Clinical calcium
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Osteoporosis has been successfully treated with anti-resorptive agents. Estrogen, ever regarded as the gold standard in the treatment of osteoporosis, has now been considered as one of the second line agents. ⋯ It has been established that BMD increase is not the primary factor on the prevention of vertebral fracture, but BMD increases seem to be critical to reduce the risk of non-vertebral fractures by anti-resorptive agents. Efficacy of combination of anti-resorptive agents with different action mechanisms such as bisphosphonates and raloxifene has not yet been established whether the combination further reduces the risk of non-vertebral fractures.
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Recently the relationship of vitamin D insufficiency and fracture is noticed in elderly people. Vitamin D nutritional status is evaluated by measuring serum 25 (OH) D. ⋯ This suggests that vitamin D insufficiency is one of fracture risk factor and improvement of vitamin D status reduce fracture risk. With the results of recent studies, we would like to discuss about fractures from the viewpoint of vitamin D insufficiency.