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Published in: Osteoporosis International 2/2011

01-02-2011 | Original Article

Age-related decline in bone density among ethnically diverse older men

Authors: Y. Sheu, J. A. Cauley, V. W. Wheeler, A. L. Patrick, C. H. Bunker, K. E. Ensrud, E. S. Orwoll, J. M. Zmuda, for the Osteoporotic Fracture in Men (MrOS) Research Group

Published in: Osteoporosis International | Issue 2/2011

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Abstract

Summary

We compared rates of BMD decline in older men of diverse ethnic backgroud. The rate of bone loss was statistically equivalent between men of African and Caucasian descent.

Introduction

Race differences in peak bone mineral density (BMD) are well established, but the magnitude of bone loss among non-white men has not been well characterized. Our objective was to compare and contrast the rates of decline in BMD with aging among older men of different race/ethnic groups.

Methods

The rate of decline in hip BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR-4500 W) with an average follow-up of 4.6 years in 3,869 Caucasian, 138 African American, 145 Asian, and 334 Afro-Caribbean men aged ≥ 65 years (Mean ages: 73 ± 5, 70 ± 4, 72 ± 5, 71 ± 5 years, respectively).

Results

The annual rate of decline in BMD at the femoral neck was −0.32%, −0.42%, −0.09%, and −0.44%/year for Caucasian, African American, Asian, and Afro-Caribbean men, respectively (p < 0.05 for Caucasian versus Asian). Although men of African ancestry have higher peak BMD than Caucasians, rates of decline in BMD with aging appear to be statistically equivalent in our study. In contrast, Asian men experienced a slower rate of decline in BMD compared with Caucasians and African Americans.

