BMJ 2000;320:1669 ( 17 June )

Letters

Genetic factors and osteoporotic fractures in elderly people

    Twin data support genetic contribution to risk of fracture
    Study supports possibility of differences in development of osteoporotic fractures between sexes
    Authors' reply

Twin data support genetic contribution to risk of fracture

The first 150 words of the full text of this article appear below.

EDITOR---Kannus et al suggest from prospective data collected on Finnish twins that genetic factors are of only minor importance in explaining the population occurrence of osteoporotic fracture, particularly in women.1

The evidence given to support this is the relatively small excess in concordance in monozygotic twins compared with dizygotic twins. But it is well recognised that twin concordances may be misleading unless the underlying prevalence of a disease is taken into account.2 For example, a small absolute difference in monozygotic compared with dizygotic concordance is more suggestive of a genetic effect for a trait that is relatively rare (such as fracture) than for one that is common. The data thus warrant closer scrutiny.

We have estimated the relative contribution of genetic, shared environmental, and unique environmental components to the variation in susceptibility to fracture in these twins from the data provided. The analysis was conducted using a variance . . . [Full text of this article]
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Relevant Article

Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins
Pekka Kannus, Mika Palvanen, Jaakko Kaprio, Jari Parkkari, and Markku Koskenvuo
BMJ 1999 319: 1334-1337. [Abstract] [Full Text] [PDF]

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