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Published in: Osteoporosis International 7/2007

01-07-2007 | Original Article

Race/ethnic differences in bone mineral density in men

Authors: A. B. Araujo, T. G. Travison, S. S. Harris, M. F. Holick, A. K. Turner, J. B. McKinlay

Published in: Osteoporosis International | Issue 7/2007

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Abstract

Summary

The epidemiology of osteoporosis in male and minority populations is understudied. We compared BMD in 1,209 Black, Hispanic, and White men. Black men exhibited higher BMD than Hispanic or White men. Age-related BMD decreases were greatest among Hispanic men. Results may help explain variation in hip fracture rates by race/ethnicity.

Introduction

The epidemiology of osteoporosis in male and minority populations is understudied. To address this concern, we conducted a study of skeletal health in a diverse population of adult males.

Methods

A total of 367 Black, 401 Hispanic, and 451 White men aged 30–79 years were randomly sampled from Boston, MA. Bone densitometry (bone area (BA), bone mineral content (BMC), and bone mineral density (BMD)) at the whole body, hip, lumbar spine, and forearm was performed. Multiple regression analyses on 1,209 men with available data were used to describe race/ethnic group-specific means (height- and age-adjusted) and age trends (height-adjusted) in BMC, BA, and BMD. Results were weighted to represent the Boston male population aged 30–79 years.

Results

Black men had greater BMC and BMD than Hispanic or White men. Femoral neck BMD was 5.6% and 13.3% higher in Black men than in Hispanic and White men, respectively. Differences between Hispanic and White subjects were restricted to the hip. Age-related declines in BMC and BMD were significantly steeper among Hispanic than Black or White men.