Conclusion

More studies are needed to better define the natural history of and factors associated with bone loss among non-white men.
Literature
1.
go back to reference Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767CrossRefPubMed Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767CrossRefPubMed
2.
go back to reference Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413CrossRefPubMed Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413CrossRefPubMed
3.
go back to reference Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed
4.
go back to reference Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475CrossRefPubMed Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475CrossRefPubMed
5.
go back to reference Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489CrossRefPubMed Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489CrossRefPubMed
6.
go back to reference Hill DD, Cauley JA, Sheu Y, Bunker CH, Patrick AL, Baker CE, Beckles GL, Wheeler VW, Zmuda JM (2008) Correlates of bone mineral density in men of African ancestry: the Tobago bone health study. Osteoporos Int 19:227–234CrossRefPubMed Hill DD, Cauley JA, Sheu Y, Bunker CH, Patrick AL, Baker CE, Beckles GL, Wheeler VW, Zmuda JM (2008) Correlates of bone mineral density in men of African ancestry: the Tobago bone health study. Osteoporos Int 19:227–234CrossRefPubMed
7.
go back to reference Burger H, de Laet CE, van Daele PL, Weel AE, Witteman JC, Hofman A, Pols HA (1998) Risk factors for increased bone loss in an elderly population: the Rotterdam Study. Am J Epidemiol 147:871–879PubMed Burger H, de Laet CE, van Daele PL, Weel AE, Witteman JC, Hofman A, Pols HA (1998) Risk factors for increased bone loss in an elderly population: the Rotterdam Study. Am J Epidemiol 147:871–879PubMed
8.
go back to reference Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 15:710–720CrossRefPubMed Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 15:710–720CrossRefPubMed
9.
go back to reference Melton LJ 3rd, Khosla S, Atkinson EJ, Oconnor MK, Ofallon WM, Riggs BL (2000) Cross-sectional versus longitudinal evaluation of bone loss in men and women. Osteoporos Int 11:592–599CrossRefPubMed Melton LJ 3rd, Khosla S, Atkinson EJ, Oconnor MK, Ofallon WM, Riggs BL (2000) Cross-sectional versus longitudinal evaluation of bone loss in men and women. Osteoporos Int 11:592–599CrossRefPubMed
10.
go back to reference Kaptoge S, Welch A, McTaggart A, Mulligan A, Dalzell N, Day NE, Bingham S, Khaw KT, Reeve J (2003) Effects of dietary nutrients and food groups on bone loss from the proximal femur in men and women in the 7th and 8th decades of age. Osteoporos Int 14:418–428CrossRefPubMed Kaptoge S, Welch A, McTaggart A, Mulligan A, Dalzell N, Day NE, Bingham S, Khaw KT, Reeve J (2003) Effects of dietary nutrients and food groups on bone loss from the proximal femur in men and women in the 7th and 8th decades of age. Osteoporos Int 14:418–428CrossRefPubMed
11.
go back to reference Bakhireva LN, Barrett-Connor E, Kritz-Silverstein D, Morton DJ (2004) Modifiable predictors of bone loss in older men: a prospective study. Am J Prev Med 26:436–442CrossRefPubMed Bakhireva LN, Barrett-Connor E, Kritz-Silverstein D, Morton DJ (2004) Modifiable predictors of bone loss in older men: a prospective study. Am J Prev Med 26:436–442CrossRefPubMed
12.
go back to reference Ensrud KE, Fullman RL, Barrett-Connor E, Cauley JA, Stefanick ML, Fink HA, Lewis CE, Orwoll E (2005) Voluntary weight reduction in older men increases hip bone loss: the osteoporotic fractures in men study. J Clin Endocrinol Metab 90:1998–2004CrossRefPubMed Ensrud KE, Fullman RL, Barrett-Connor E, Cauley JA, Stefanick ML, Fink HA, Lewis CE, Orwoll E (2005) Voluntary weight reduction in older men increases hip bone loss: the osteoporotic fractures in men study. J Clin Endocrinol Metab 90:1998–2004CrossRefPubMed
13.
go back to reference Cawthon PM, Ewing SK, McCulloch CE, Ensrud KE, Cauley JA, Cummings SR, Orwoll ES (2009) Loss of hip BMD in older men: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 24:1728–1735CrossRefPubMed Cawthon PM, Ewing SK, McCulloch CE, Ensrud KE, Cauley JA, Cummings SR, Orwoll ES (2009) Loss of hip BMD in older men: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 24:1728–1735CrossRefPubMed
