Prediction of osteoporotic fractures : the Rotterdam study

This thesis focuses on the application of new methods to predict fractures. Chapter 2 deals with ultrasound measurement as an emerging technique, with the potential advantage to detect qualitative deterioration of bone. In chapter 2.1, a review of ultrasound measurement is presented. Chapters 2.2 and 2.3 aim at age-related changes in ultrasound parameters. In chapter 2.4 the association between ultrasound parameters and fracture risk is discussed. Chapter 3 discusses metabolic factors of osteoporosis and fracture risk. In chapter 3.1, the association between non-insulin-dependent diabetes mellitus, bone density and fracture risk is discussed. Chapter 3.2 summarizes the currently available biochemical markers of bone turnover. In chapters 3.3 and 3.4 we discuss the use of biochemical markers in fracture prediction. The thesis concludes with a general discussion including comments on clinical relevance and suggestions for further research in chapter 4.