Conclusions

Differences in BMC and BMD could explain variation in fracture rates among Black, Hispanic, and White men. The steeper age-related BMD decline in Hispanic men is of particular concern.
Literature
1.
go back to reference National Institutes of Health (2001) Osteoporosis prevention, diagnosis, and therapy. National Institutes of Health Consensus Development Conference Statement. Jama 285:785–795CrossRef National Institutes of Health (2001) Osteoporosis prevention, diagnosis, and therapy. National Institutes of Health Consensus Development Conference Statement. Jama 285:785–795CrossRef
2.
go back to reference Heaney RP (1995) Bone mass, the mechanostat, and ethnic differences. J Clin Endocrinol Metab 80:2289–2290PubMedCrossRef Heaney RP (1995) Bone mass, the mechanostat, and ethnic differences. J Clin Endocrinol Metab 80:2289–2290PubMedCrossRef
4.
go back to reference U.S. Department of Health and Human Services (2004) Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD. U.S. Department of Health and Human Services (2004) Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD.
5.
go back to reference Jacobsen SJ, Goldberg J, Miles TP et al (1992) Race and sex differences in mortality following fracture of the hip. Am J Public Health 82:1147–1150PubMed Jacobsen SJ, Goldberg J, Miles TP et al (1992) Race and sex differences in mortality following fracture of the hip. Am J Public Health 82:1147–1150PubMed
6.
go back to reference Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed
7.
go back to reference Barondess DA, Nelson DA, Schlaen SE (1997) Whole body bone, fat, and lean mass in black and white men. J Bone Miner Res 12:967–971PubMedCrossRef Barondess DA, Nelson DA, Schlaen SE (1997) Whole body bone, fat, and lean mass in black and white men. J Bone Miner Res 12:967–971PubMedCrossRef
8.
go back to reference Cauley JA, Fullman RL, Stone KL et al (2005) Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int 16:1525–1537PubMedCrossRef Cauley JA, Fullman RL, Stone KL et al (2005) Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int 16:1525–1537PubMedCrossRef
9.
go back to reference George A, Tracy JK, Meyer WA et al (2003) Racial differences in bone mineral density in older men. J Bone Miner Res 18:2238–2244PubMedCrossRef George A, Tracy JK, Meyer WA et al (2003) Racial differences in bone mineral density in older men. J Bone Miner Res 18:2238–2244PubMedCrossRef
10.
go back to reference Looker AC, Orwoll ES, Johnston CC et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768PubMedCrossRef Looker AC, Orwoll ES, Johnston CC et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768PubMedCrossRef
11.
go back to reference Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef
12.
go back to reference Melton LJ 3rd, Marquez MA, Achenbach SJ et al (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13:551–559CrossRef Melton LJ 3rd, Marquez MA, Achenbach SJ et al (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13:551–559CrossRef
13.
go back to reference Nelson DA, Jacobsen G, Barondess DA et al (1995) Ethnic differences in regional bone density, hip axis length, and lifestyle variables among healthy black and white men. J Bone Miner Res 10:782–787PubMed Nelson DA, Jacobsen G, Barondess DA et al (1995) Ethnic differences in regional bone density, hip axis length, and lifestyle variables among healthy black and white men. J Bone Miner Res 10:782–787PubMed
14.
go back to reference Stehman-Breen CO, Sherrard D, Walker A et al (1999) Racial differences in bone mineral density and bone loss among end-stage renal disease patients. Am J Kidney Dis 33:941–946PubMed Stehman-Breen CO, Sherrard D, Walker A et al (1999) Racial differences in bone mineral density and bone loss among end-stage renal disease patients. Am J Kidney Dis 33:941–946PubMed
15.
go back to reference Taaffe DR, Cauley JA, Danielson M et al (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the health, aging, and body composition study. J Bone Miner Res 16:1343–1352PubMedCrossRef Taaffe DR, Cauley JA, Danielson M et al (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the health, aging, and body composition study. J Bone Miner Res 16:1343–1352PubMedCrossRef
16.
go back to reference Wright NM, Renault J, Willi S et al (1995) Greater secretion of growth hormone in black than in white men: possible factor in greater bone mineral density–a clinical research center study. J Clin Endocrinol Metab 80:2291–2297PubMedCrossRef Wright NM, Renault J, Willi S et al (1995) Greater secretion of growth hormone in black than in white men: possible factor in greater bone mineral density–a clinical research center study. J Clin Endocrinol Metab 80:2291–2297PubMedCrossRef
17.
go back to reference Baron JA, Karagas M, Barrett J et al (1996) Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology 7:612–618PubMedCrossRef Baron JA, Karagas M, Barrett J et al (1996) Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology 7:612–618PubMedCrossRef
18.
go back to reference Bauer RL (1988) Ethnic differences in hip fracture: a reduced incidence in Mexican Americans. Am J Epidemiol 127:145–149PubMed Bauer RL (1988) Ethnic differences in hip fracture: a reduced incidence in Mexican Americans. Am J Epidemiol 127:145–149PubMed
