Inclusion Criteria:

- treatment naïve patients seen in the 1917 Clinic between January 1, 2000 and May 1,
2010

- currently under care at the time of the initiation of the study (>1 clinic visit in
the past 12 months)

Exclusion Criteria:

- history of chronic renal failure (estimated GFR <30ml/min)

- known diagnosis of a metabolic bone disease (i.e. osteoporosis, primary
hyperparathyroidism, Paget Disease, Osteogenesis Imperfecta)

- multiple myeloma, cancer, untreated thyroid disease, or inflammatory bowel disease,
or persons currently treated with or plans to begin an osteoporosis-specific
medication (including estrogen)

- treatment with oral glucocorticoids and anticonvulsants