Skip to main content
Top
Published in: Archives of Osteoporosis 1/2015

Open Access 01-12-2015 | Short Communication

Lower bone mineral density in Somali women living in Sweden compared with African–Americans

Authors: Taye Demeke, Gamal Abd El-Gawad, Amra Osmancevic, Martin Gillstedt, Kerstin Landin-Wilhelmsen

Published in: Archives of Osteoporosis | Issue 1/2015

Login to get access

Abstract

Summary

Vitamin D deficiency can lead to osteomalacia. Bone mineral density was lower in Somali women, living in Sweden, in relation to both the American and the African–American reference populations. The majority, 73 %, had vitamin D deficiency, and supplementation should be considered to prevent from osteomalacia, osteoporosis and future fractures.

Purpose

Low vitamin D can lead to osteomalacia. The hypothesis was that bone mineral density (BMD) in Somali women living in Sweden was lower in comparison with different ethnic reference populations.

Methods

Women from Somalia, n = 67, median age 35.8 years (range 18 to 56), latitude 0–10° North living in Gothenburg, Sweden, latitude 57° North, >2 years were studied. All wore traditional Islamic clothing and had skin photo type V. BMD was recorded as the Z-score and compared with white American and African–American women, respectively, using standard data from the dual energy X-ray absorptiometry (DXA) manufacturer (Lunar Prodigy enCORETM, GE Healthcare, LU44663). A fasting blood test was drawn for analysis of serum 25(OH)D.

Results

The median Z-score compared with the American white population was −0.9 SD of the lumbar spine (p < 0.00001), 0.1 SD of the left hip and 0.0 SD of the right hip (ns).
The median Z-score compared with the African–American population was −1.6 SD of the lumbar spine (p < 0.00001), −0.9 SD of the left hip and −0.9 SD of the right hip (p < 0.001). The majority, 73 %, had vitamin D deficiency, serum 25(OH)D <25 nmol/l (<10 ng/ml). BMD did not correlate to vitamin D levels or to the number of years in Sweden. One wrist fracture was reported.