14.
go back to reference Dennison E, Eastell R, Fall CH, Kellingray S, Wood PJ, Cooper C (1999) Determinants of bone loss in elderly men and women: a prospective population-based study. Osteoporos Int 10:384–391CrossRefPubMed Dennison E, Eastell R, Fall CH, Kellingray S, Wood PJ, Cooper C (1999) Determinants of bone loss in elderly men and women: a prospective population-based study. Osteoporos Int 10:384–391CrossRefPubMed
15.
go back to reference Emaus N, Berntsen GK, Joakimsen R, Fonnebo V (2006) Longitudinal changes in forearm bone mineral density in women and men aged 45–84 years: the Tromso Study, a population-based study. Am J Epidemiol 163:441–449CrossRefPubMed Emaus N, Berntsen GK, Joakimsen R, Fonnebo V (2006) Longitudinal changes in forearm bone mineral density in women and men aged 45–84 years: the Tromso Study, a population-based study. Am J Epidemiol 163:441–449CrossRefPubMed
16.
go back to reference Kaptoge S, Reid DM, Scheidt-Nave C, Poor G, Pols HA, Khaw KT, Felsenberg D, Benevolenskaya LI, Diaz MN, Stepan JJ, Eastell R, Boonen S, Cannata JB, Glueer CC, Crabtree NJ, Kaufman JM, Reeve J (2007) Geographic and other determinants of BMD change in European men and women at the hip and spine. a population-based study from the Network in Europe for Male Osteoporosis (NEMO). Bone 40:662–673CrossRefPubMed Kaptoge S, Reid DM, Scheidt-Nave C, Poor G, Pols HA, Khaw KT, Felsenberg D, Benevolenskaya LI, Diaz MN, Stepan JJ, Eastell R, Boonen S, Cannata JB, Glueer CC, Crabtree NJ, Kaufman JM, Reeve J (2007) Geographic and other determinants of BMD change in European men and women at the hip and spine. a population-based study from the Network in Europe for Male Osteoporosis (NEMO). Bone 40:662–673CrossRefPubMed
17.
go back to reference Warming L, Hassager C, Christiansen C (2002) Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporos Int 13:105–112CrossRefPubMed Warming L, Hassager C, Christiansen C (2002) Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporos Int 13:105–112CrossRefPubMed
18.
go back to reference Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–695PubMed Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–695PubMed
19.
go back to reference Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2005) Racial differences in rate of decline in bone mass in older men: the Baltimore men's osteoporosis study. J Bone Miner Res 20:1228–1234CrossRefPubMed Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2005) Racial differences in rate of decline in bone mass in older men: the Baltimore men's osteoporosis study. J Bone Miner Res 20:1228–1234CrossRefPubMed
20.
go back to reference Blank JB, Cawthon PM, Carrion-Petersen ML, Harper L, Johnson JP, Mitson E, Delay RR (2005) Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemp Clin Trials 26:557–568CrossRefPubMed Blank JB, Cawthon PM, Carrion-Petersen ML, Harper L, Johnson JP, Mitson E, Delay RR (2005) Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemp Clin Trials 26:557–568CrossRefPubMed
21.
go back to reference Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (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 26:569–585CrossRefPubMed Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (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 26:569–585CrossRefPubMed
22.
go back to reference Bunker CH, Patrick AL, Konety BR, Dhir R, Brufsky AM, Vivas CA, Becich MJ, Trump DL, Kuller LH (2002) High prevalence of screening-detected prostate cancer among Afro-Caribbeans: the Tobago Prostate Cancer Survey. Cancer Epidemiol Biomarkers Prev 11:726–729PubMed Bunker CH, Patrick AL, Konety BR, Dhir R, Brufsky AM, Vivas CA, Becich MJ, Trump DL, Kuller LH (2002) High prevalence of screening-detected prostate cancer among Afro-Caribbeans: the Tobago Prostate Cancer Survey. Cancer Epidemiol Biomarkers Prev 11:726–729PubMed
23.
