Femur Fracture Risk — Genes & Biomarkers Summary Biomarker / Gene Bad Score Free Actions Non-free Actions GENES COL1A1 Ss / ss allele Exercise, calcium-rich diet Genetic counseling, bisphosphonates VDR ff genotype Sun exposure, vit D foods Vitamin D supplements LRP5 Low-function variant Weight-bearing exercise DXA scan, bisphosphonates RANKL (TNFSF11) Overexpression allele Anti-inflammatory diet Denosumab BIOMARKERS Vitamin D (25-OH) < 20 ng/mL Sunlight, dairy products Vitamin D / calcium supplements CTX (C-telopeptide) > 0.57 ng/mL Reduce alcohol & smoking Bisphosphonates P1NP < 25 µg/L Protein diet, exercise Teriparatide (anabolic therapy) FRAX Score > 20% (10-yr risk) Fall prevention, balance training Osteoporosis medication