Definition

NIH Consensus Development Panel 2001, Chesnut. JBMR 2001;16:2163

40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99
History of prior non-violent fracture: consider BMD measurement and treatment

90 80 70
Prevalence (%)

N=2589 63.9% 48.7% 30.8% 14.3% 2.8%

60 50 40 30 20 10 0

<9

<15

<20

<25

<30

Cutoff points for 25(OH)D concentration (ng/ml)

*Vitamin D inadequacy was defined as serum 25(OH)D <30 ng/ml Study Design: Observational, cross-sectional study of 2589 community-dwelling women with osteoporosis from 18 countries to evaluate serum 25(OH)D distribution. Adapted from Lips P et al. Poster presented at ASBMR, Nashville, TN, USA, September 2327, 2005; Heaney RP Osteoporos Int 2000;11:553555.

90 80

N=2589 63.9% 53.4%

81.8% 71.4% 57.7% 60.3%

Prevalence (%)

70 60 50 40 30 20 10 0

All

Latin America

Europe

Middle East

Asia

Australia

Regions
*Vitamin D inadequacy was defined as serum 25(OH)D <30 ng/ml Study Design: Cross-sectional, observational, international study of 2589 community-dwelling women with osteoporosis from 18 countries to evaluate serum 25(OH)D distribution. Adapted from Lips P et al. Poster presented at ASBMR, Nashville, TN, USA, September 2327, 2005; Heaney RP Osteoporos Int 2000;11:553555.

Jung-Fu Chen, Leung Wing Chu, Nghia Nguyen Dac, Chang Ming Goh, David Hosking, Tai Pang Ip, Leonard Koh, Annie Kung, Ning-Sheng Lai, Edith Lau, Tang Ching Lau, Joon Kiong Lee, Siew Pheng Chan, Rattana Leewattana, Young-gi Min, Boonsong, Ongphiphadhanakul, Hyung-moo Park, Van Dai Phi, Johann Ringe, Bambang Setyohadi, Chan Soo Shin, Suppasin Soontrapa, Nimit Taechakraichana, Dohar Tobing, Keh-Sung Tsai, Jean Woo, Jung Sen Yang, EM Yunir

23 to 24 September 2006 in Hong Kong The main outcome and goal of the Meta-forum were to produce a Declaration on the role of vitamin D in bone health and disease prevention, particularly with respect to osteoporosis This Declaration defines key statements and actions for improving osteoporosis management and vitamin D inadequacy in Asia, as well as criteria for measuring success.

Therapeutic Management of Postmenopausal Osteoporosis

Osteoporosis prevention T-score >2.5 Osteoporosis treatment with or without previous fracture Osteoporosis treatment with multiple fractures and at risk for hip fracture

SERM

Teriparatide

ET/EPT

Bisphosphonates

50

55

60

65

70

75

80

85

90
2004

ET = Estrogen therapy EPT = Estrogen plus progestin therapy

Age (years)

Projected Number of Hip Fracture Worldwide

Total Number of Hip Fractures 195020501.66 million 6.26 million

What Can We Do?