go back to reference Melton LJ 3rd, Khosla S, Achenbach SJ, O'Connor MK, O'Fallon WM, Riggs BL (2000) Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men. Osteoporos Int 11:977–983CrossRefPubMed Melton LJ 3rd, Khosla S, Achenbach SJ, O'Connor MK, O'Fallon WM, Riggs BL (2000) Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men. Osteoporos Int 11:977–983CrossRefPubMed
24.
go back to reference Glover FE Jr, Coffey DS, Douglas LL, Cadogan M, Russell H, Tulloch T, Baker TD, Wan RL, Walsh PC (1998) The epidemiology of prostate cancer in Jamaica. J Urol 159:1984–1986, discussion 1986-1987CrossRefPubMed Glover FE Jr, Coffey DS, Douglas LL, Cadogan M, Russell H, Tulloch T, Baker TD, Wan RL, Walsh PC (1998) The epidemiology of prostate cancer in Jamaica. J Urol 159:1984–1986, discussion 1986-1987CrossRefPubMed
25.
go back to reference Conde FA, Sarna L, Oka RK, Vredevoe DL, Rettig MB, Aronson WJ (2004) Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy. Urology 64:335–340CrossRefPubMed Conde FA, Sarna L, Oka RK, Vredevoe DL, Rettig MB, Aronson WJ (2004) Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy. Urology 64:335–340CrossRefPubMed
26.
go back to reference Kiratli BJ, Srinivas S, Perkash I, Terris MK (2001) Progressive decrease in bone density over 10 years of androgen deprivation therapy in patients with prostate cancer. Urology 57:127–132CrossRefPubMed Kiratli BJ, Srinivas S, Perkash I, Terris MK (2001) Progressive decrease in bone density over 10 years of androgen deprivation therapy in patients with prostate cancer. Urology 57:127–132CrossRefPubMed
27.
go back to reference Preston DM, Torrens JI, Harding P, Howard RS, Duncan WE, McLeod DG (2002) Androgen deprivation in men with prostate cancer is associated with an increased rate of bone loss. Prostate Cancer Prostatic Dis 5:304–310CrossRefPubMed Preston DM, Torrens JI, Harding P, Howard RS, Duncan WE, McLeod DG (2002) Androgen deprivation in men with prostate cancer is associated with an increased rate of bone loss. Prostate Cancer Prostatic Dis 5:304–310CrossRefPubMed
28.
go back to reference Maillefert JF, Sibilia J, Michel F, Saussine C, Javier RM, Tavernier C (1999) Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma. J Urol 161:1219–1222CrossRefPubMed Maillefert JF, Sibilia J, Michel F, Saussine C, Javier RM, Tavernier C (1999) Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma. J Urol 161:1219–1222CrossRefPubMed
29.
go back to reference Goldray D, Weisman Y, Jaccard N, Merdler C, Chen J, Matzkin H (1993) Decreased bone density in elderly men treated with the gonadotropin-releasing hormone agonist decapeptyl (D-Trp6-GnRH). J Clin Endocrinol Metab 76:288–290CrossRefPubMed Goldray D, Weisman Y, Jaccard N, Merdler C, Chen J, Matzkin H (1993) Decreased bone density in elderly men treated with the gonadotropin-releasing hormone agonist decapeptyl (D-Trp6-GnRH). J Clin Endocrinol Metab 76:288–290CrossRefPubMed
30.
go back to reference Greenspan SL, Coates P, Sereika SM, Nelson JB, Trump DL, Resnick NM (2005) Bone loss after initiation of androgen deprivation therapy in patients with prostate cancer. J Clin Endocrinol Metab 90:6410–6417CrossRefPubMed Greenspan SL, Coates P, Sereika SM, Nelson JB, Trump DL, Resnick NM (2005) Bone loss after initiation of androgen deprivation therapy in patients with prostate cancer. J Clin Endocrinol Metab 90:6410–6417CrossRefPubMed
31.
go back to reference Wei JT, Gross M, Jaffe CA, Gravlin K, Lahaie M, Faerber GJ, Cooney KA (1999) Androgen deprivation therapy for prostate cancer results in significant loss of bone density. Urology 54:607–611CrossRefPubMed Wei JT, Gross M, Jaffe CA, Gravlin K, Lahaie M, Faerber GJ, Cooney KA (1999) Androgen deprivation therapy for prostate cancer results in significant loss of bone density. Urology 54:607–611CrossRefPubMed
32.
go back to reference Mittan D, Lee S, Miller E, Perez RC, Basler JW, Bruder JM (2002) Bone loss following hypogonadism in men with prostate cancer treated with GnRH analogs. J Clin Endocrinol Metab 87:3656–3661CrossRefPubMed Mittan D, Lee S, Miller E, Perez RC, Basler JW, Bruder JM (2002) Bone loss following hypogonadism in men with prostate cancer treated with GnRH analogs. J Clin Endocrinol Metab 87:3656–3661CrossRefPubMed
33.
