in whom spinal radiography (a nonmandatory procedure) was performed during the course of the study.

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Early diagnosis of onset osteoporosis is essential for the delivery of effective therapy. Biochemical markers of bone turnover provide a means of evaluating skeletal dynamics that complements static measurements of bone mineral density (BMD) by dual energy X-ray absorptiometry. Conventional clinical measurements of bone turnover, primarily the estimation of collagen and its breakdown products in the blood or urine, lack both sensitivity and specificity as a reliable diagnostic tool. In this study [1], the serum proteome of 58 postmenopausal women with high or low/normal bone turnover (training set) was analyzed by surface-enhanced laser-desorption/ionization time-of-flight (SELDI-TOF) mass spectrometry, and a diagnostic fingerprint was identified using a variety of statistical and machine-learning tools. The diagnostic fingerprint was validated in a separate test set, consisting of serum samples from an additional 59 postmenopausal women obtained from the same Mayo cohort, with a gap of 2 y.

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Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Although the diagnosis of the disease relies on the quantitative assessment of bone mineral density (BMD), which is a major determinant of bone strength, the clinical significance of osteoporosis lies in the fractures that arise.

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