Aspects of Bone Quality Among Chinese American Women

描述（由申请人提供）：尽管骨质疏松症在白种人绝经后妇女中最常见，但在非白种人妇女中也不罕见，尤其是华裔和华裔美国妇女。美籍华人患骨质疏松症的风险越来越大。美国人口普查局估计，到2050年，十分之一的美国人口将是亚裔，其中许多是华裔。骨质疏松症显然是华裔美国人中一个重要的公共健康问题。然而，大多数与骨密度（BMD）与骨折风险相关的流行病学数据都是在绝经后的高加索妇女中获得的，因此，骨质疏松症的密度测量定义和治疗指南仅严格适用于这一群体。目前尚不清楚骨密度与中国人群骨折风险之间的关系，也不知道什么样的t评分能准确描述高危人群。在缺乏前瞻性数据的情况下，骨质疏松症或绝经后高加索妇女的t评分定义已应用于其他种族群体。此外，一个高加索骨密度参考数据库被用来评估亚洲女性的骨折风险。越来越明显的是，骨密度和骨折风险的种族差异使得这一定义和高加索数据库的应用存在问题。例如，尽管中国女性的实际骨密度较低，但在亚洲和美国的中国女性髋部骨折的发生率明显低于白人女性。这些发现表明，骨密度与骨折风险之间的关系在白种人和中国女性中可能有所不同。本研究的总体目标是表征美籍华人女性的面骨密度以及骨质量的其他方面，如体积密度、骨大小、骨微结构、骨重塑、矿化密度、羟基磷灰石晶体大小和基质特性。将这些新数据与高加索女性的数据进行比较，可能会让我们深入了解，尽管骨密度较低，中国女性似乎是如何避免髋部骨折的。这一新发现可以更准确地确定华裔美国女性的骨折风险，并可能有助于制定与华裔美国人群直接相关的诊断和治疗指南。此外，这个项目将使我获得发展成为代谢性骨病独立研究者所必需的技术和研究方法技能。

DESCRIPTION (provided by applicant): Although osteoporosis is most common among Caucasian postmenopausal women, it is not infrequent among non-Caucasian women, particularly Chinese and Chinese American women. Chinese Americans are a growing population at risk for osteoporosis. The US Census Bureau estimates by 2050, one-tenth of the US population will be of Asian descent, many Chinese American. Osteoporosis is clearly an important public health problem among Chinese Americans. However, most epidemiologic data that relates bone mineral density (BMD) to fracture risk has been acquired among postmenopausal Caucasian women and it is, thus, only for this group that the densitometric definition of osteoporosis and treatment guidelines strictly apply. It s not known how BMD relates to fracture risk in the Chinese population nor what T-score accurately describes the population at risk. In the absence of prospective data, the T-score definition of osteoporosis or postmenopausal Caucasian women has been applied to other racial groups. Moreover, a Caucasian BMD referent database is used to assess fracture risk among Asian women. It is becoming increasingly apparent that racial differences in BMD and fracture risk make application of this definition and the Caucasian database problematic. For example, Chinese women in Asia and the US have a significantly lower rate of hip fracture than Caucasian women, despite the fact that areal BMD is lower among Chinese women. These findings suggest that the relationship between BMD and fracture risk may differ among Caucasian and Chinese women. The overall goal of this proposal is to characterize areal bone density as well as other aspects of bone quality, such as volumetric density, bone size, bone microarchitecture, remodeling, mineralization density, hydroxyapetite crystal size and matrix properties among Chinese American women. Comparing these new data to that of Caucasian women may provide insight into how, despite lower BMD, Chinese women are seemingly protected against hip fracture. This new knowledge may permit fracture risk to be more accurately determined among Chinese American women and may allow for the development of diagnostic and treatment guidelines that are directly relevant to the Chinese American population. This project will, in addition, enable me to acquire both the technical and research methodological skills necessary to develop into an independent investigator in metabolic bone disease.