Response to Letter to the Editor: “Two-Thirds of All Fractures Are Not Attributable to Osteoporosis and Advancing Age: Implications for Fracture Prevention”

We thank Wen et al. for their interest in our article (1). All of their comments are facts that have been well documented in textbooks; they contribute absolutely nothing to the literature. We would like to comment on their comments as follows.

First, we did not exclude comorbidities (e.g., diabetes, osteomalacia, osteoarthritis) from the analysis. Osteophytosis is more likely to affect lumbar spine bone mineral density (BMD) than femoral neck BMD. We used femoral neck BMD in the analysis of attributable fraction.

Second, the number of patients on antiosteoporosis medications (e.g., bisphosphonates) was <100. The use of medication did not materially affect the attributable fraction of osteoporosis.

Third, the time-variant analysis of association between BMD and fracture was adjusted for age and body mass index, as mentioned clearly in the “Data Analysis” section.

References and Notes