A study by Dr. Shunichi Kumagai of Kobe University Graduate School of Medicine suggests a link between treatment with high-dose glucocorticoids (steroids) for autoimmune diseases and the occurrence of vertebral fractures in premenopausal women that is independent of bone mineral density (BMD).
Fracture was also found to be more common in women with elevated total cholesterol levels. In fact, women with high total cholesterol were found to have lower BMD than women with normal cholesterol levels. The researchers concluded that BMD is "not the only factor that affects the risk of vertebral fractures."