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Racial/ethnic differences in bone mineral density among older women

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Abstract

The epidemiologic information regarding international differences in bone mineral density (BMD) in women is currently insufficient. We compared BMD in older women across five racial/ethnic groups in four countries. The femoral neck, total hip, and lumbar spine BMD were measured in women (aged 65–74 years) from the Study of Osteoporotic Fractures (SOF) (5,035 Caucasian women and 256 African American women in the US), the Tobago Women’s Health Study (116 Afro-Caribbean women), the Ms Os Hong Kong Study (794 Hong Kong Chinese women) and the Namwon Study (1,377 South Korean women). BMD was corrected according to the cross-site calibration results for all scanners. When compared with US Caucasian women, the age adjusted mean BMD measurements at the hip sites were 21–31 % higher among Tobago Afro-Caribbean women and 13–23 % higher among African American women. The total hip and spine BMD values were 4–5 % lower among Hong Kong Chinese women and 4–7 % lower among South Korean women compared to US Caucasians. The femoral neck BMD was similar in Hong Kong Chinese women, but higher among South Korean women compared to US Caucasians. Current/past estrogen use was a significant contributing factor to the difference in BMD between US versus non-US women. Differences in body weight partially explained the difference in BMD between Asian versus non-Asian women. These findings show substantial racial/ethnic differences in BMD even within African or Asian origin individuals, and highlight the contributing role of body weight and estrogen use to the geographic and racial/ethnic variation in BMD.

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Acknowledgments

This work was supported by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD, Basic Research Promotion Fund) (KRF-2008-013-E00011). The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: AG05407, AR35582, AG05394, AR35584, AR35583, R01 AG005407, R01 AG027576-22, 2 R01 AG005394-22A1, and 2 R01 AG027574-22A1. The Tobago Women’s Health Study was supported, in part, by funding or in-kind services from the Division of Health and Social Services, Tobago House of Assembly and grant R01 AR049747 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The Ms Os Hong Kong Study was supported by grants from the National Institute of Health, USA, with grant no. 1R01 AR049439-01A1, and the Research Grant Council of Hong Kong.

Conflict of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, South Korea

    Hae-Sung Nam

  2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Crabtree Hall A524, Pittsburgh, PA, 15261, USA

    Hae-Sung Nam, Joseph M. Zmuda, Alan L. Patrick & Jane A. Cauley

  3. Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, South Korea

    Sun-Seog Kweon

  4. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea

    Sun-Seog Kweon & Jin-Su Choi

  5. Jockey Club Centre for Osteoporosis Care and Control, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China

    P. C. Leung

  6. San Francisco Coordinating Center, California Pacific Medical Center, San Francisco, CA, USA

    Li-Yung Lui

  7. Worldwide Epidemiology, GlaxoSmithKline Research & Development, Collegeville, PA, USA

    Deanna D. Hill

  8. Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago

    Alan L. Patrick

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  1. Hae-Sung Nam
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  2. Sun-Seog Kweon
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Correspondence to Jane A. Cauley.

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Nam, HS., Kweon, SS., Choi, JS. et al. Racial/ethnic differences in bone mineral density among older women. J Bone Miner Metab 31, 190–198 (2013). https://doi.org/10.1007/s00774-012-0402-0

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  • DOI: https://doi.org/10.1007/s00774-012-0402-0

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