Genetic influences on bone turnover, bone density and fracture

Fractures due to osteoporosis are an increasing healthcare problem in all ageing communities. A major determinant of fracture risk is bone density, independent of other contributory factors such as falls and ageing (1–4). Bone density in later life is contributed to by both peak bone mass achieved in early adulthood and subsequent bone loss. There is compelling evidence suggesting that both peak bone mass and its subsequent loss are determined by combinations of genetic and environmental factors. To identify the molecular genetic factors that underly the genetic determination of bone density remains a sizeable challenge with potential impact on both therapy and prevention of osteoporosis. This review will examine the evidence for genetic contributions to osteoporosis in light of recent advances in this area.