Ethnic variability in bone geometry as assessed by hip structure analysis: findings from the hip strength across the menopausal transition study.
Ethnic variability in bone geometry as assessed by hip structure analysis: findings from the hip strength across the menopausal transition study.
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DOI：
10.1002/jbmr.1781
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发表时间：
2013-04
影响因子：
6.2
通讯作者：
Cauley, Jane A
中科院分区：
文献类型：
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作者：
Danielson, Michelle E;Beck, Thomas J;Lian, Yinjuan;Karlamangla, Arun S;Greendale, Gail A;Ruppert, Kristine;Lo, Joan;Greenspan, Susan;Vuga, Marike;Cauley, Jane A
种族/民族出身在骨折风险中起重要作用。骨折率的种族/民族差异不能完全用骨密度（BMD）来解释。检查骨骼几何形状和强度对骨折风险影响的研究主要集中在老年人身上，没有包括来自不同种族/民族背景的人。我们的目标是在大量中年女性样本中探索种族/民族在臀部几何形状和力量方面的差异。我们对1942名绝经前和早期围绝经期妇女的髋关节DXA扫描进行了髋关节结构分析（HSA）。样本包括白人（50%）、非裔美国人（27%）、中国人（11%）和日本人（12%），年龄在42-52岁之间。HSA使用约翰霍普金斯大学开发的软件进行。非裔美国女性的常规骨密度（8.4-9.7%）和HSA骨密度（5.4-19.8%）高于其他人群，但日本女性的HSA骨密度最高（9.7-31.4%）。HSA指数与更有利的几何形状、更强的强度和抗骨折性相关，在非裔美国人和日本女性中更为普遍。非裔美国女性股骨外径较小，横截面积和截面模量较大，屈曲比较低。日本女性表现出不同的模式，截面模量较高，屈曲比较低，与非裔美国女性相似，但外径更宽；这被更大的横截面积和更中心的质心所抵消。中国女性的传统骨密度与高加索女性相似，但颈部面积和HSA骨密度都较小。与高加索女性相比，她们的横截面积和横截模量更小，质心位置更中间，屈曲率更高。观察到的生物力学差异可能有助于解释种族/民族骨折率的差异。未来的研究应探讨髋部几何形状对所有种族/民族骨折风险的影响。
Racial/ethnic origin plays an important role in fracture risk. Racial/ethnic differences in fracture rates cannot be fully explained by bone mineral density (BMD). Studies examining the influence of bone geometry and strength on fracture risk have focused primarily on older adults and have not included people from diverse racial/ethnic backgrounds. Our goal was to explore racial/ethnic differences in hip geometry and strength in a large sample of midlife women. We performed Hip Structure Analysis (HSA) on hip DXA scans from 1942 pre- and early peri-menopausal women. The sample included Caucasian (50%), African American (27%), Chinese (11%) and Japanese (12%) women, age 42–52 years. HSA was performed using software developed at John’s Hopkins University. African American women had higher conventional (8.4–9.7%) and HSA BMD (5.4–19.8%) than other groups with the exception being Japanese women who had the highest HSA BMD (9.7–31.4%). HSA indices associated with more favorable geometry and greater strength and resistance to fracture were more prevalent in African American and Japanese women. Femurs of African American women had a smaller outer diameter, a larger cross-sectional area and section modulus, and a lower buckling ratio. Japanese women presented a different pattern with a higher section modulus and lower buckling ratio, similar to African American women, but a wider outer diameter; this was offset by a greater cross-sectional area and a more centrally located centroid. Chinese women had similar conventional BMD as Caucasian women but a smaller neck region area and HSA BMD at both regions. They also had a smaller cross-sectional area and section modulus, a more medially located centroid, and a higher buckling ratio than Caucasian women. The observed biomechanical differences may help explain racial/ethnic variability in fracture rates. Future research should explore the contribution of hip geometry to fracture risk across all race/ethnicities.