Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors
Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors
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DOI：
10.1210/jc.87.7.3057
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发表时间：
2002-07-01
影响因子：
5.8
通讯作者：
Greendale, GA
中科院分区：
文献类型：
--
作者：
Finkelstein, JS;Lee, MLT;Greendale, GA
不同种族的女性的骨密度(BMD)和骨折发生率各不相同。大多数报告表明，非裔美国人的骨密度最高，亚洲人最低，高加索人居中，但亚洲人的骨折发生率低于高加索人。为了评估人体测量学和生活方式特征对骨密度种族差异的影响，我们用双能X射线骨密度仪对参加全国妇女健康研究的2277名(腰椎)和2330名(股骨颈)绝经前或围绝经期早期妇女(平均年龄46.2岁)的腰椎和股骨颈骨密度进行了评估。49%的女性是高加索人，28%是非裔美国人，12%是日本人，11%是中国人。调整协变量前后，比较不同民族间的骨密度。调整前，非裔美国女性的腰椎和股骨颈骨密度最高，高加索女性次之，中国和日本女性最低。非裔美国女性未经调整的腰椎和股骨颈骨密度分别比高加索、日本或中国女性高7-12%和14-24%。调整后，非裔美国女性的腰椎和股骨颈骨密度仍然最高，其余组之间没有显著差异。当对体重小于70公斤的一组女性进行骨密度评估，然后对协变量进行调整后，非裔美国人、中国人和日本人的腰椎骨密度相似，而高加索女性的腰椎骨密度最低。对骨大小进行调整后，中国女性的骨大小增加到与高加索和日本女性相同或更高的水平。在体重相当的女性中，非裔美国人、中国人和日本人的腰椎骨密度没有差异，她们的骨密度都高于高加索人。股骨颈骨密度在非裔美国人中最高，在中国人、日本人和高加索人中相似。这些发现可能解释了为什么高加索女性的骨折发生率高于非裔美国人和亚洲人。
Bone mineral density (BMD) and fracture rates vary among women of differing ethnicities. Most reports suggest that BMD is highest in African-Americans, lowest in Asians, and intermediate in Caucasians, yet Asians have lower fracture rates than Caucasians. To assess the contributions of anthropometric and lifestyle characteristics to ethnic differences in BMD, we assessed lumbar spine and femoral neck BMD by dual-energy x-ray absorptiometry in 2277 (for the lumbar spine) and 2330 (for the femoral neck) premenopausal or early perimenopausal women (mean age, 46.2 yr) participating in the Study of Women's Health Across the Nation. Forty-nine percent of the women were Caucasian, 28% were African-American, 12% were Japanese, and 11% were Chinese. BMDs were compared among ethnic groups before and after adjustment for covariates. Before adjustment, lumbar spine and femoral neck BMDs were highest in African-American women, next highest in Caucasian women, and lowest in Chinese and Japanese women. Unadjusted lumbar spine and femoral neck BMDs were 7-12% and 14-24% higher, respectively, in African-American women than in Caucasians, Japanese, or Chinese women. After adjustment, lumbar spine and femoral neck BMD remained highest in African-American women, and there were no significant differences between the remaining groups. When BMD was assessed in a subset of women weighing less than 70 kg and then adjusted for covariates, lumbar spine BMD became similar in African-American, Chinese, and Japanese women and was lowest in Caucasian women. Adjustment for bone size increased values for Chinese women to levels equal to or above those of Caucasian and Japanese women. Among women of comparable weights, there are no differences in lumbar spine BMD among African-American, Chinese, and Japanese women, all of whom have higher BMDs than Caucasians. Femoral neck BMD is highest in African-Americans and similar in Chinese, Japanese, and Caucasians. These findings may explain why Caucasian women have higher fracture rates than African-Americans and Asians.