LATE CONSEQUENCES OF A LOW PEAK BONE MASS

The strong relationship between reduced bone mass and the risk of osteoporotic fractures has been well established in recently published, prospective studies. As bone mass decreases with advancing age, it seems logical to assume that a lower peak bone mass contributes to increasing bone fragility and, thus, to the incidence of fractures. However, the scarcity of osteoporotic fractures in middle-age suggests that a low peak bone mass might not be the only determinant of the risk of osteoporosis. The aim of this review is to examine the relationship between bone mass and the risk of fractures and to determine whether peak bone mass or the subsequent rate of bone loss is more important in determining the ultimate risk of osteoporosis. Such a prediction will have important implications for the prevention of osteoporosis.