Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores

Hippisley-Cox and Coupland (1) have performed an interesting paper on
prediction of osteoporotic fractures. QFracturesScores seems to be a good
way to investigate when a patient needs further tests in a primary care
setting. Important variables have been included. However, data on levels
of 25OHD determination are missing, which is an important issue to
consider since vitamin D deficiency constitutes a cool topic as a future
factor for metabolic bone disorders. In fact, Vitamin D deficiency is
getting an increasing role as it has been found to be one of the most
common medical condition in both children and adult (2). Moreover, Vitamin
D deficiency can be present long before symptoms appear. Beside the
consequences of Vitamin D deficiency on bone metabolism, its deficiency
has also been linked to an increase in the risk of chronic diseases,
cancer, all cause and cardiovascular mortality (3), (4), and immune system
disorders (5). Levels of 25OHD should be considered as other risk
conditions when predicting risk of osteoporosis in primary care.

1. Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic
fracture in men and women in England and Wales: prospective derivation and
validation of QfractureScores. BMJ 2009;339:b 4229
2. Holick MF. Vitamin D Deficiency. NEJM 2007; 357:266-281
3. Peterlik M, Cross HS. VitaminD and calcium insufficiency-related
chronic diseases: molecular and cellular pathophysiology. Eur J Clin Nutr
2009; 63:1377-1386
4. Semba RD, Houston DK, Bandinelli S, Sun K ,Cherubini A, Cappola AR,
Guralnik JM and Ferrucci L. Eur J Clin Nutr 2009;
doi:10.1038/ejcn.2009.140
5. Dogan M, Erol M, Cesur Y, Yuca SA, DoÄŸan Z. The effect of 25-
hydroxyvitamin D3 on the immune system. J Pediatr Endocrinol Metab 2009;
22(10):929-935

Competing interests:
None declared