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Differential Effect of Race on the Axial and Appendicular Skeletons of Children¹

Departments of Radiology (V.G., A.K., M.L.L.), Orthopedics (D.L.S.), and Pediatrics (F.K.), Childrens Hospital Los Angeles, Los Angeles, California 90027; Departments of Endocrinology (S.G.K.) and Biostatistics (J.S.), University of California School of Medicine, Los Angeles, California 90024

Address all correspondence and requests for reprints to: Vicente Gilsanz, M.D., Ph.D., Childrens Hospital Los Angeles, Department of Radiology, MS #81, 4650 Sunset Boulevard, Los Angeles, California 90027. E-mail: gilsanz{at}hsc.usc.edu

The prevalence of osteoporosis and the incidence of fractures are substantially lower in black than in white subjects, a finding generally attributed to racial differences in adult bone mass. Whether these racial differences are present in childhood is the subject of considerable interest, as the amount of bone gained during growth is a major determinant of future susceptibility to fractures. We measured the density and size of the vertebrae and femurs of 80 black and 80 white healthy children, 8–18 yr of age, matched for age, gender, height, weight, and stage of sexual development, using computed tomography. Race had a significant and differential effect on the bones in the axial and appendicular skeletons. In the axial skeleton, black children had greater cancellous bone density, but similar cross-sectional area of the vertebral bodies. In contrast, in the appendicular skeleton, black children had greater femoral cross-sectional area, but similar cortical bone area and cortical bone density. Compared to white children, vertebral bone density and femoral cross-sectional area at sexual maturity were, on the average, 10.75% and 5.7% higher, respectively, in black children. Such significant variations may contribute to the racial differences in the prevalence of osteoporosis between black and white adults.

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