Low-energy fracture of the distal radius in middle- aged and elderly Norwegian women and men

Introduction Low-energy distal radius fractures normally occur earlier in life than hip and spine fractures and may be the first presentation of osteoporosis. Few studies have addressed the association between distal radius fracture and osteoporosis. Vitamin D inadequacy is associated with an increased risk of hip fractures, but the association with distal radius fractures has not been explored. Aims The aims of this study were to determine the prevalence of patients with a distal radius fracture in need of osteoporosis treatment according to certain guidelines, calculate the subsequent fracture risk, and to investigate the association between distal radius fracture and osteoporosis and vitamin D inadequacy. Materials and methods Paper I is a cross-sectional study of 1,576 female and 218 male distal radius fracture patients aged 50 years and older from Bergen, Kristiansand and Skien. Papers II and III are casecontrol studies based on the 664 female and 85 male patients from Bergen and 554 female and 54 male controls from the same area. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA). A self-administered questionnaire included information on health and lifestyle factors. A fracture risk assessment tool (FRAX) was used to calculate the 10-year fracture risk. Serum 25-hydroxyvitamin D (s-25(OH)D) was analysed. Results The prevalence of T-score −2.0 and −2.5 standard deviation (SD) at femoral neck was 51% and 31% in female and 38% and 20% in male distal radius fracture patients, respectively (Paper I). The 10-year FRAX estimated hip fracture risk in all female and male patients was 9% and 6%, respectively. The corresponding figures for female and male