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Osteoporosis and fracture risk in women of different ethnic groups.
J Bone Miner Res. 2005 Feb; 20(2):185-94.JB

Abstract

Osteoporosis and 1-year fracture risk were studied in 197,848 postmenopausal American women from five ethnic groups. Weight explained differences in BMD, except among blacks, who had the highest BMD. One SD decrease in BMD predicted a 50% increased fracture risk in each group. Despite similar relative risks, absolute fracture rates differed.

INTRODUCTION

Most information about osteoporosis comes from studies of white women. This study describes the frequency of osteoporosis and the association between BMD and fracture in women from five ethnic groups.

MATERIALS AND METHODS

This study was made up of a cohort of 197,848 community-dwelling postmenopausal women (7784 blacks, 1912 Asians, 6973 Hispanics, and 1708 Native Americans) from the United States, without known osteoporosis or a recent BMD test. Heel, forearm, or finger BMD was measured, and risk factor information was obtained; 82% were followed for 1 year for new fractures. BMD and fracture rates were compared, adjusting for differences in covariates.

RESULTS

By age 80, more than one-fifth of women in each ethnic group had peripheral BMD T scores <-2.5. Black women had the highest BMD; Asian women had the lowest. Only the BMD differences for blacks were not explained by differences in weight. After 1 year, 2414 new fractures of the spine, hip, forearm, wrist, or rib were reported. BMD at each site predicted fractures equally well within each ethnic group. After adjusting for BMD, weight, and other covariates, white and Hispanic women had the highest risk for fracture (relative risk [RR] 1.0 [referent group] and 0.95, 95% CI, 0.76, 1.20, respectively), followed by Native Americans (RR, 0.87; 95% CI, 0.57, 1.32), blacks (RR, 0.52; 95% CI, 0.38, 0.70), and Asian Americans (RR, 0.32; 95% CI, 0.15, 0.66). In age- and weight-adjusted models, each SD decrease in peripheral BMD predicted a 1.54 times increased risk of fracture in each ethnic group (95% CI, 1.48-1.61). Excluding wrist fractures, the most common fracture, did not materially change associations.

CONCLUSIONS

Ethnic differences in BMD are strongly influenced by body weight; fracture risk is strongly influenced by BMD in each group. Ethnic differences in absolute fracture risk remain, which may warrant ethnic-specific clinical recommendations.

Authors+Show Affiliations

Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA 92093-0607, USA. ebarrettconnor@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15647811

Citation

Barrett-Connor, Elizabeth, et al. "Osteoporosis and Fracture Risk in Women of Different Ethnic Groups." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 2, 2005, pp. 185-94.
Barrett-Connor E, Siris ES, Wehren LE, et al. Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res. 2005;20(2):185-94.
Barrett-Connor, E., Siris, E. S., Wehren, L. E., Miller, P. D., Abbott, T. A., Berger, M. L., Santora, A. C., & Sherwood, L. M. (2005). Osteoporosis and fracture risk in women of different ethnic groups. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(2), 185-94.
Barrett-Connor E, et al. Osteoporosis and Fracture Risk in Women of Different Ethnic Groups. J Bone Miner Res. 2005;20(2):185-94. PubMed PMID: 15647811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Osteoporosis and fracture risk in women of different ethnic groups. AU - Barrett-Connor,Elizabeth, AU - Siris,Ethel S, AU - Wehren,Lois E, AU - Miller,Paul D, AU - Abbott,Thomas A, AU - Berger,Marc L, AU - Santora,Arthur C, AU - Sherwood,Louis M, Y1 - 2004/10/18/ PY - 2004/02/10/received PY - 2004/09/02/revised PY - 2004/09/14/accepted PY - 2005/1/14/pubmed PY - 2005/6/9/medline PY - 2005/1/14/entrez SP - 185 EP - 94 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 20 IS - 2 N2 - UNLABELLED: Osteoporosis and 1-year fracture risk were studied in 197,848 postmenopausal American women from five ethnic groups. Weight explained differences in BMD, except among blacks, who had the highest BMD. One SD decrease in BMD predicted a 50% increased fracture risk in each group. Despite similar relative risks, absolute fracture rates differed. INTRODUCTION: Most information about osteoporosis comes from studies of white women. This study describes the frequency of osteoporosis and the association between BMD and fracture in women from five ethnic groups. MATERIALS AND METHODS: This study was made up of a cohort of 197,848 community-dwelling postmenopausal women (7784 blacks, 1912 Asians, 6973 Hispanics, and 1708 Native Americans) from the United States, without known osteoporosis or a recent BMD test. Heel, forearm, or finger BMD was measured, and risk factor information was obtained; 82% were followed for 1 year for new fractures. BMD and fracture rates were compared, adjusting for differences in covariates. RESULTS: By age 80, more than one-fifth of women in each ethnic group had peripheral BMD T scores <-2.5. Black women had the highest BMD; Asian women had the lowest. Only the BMD differences for blacks were not explained by differences in weight. After 1 year, 2414 new fractures of the spine, hip, forearm, wrist, or rib were reported. BMD at each site predicted fractures equally well within each ethnic group. After adjusting for BMD, weight, and other covariates, white and Hispanic women had the highest risk for fracture (relative risk [RR] 1.0 [referent group] and 0.95, 95% CI, 0.76, 1.20, respectively), followed by Native Americans (RR, 0.87; 95% CI, 0.57, 1.32), blacks (RR, 0.52; 95% CI, 0.38, 0.70), and Asian Americans (RR, 0.32; 95% CI, 0.15, 0.66). In age- and weight-adjusted models, each SD decrease in peripheral BMD predicted a 1.54 times increased risk of fracture in each ethnic group (95% CI, 1.48-1.61). Excluding wrist fractures, the most common fracture, did not materially change associations. CONCLUSIONS: Ethnic differences in BMD are strongly influenced by body weight; fracture risk is strongly influenced by BMD in each group. Ethnic differences in absolute fracture risk remain, which may warrant ethnic-specific clinical recommendations. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15647811/Osteoporosis_and_fracture_risk_in_women_of_different_ethnic_groups_ L2 - https://doi.org/10.1359/JBMR.041007 DB - PRIME DP - Unbound Medicine ER -