Researchers at the Ohio State University in Columbus, Ohio reviewed data from the Women's Health Initiative study and found two things postmenopausal women can do to reduce their risk of osteoporosis and its associated hip fracture, using hormone replacement therapy and calcium/vitamin D supplements.

The researchers identified arrange of factors that may increase risk of osteoporosis and hip fracture including parental hip fracture, fracture history after age 54, current smoking status, corticosteroid use, and history of diabetes treatment.  Among the factors, age and fracture history predict risk for total fractures irrespective of race-ethnicity.

The study data also reveal a range of biomarkers associated with increased risk of osteoporosis/hip fractures including low vitamin D or bioavailable testosterone, high cystatin C, inflammatory cytokines, osteoprotegerin and sex hormone binding protein.

Most importantly, the researchers identified two treatments for osteoporosis in postmenopausal women, postmenopausal hormone replacement therapy and calcium plus vitamin D supplementation.

Study results show that estrogen with or without progestin was effective at reducing risk of bone loss and hip, clinical vertebral and total fractures.

Keep in mind though that hormone replacement therapy is one major risk factor for breast cancer and heart disease.

Calcium plus vitamin D supplementation was found to render a small yet significant increase in hip bone density, but it remains unknown whether such as an effect would be powerful enough to prevent osteoporosis or prevent hip fracture. (David Liu)

Jackson RD, Mysiw WJ.  Insights into the Epidemiology of Postmenopausal Osteoporosis: The Women's Health Initiative.  Semin Reprod Med. 2014 Nov;32(6):454-462.