19.
go back to reference Espino DV, Palmer RF, Miles TP et al (2000) Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. J Am Geriatr Soc 48:1252–1260PubMed Espino DV, Palmer RF, Miles TP et al (2000) Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. J Am Geriatr Soc 48:1252–1260PubMed
20.
go back to reference Lauderdale DS, Jacobsen SJ, Furner SE et al (1998) Hip fracture incidence among elderly Hispanics. Am J Public Health 88:1245–1247PubMed Lauderdale DS, Jacobsen SJ, Furner SE et al (1998) Hip fracture incidence among elderly Hispanics. Am J Public Health 88:1245–1247PubMed
21.
go back to reference Maggi S, Kelsey JL, Litvak J et al (1991) Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1:232–241PubMedCrossRef Maggi S, Kelsey JL, Litvak J et al (1991) Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1:232–241PubMedCrossRef
22.
go back to reference Silverman SL, Madison RE (1988) Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California hospital discharge data. Am J Public Health 78:1482–1483PubMedCrossRef Silverman SL, Madison RE (1988) Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California hospital discharge data. Am J Public Health 78:1482–1483PubMedCrossRef
23.
go back to reference Orwoll E, Blank JB, Barrett-Connor E et al (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study–a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585PubMedCrossRef Orwoll E, Blank JB, Barrett-Connor E et al (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study–a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585PubMedCrossRef
24.
go back to reference Melton LJ 3rd (1999) Epidemiology of fractures. In: Orwoll E (ed) Osteoporosis in Men: The Effects of Gender on Skeletal Health. Academic Press, San Diego, CA, pp 1–13 Melton LJ 3rd (1999) Epidemiology of fractures. In: Orwoll E (ed) Osteoporosis in Men: The Effects of Gender on Skeletal Health. Academic Press, San Diego, CA, pp 1–13
25.
go back to reference Riggs BL, Wahner HW, Dunn WL et al (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 67:328–335PubMedCrossRef Riggs BL, Wahner HW, Dunn WL et al (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 67:328–335PubMedCrossRef
26.
go back to reference Melton LJ 3rd, Khosla S, Atkinson EJ et al (2000) Cross-sectional versus longitudinal evaluation of bone loss in men and women. Osteoporos Int 11:592–599PubMedCrossRef Melton LJ 3rd, Khosla S, Atkinson EJ et al (2000) Cross-sectional versus longitudinal evaluation of bone loss in men and women. Osteoporos Int 11:592–599PubMedCrossRef
27.
go back to reference Tracy JK, Meyer WA, Flores RH et al (2005) Racial differences in rate of decline in bone mass in older men: the Baltimore men’s osteoporosis study. J Bone Miner Res 20:1228–1234PubMedCrossRef Tracy JK, Meyer WA, Flores RH et al (2005) Racial differences in rate of decline in bone mass in older men: the Baltimore men’s osteoporosis study. J Bone Miner Res 20:1228–1234PubMedCrossRef
28.
go back to reference Litman HJ, Bhasin S, Link CL et al (2006) Serum androgen levels in Black, Hispanic and White men. J Clin Endocrinol Metab 91:4326–4334PubMedCrossRef Litman HJ, Bhasin S, Link CL et al (2006) Serum androgen levels in Black, Hispanic and White men. J Clin Endocrinol Metab 91:4326–4334PubMedCrossRef
29.
go back to reference Feldman HA, McKinlay SM, Niknian M (1996) Batch sampling to improve power in a community trial. Experience from the Pawtucket Heart Health Program. Eval Rev 20:244–274PubMedCrossRef Feldman HA, McKinlay SM, Niknian M (1996) Batch sampling to improve power in a community trial. Experience from the Pawtucket Heart Health Program. Eval Rev 20:244–274PubMedCrossRef
30.
go back to reference McEvoy GK (1989) American hospital formulary service drug information. American Society of Hospital Pharmacists, Bethesda, MD McEvoy GK (1989) American hospital formulary service drug information. American Society of Hospital Pharmacists, Bethesda, MD
31.
go back to reference Khavari KA, Farber PD (1978) A profile instrument for the quantification and assessment of alcohol consumption. The Khavari Alcohol Test. J Stud Alcohol 39:1525–1539PubMed Khavari KA, Farber PD (1978) A profile instrument for the quantification and assessment of alcohol consumption. The Khavari Alcohol Test. J Stud Alcohol 39:1525–1539PubMed
32.
go back to reference Block G, Hartman AM, Dresser CM et al (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124:453–469PubMed Block G, Hartman AM, Dresser CM et al (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124:453–469PubMed
33.
go back to reference Washburn RA, Ficker JL (1999) Physical Activity Scale for the Elderly (PASE): the relationship with activity measured by a portable accelerometer. J Sports Med Phys Fitness 39:336–340PubMed Washburn RA, Ficker JL (1999) Physical Activity Scale for the Elderly (PASE): the relationship with activity measured by a portable accelerometer. J Sports Med Phys Fitness 39:336–340PubMed
34.
go back to reference Wallman K (1997) Data on race and ethnicity: revising the federal standard. Am Stat 31–35 Wallman K (1997) Data on race and ethnicity: revising the federal standard. Am Stat 31–35