Conclusions

BMD was lower in these fairly young immigrant women from Somalia, living in Sweden, in relation to both the American and the African–American reference populations. Vitamin D supplementation should be considered to prevent from osteomalacia, osteoporosis and future fractures.
Literature
2.
go back to reference Grant WB, Holick MF (2005) Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10:94–111PubMed Grant WB, Holick MF (2005) Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10:94–111PubMed
3.
go back to reference Yoshida T, Stern PH (2012) How vitamin D works on bone. Endocrinol Metab Clin N Am 41:557–569CrossRef Yoshida T, Stern PH (2012) How vitamin D works on bone. Endocrinol Metab Clin N Am 41:557–569CrossRef
4.
go back to reference Holick MF (2013) Bioavailability of vitamin D and its metabolites in black and white adults. N Engl J Med 369:2047–2048PubMedCrossRef Holick MF (2013) Bioavailability of vitamin D and its metabolites in black and white adults. N Engl J Med 369:2047–2048PubMedCrossRef
5.
go back to reference Leslie WD (2012) Clinical review: ethnic differences in bone mass–clinical implications. J Clin Endocrinol Metab 97:4329–4340PubMedCrossRef Leslie WD (2012) Clinical review: ethnic differences in bone mass–clinical implications. J Clin Endocrinol Metab 97:4329–4340PubMedCrossRef
6.
go back to reference Finkelstein JS, Lee M-LT, Sowers M, Ettinger B, Neer RM, Kelsey JL, Cauley JA, Huang MH, Greendale GA (2002) Ethnic variation in bone density in premenopausal and early perimenopausal women: effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab 87:3057–3067PubMedCrossRef Finkelstein JS, Lee M-LT, Sowers M, Ettinger B, Neer RM, Kelsey JL, Cauley JA, Huang MH, Greendale GA (2002) Ethnic variation in bone density in premenopausal and early perimenopausal women: effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab 87:3057–3067PubMedCrossRef
7.
go back to reference Gong G, Haynatzki G, Haynatzka V, Kosoko-Lasaki S, Howell R, Fu Y-X, Gallagher JC, Wilson MR (2006) Bone mineral density of recent African immigrants in the United States. J Natl Med Assoc 98:746–752PubMedPubMedCentral Gong G, Haynatzki G, Haynatzka V, Kosoko-Lasaki S, Howell R, Fu Y-X, Gallagher JC, Wilson MR (2006) Bone mineral density of recent African immigrants in the United States. J Natl Med Assoc 98:746–752PubMedPubMedCentral
8.
go back to reference Schnitzler CM (1993) Bone quality: a determinant for certain risk factors for bone fragility. Calcif Tissue Int 53(Suppl 1):S27–S31PubMedCrossRef Schnitzler CM (1993) Bone quality: a determinant for certain risk factors for bone fragility. Calcif Tissue Int 53(Suppl 1):S27–S31PubMedCrossRef
9.
go back to reference Melton III LJ, Marquez MA, Achenbach SJ, Tefferi A, O’Connor MK, O’Fallon WM, Riggs BL (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13:551–559 Melton III LJ, Marquez MA, Achenbach SJ, Tefferi A, O’Connor MK, O’Fallon WM, Riggs BL (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13:551–559
10.
go back to reference Sullivan M, Sullivan M, Karlsson J, Ware J (1995) The Swedish SF-36 Health Survey-I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41:1349–58PubMedCrossRef Sullivan M, Sullivan M, Karlsson J, Ware J (1995) The Swedish SF-36 Health Survey-I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41:1349–58PubMedCrossRef
11.
go back to reference Islam MZ, Viljakainen HT, Kärkkäinen MU, Saarnio E, Laitinen K, Lamberg-Allardt C (2012) Prevalence of vitamin D deficiency and secondary hyperparathyroidism during winter in pre-menopausal Bangladeshi and Somali immigrant and ethnic Finnish women: associations with forearm bone mineral density. Br J Nutr 107:277–283PubMedCrossRef Islam MZ, Viljakainen HT, Kärkkäinen MU, Saarnio E, Laitinen K, Lamberg-Allardt C (2012) Prevalence of vitamin D deficiency and secondary hyperparathyroidism during winter in pre-menopausal Bangladeshi and Somali immigrant and ethnic Finnish women: associations with forearm bone mineral density. Br J Nutr 107:277–283PubMedCrossRef
12.
go back to reference Mytton J, Frater AP, Oakley G, Murphy E, Barber MJ, Jahfar S (2007) Vitamin D deficiency in multicultural primary care: a case series of 299 patients. Br J Gen Pract 57:577–579PubMedPubMedCentral Mytton J, Frater AP, Oakley G, Murphy E, Barber MJ, Jahfar S (2007) Vitamin D deficiency in multicultural primary care: a case series of 299 patients. Br J Gen Pract 57:577–579PubMedPubMedCentral
13.
go back to reference Bhan A, Rao AD, Rao DS (2012) Osteomalacia as a result of vitamin D deficiency. Rheum Dis Clin N Am 38:81–91CrossRef Bhan A, Rao AD, Rao DS (2012) Osteomalacia as a result of vitamin D deficiency. Rheum Dis Clin N Am 38:81–91CrossRef
14.
go back to reference Benson J, Skull S (2007) Hiding from the sun—vitamin D deficiency in refugees. Aust Fam Physician 36:355–357PubMed Benson J, Skull S (2007) Hiding from the sun—vitamin D deficiency in refugees. Aust Fam Physician 36:355–357PubMed
15.
16.
go back to reference Graafmans WC, Lips P, Ooms ME, van Leeuwen JP, Pols HA, Uitterlinden AG (1997) The effect of vitamin D supplementation on the bone mineral density of the femoral neck is associated with vitamin D receptor genotype. J Bone Miner Res 12:1241–1245PubMedCrossRef Graafmans WC, Lips P, Ooms ME, van Leeuwen JP, Pols HA, Uitterlinden AG (1997) The effect of vitamin D supplementation on the bone mineral density of the femoral neck is associated with vitamin D receptor genotype. J Bone Miner Res 12:1241–1245PubMedCrossRef
17.
go back to reference Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellström D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194PubMedCrossRef Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellström D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194PubMedCrossRef
18.
go back to reference Borgström F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Lunsjö K, Thorngren KG, Sernbo I, Rehnberg C, Jönsson B (2006) Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17:637–650PubMedCrossRef Borgström F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Lunsjö K, Thorngren KG, Sernbo I, Rehnberg C, Jönsson B (2006) Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17:637–650PubMedCrossRef
19.
go back to reference Landin-Wilhelmsen K, Wilhelmsen L, Wilske J, Lappas G, Rosen T, Lindstedt G, Lundberg P-A, Bengtsson B-Å (1995) Sunlight increases serum 25(OH) vitamin D concentration whereas 1,25(OH)2D3 is unaffected. Results from a general population study in Gothenburg, Sweden. (The WHO MONICA Project). Eur J Clin Nutr 49:400–407PubMed Landin-Wilhelmsen K, Wilhelmsen L, Wilske J, Lappas G, Rosen T, Lindstedt G, Lundberg P-A, Bengtsson B-Å (1995) Sunlight increases serum 25(OH) vitamin D concentration whereas 1,25(OH)2D3 is unaffected. Results from a general population study in Gothenburg, Sweden. (The WHO MONICA Project). Eur J Clin Nutr 49:400–407PubMed
20.
go back to reference Tan S, Ji L, Tsai J, Eng J, Ko HJ, Yau A, Edwards G, Bunta A, Edwards BJ (2009) Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown. Chic Osteoporos Int 20:1517–1522CrossRef Tan S, Ji L, Tsai J, Eng J, Ko HJ, Yau A, Edwards G, Bunta A, Edwards BJ (2009) Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown. Chic Osteoporos Int 20:1517–1522CrossRef
Metadata
Title
Lower bone mineral density in Somali women living in Sweden compared with African–Americans
Authors
Taye Demeke
Gamal Abd El-Gawad
Amra Osmancevic
Martin Gillstedt
Kerstin Landin-Wilhelmsen
Publication date
01-12-2015
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2015
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-015-0208-5

Other articles of this Issue 1/2015

Archives of Osteoporosis 1/2015 Go to the issue