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Objective: To determine the ability of measurements of bone density in women to predict later fractures.

Design: Meta-analysis of prospective cohort studies published between 1985 and end of 1994 with a baseline measurement of bone density in women and subsequent follow up for fractures. For comparative purposes, we also reviewed case control studies of hip fractures published between 1990 and 1994.

Subjects: Eleven separate study populations with about 90000 person years of observation time and over 2000 fractures.

Main outcome measures: Relative risk of fracture for a decrease in bone mineral density of one standard deviation below age adjusted mean.

Results: All measuring sites had similar predictive abilities (relative risk 1.5 (95% confidence interval 1.4 to 1.6)) for decrease in bone mineral density except for measurement at spine for predicting vertebral fractures (relative risk 2.3 (1.9 to 2.8 …