35.
go back to reference Baran D (1995) Precision in fan beam densitometry: A mulit-site validation. Manufacturer’s specifications, Hologic Inc, Bedford, MA Baran D (1995) Precision in fan beam densitometry: A mulit-site validation. Manufacturer’s specifications, Hologic Inc, Bedford, MA
36.
go back to reference Reuben DB, Siu AL (1990) An objective measure of physical function of elderly outpatients. The physical performance test. J Am Geriatr Soc 38:1105–1112PubMed Reuben DB, Siu AL (1990) An objective measure of physical function of elderly outpatients. The physical performance test. J Am Geriatr Soc 38:1105–1112PubMed
37.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94PubMed Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94PubMed
38.
go back to reference Harkonen R, Harju R, Alaranta H (1993) Accuracy of the Jamar dynamometer. J Hand Ther 6:259–262PubMed Harkonen R, Harju R, Alaranta H (1993) Accuracy of the Jamar dynamometer. J Hand Ther 6:259–262PubMed
39.
go back to reference Chen TC, Turner AK, Holick MF (1990) Methods for the determination of the circulating concentration of 25-hydroxyvitamin D. J Nutr Biochem 1:315–319PubMedCrossRef Chen TC, Turner AK, Holick MF (1990) Methods for the determination of the circulating concentration of 25-hydroxyvitamin D. J Nutr Biochem 1:315–319PubMedCrossRef
40.
go back to reference Green LW (1970) Manual for scoring socioeconomic status for research on health behavior. Public Health Rep 85:815–827PubMed Green LW (1970) Manual for scoring socioeconomic status for research on health behavior. Public Health Rep 85:815–827PubMed
41.
go back to reference Cummings SR, Marcus R, Palermo L et al (1994) Does estimating volumetric bone density of the femoral neck improve the prediction of hip fracture? A prospective study. Study of Osteoporotic Fractures Research Group. J Bone Miner Res 9:1429–1432PubMed Cummings SR, Marcus R, Palermo L et al (1994) Does estimating volumetric bone density of the femoral neck improve the prediction of hip fracture? A prospective study. Study of Osteoporotic Fractures Research Group. J Bone Miner Res 9:1429–1432PubMed
42.
go back to reference Hui SL, Slemenda CW, Carey MA et al (1995) Choosing between predictors of fractures. J Bone Miner Res 10:1816–1822PubMedCrossRef Hui SL, Slemenda CW, Carey MA et al (1995) Choosing between predictors of fractures. J Bone Miner Res 10:1816–1822PubMedCrossRef
43.
go back to reference Melton LJ 3rd, Atkinson EJ, O’Connor MK et al (1998) Bone density and fracture risk in men. J Bone Miner Res 13:1915–1923PubMedCrossRef Melton LJ 3rd, Atkinson EJ, O’Connor MK et al (1998) Bone density and fracture risk in men. J Bone Miner Res 13:1915–1923PubMedCrossRef
44.
go back to reference Nevill AM, Holder RL, Maffulli N et al (2002) Adjusting bone mass for differences in projected bone area and other confounding variables: an allometric perspective. J Bone Miner Res 17:703–708PubMedCrossRef Nevill AM, Holder RL, Maffulli N et al (2002) Adjusting bone mass for differences in projected bone area and other confounding variables: an allometric perspective. J Bone Miner Res 17:703–708PubMedCrossRef
45.
go back to reference Lin SS, Kelsey JL (2000) Use of race and ethnicity in epidemiologic research: concepts, methodological issues, and suggestions for research. Epidemiol Rev 22:187–202PubMed Lin SS, Kelsey JL (2000) Use of race and ethnicity in epidemiologic research: concepts, methodological issues, and suggestions for research. Epidemiol Rev 22:187–202PubMed
46.
go back to reference Hernán MA, Hernández-Díaz S, Werler MM et al (2002) Causal knowledge as a prerequisite for confounding evaluation: an application to birth defects epidemiology. Am J Epidemiol 155:176–184PubMedCrossRef Hernán MA, Hernández-Díaz S, Werler MM et al (2002) Causal knowledge as a prerequisite for confounding evaluation: an application to birth defects epidemiology. Am J Epidemiol 155:176–184PubMedCrossRef
47.
go back to reference Leib ES, Lewiecki EM, Binkley N et al (2004) Official positions of the International Society for Clinical Densitometry. J Clin Densitom 7:1–6PubMedCrossRef Leib ES, Lewiecki EM, Binkley N et al (2004) Official positions of the International Society for Clinical Densitometry. J Clin Densitom 7:1–6PubMedCrossRef
48.
go back to reference Seeman E (1998) Growth in bone mass and size–are racial and gender differences in bone mineral density more apparent than real? J Clin Endocrinol Metab 83:1414–1419PubMedCrossRef Seeman E (1998) Growth in bone mass and size–are racial and gender differences in bone mineral density more apparent than real? J Clin Endocrinol Metab 83:1414–1419PubMedCrossRef
49.
51.
go back to reference Hastie TJ, Tibshurani RJ (1990) Generalized additive models. Chapman and Hall/CRC, Boca Raton Hastie TJ, Tibshurani RJ (1990) Generalized additive models. Chapman and Hall/CRC, Boca Raton
Metadata
Title
Race/ethnic differences in bone mineral density in men
Authors
A. B. Araujo
T. G. Travison
S. S. Harris
M. F. Holick
A. K. Turner
J. B. McKinlay
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 7/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0321-9

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