A prospective study of bone loss in African-American and white women--a clinical research center study
MM Luckey, S Wallenstein, R Lapinski and DE Meier
Departments of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York 10029, USA.
Although bone loss occurs universally with age, the incidence of age-
related osteoporotic fractures varies widely among ethnic groups. In the
U.S., age-adjusted hip fracture incidence is 50% lower in African- American
than in white women. Adult African-American women also have higher bone
mass, but it is not known whether this difference is entirely due to higher
peak bone mass or also results from slower rates of bone loss. Rates of
bone loss were measured prospectively in 122 white and 121 African-American
healthy, nonobese, pre- and postmenopausal women. Bone density was measured
at 6-month intervals over a mean of 3-4 yr using single and dual photon
absorptiometry of the forearm (cortical bone) and spine (trabecular bone).
Similar rates of premenopausal bone loss were documented in both white and
African- American women. However, in early menopause, bone loss was faster
in the white women in the forearm (-2.4%/yr in whites vs. -1.2%/yr in
African-Americans; P = 0.045), with a similar trend in the spine (- 2.2%/yr
in whites vs. -1.3/yr in African-Americans; P = 0.27). In women more than 5
yr postmenopause, the rates of bone loss did not differ by ethnic group.
Our results indicate that the higher bone mass in African- American women
is largely due to the attainment of a greater peak bone mass by early
adulthood. However, slower rates of bone loss in the early postmenopausal
period may also contribute to the higher bone density of older
African-American women. Although bone loss occurs in both groups, there are
ethnic differences in bone loss rates which indicate that data derived from
white women cannot be simply extrapolated to nonwhite populations. Ethnic
group-specific data on the determinants of bone homeostasis are needed.
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