go back to reference Nelson DA, Jacobsen G, Barondess DA, Parfitt AM (1995) Ethnic differences in regional bone density, hip axis length, and lifestyle variables among healthy black and white men. J Bone Miner Res 10:782–787CrossRefPubMed Nelson DA, Jacobsen G, Barondess DA, Parfitt AM (1995) Ethnic differences in regional bone density, hip axis length, and lifestyle variables among healthy black and white men. J Bone Miner Res 10:782–787CrossRefPubMed
34.
go back to reference Araujo AB, Travison TG, Harris SS, Holick MF, Turner AK, McKinlay JB (2007) Race/ethnic differences in bone mineral density in men. Osteoporos Int 18:943–953CrossRefPubMed Araujo AB, Travison TG, Harris SS, Holick MF, Turner AK, McKinlay JB (2007) Race/ethnic differences in bone mineral density in men. Osteoporos Int 18:943–953CrossRefPubMed
35.
go back to reference Bachrach LK, Hastie T, Wang MC, Narasimhan B, Marcus R (1999) Bone mineral acquisition in healthy Asian, Hispanic, black, and Caucasian youth: a longitudinal study. J Clin Endocrinol Metab 84:4702–4712CrossRefPubMed Bachrach LK, Hastie T, Wang MC, Narasimhan B, Marcus R (1999) Bone mineral acquisition in healthy Asian, Hispanic, black, and Caucasian youth: a longitudinal study. J Clin Endocrinol Metab 84:4702–4712CrossRefPubMed
36.
go back to reference Bell NH, Gordon L, Stevens J, Shary JR (1995) Demonstration that bone mineral density of the lumbar spine, trochanter, and femoral neck is higher in black than in white young men. Calci Tissue Int 56:11–13CrossRef Bell NH, Gordon L, Stevens J, Shary JR (1995) Demonstration that bone mineral density of the lumbar spine, trochanter, and femoral neck is higher in black than in white young men. Calci Tissue Int 56:11–13CrossRef
37.
go back to reference George A, Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2003) Racial differences in bone mineral density in older men. J Bone Miner Res 18:2238–2244CrossRefPubMed George A, Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2003) Racial differences in bone mineral density in older men. J Bone Miner Res 18:2238–2244CrossRefPubMed
38.
go back to reference Kalkwarf HJ, Zemel BS, Gilsanz V, Lappe JM, Horlick M, Oberfield S, Mahboubi S, Fan B, Frederick MM, Winer K, Shepherd JA (2007) The bone mineral density in childhood study: bone mineral content and density according to age, sex, and race. J Clin Endocrinol Metab 92:2087–2099CrossRefPubMed Kalkwarf HJ, Zemel BS, Gilsanz V, Lappe JM, Horlick M, Oberfield S, Mahboubi S, Fan B, Frederick MM, Winer K, Shepherd JA (2007) The bone mineral density in childhood study: bone mineral content and density according to age, sex, and race. J Clin Endocrinol Metab 92:2087–2099CrossRefPubMed
39.
go back to reference Miljkovic-Gacic I, Ferrell RE, Patrick AL, Kammerer CM, Bunker CH (2005) Estimates of African, European and Native American ancestry in Afro-Caribbean men on the island of Tobago. Hum Hered 60:129–133CrossRefPubMed Miljkovic-Gacic I, Ferrell RE, Patrick AL, Kammerer CM, Bunker CH (2005) Estimates of African, European and Native American ancestry in Afro-Caribbean men on the island of Tobago. Hum Hered 60:129–133CrossRefPubMed
40.
go back to reference Nguyen TV, Eisman JA, Kelly PJ, Sambrook PN (1996) Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144:255–263PubMed Nguyen TV, Eisman JA, Kelly PJ, Sambrook PN (1996) Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144:255–263PubMed
41.
go back to reference Chiu HC, Chen CH, Ho ML, Liu HW, Wu SF, Chang JK (2008) Longitudinal changes in bone mineral density of healthy elderly men in southern Taiwan. J Formosan Med Assoc 107:653–658CrossRefPubMed Chiu HC, Chen CH, Ho ML, Liu HW, Wu SF, Chang JK (2008) Longitudinal changes in bone mineral density of healthy elderly men in southern Taiwan. J Formosan Med Assoc 107:653–658CrossRefPubMed
Metadata
Title
Age-related decline in bone density among ethnically diverse older men
Authors
Y. Sheu
J. A. Cauley
V. W. Wheeler
A. L. Patrick
C. H. Bunker
K. E. Ensrud
E. S. Orwoll
J. M. Zmuda
for the Osteoporotic Fracture in Men (MrOS) Research Group
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 2/2011
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-010-1330-2

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