Aspects of Bone Quality Among Chinese American Women

描述（由申请人提供）：尽管骨质疏松症在绝经后白人女性中最常见，但在非白人女性中并不罕见，尤其是中国和华裔美国女性。华裔美国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，美国人口的十分之一将是亚裔，其中许多是华裔。骨质疏松症显然是一个重要的公共卫生问题，在美国华人。然而，大多数与骨密度（BMD）骨折风险相关的流行病学数据都是在绝经后白人妇女中获得的，因此，骨质疏松症的密度测定定义和治疗指南仅严格适用于这一组。目前尚不清楚BMD与中国人群骨折风险的关系，也不清楚T评分如何准确描述风险人群。在缺乏前瞻性数据的情况下，骨质疏松症或绝经后白人女性的T评分定义已应用于其他种族群体。此外，高加索人骨密度参考数据库被用来评估亚洲妇女骨折的风险。越来越明显的是，BMD和骨折风险的种族差异使得该定义和高加索数据库的应用存在问题。例如，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，尽管中国女性的区域BMD较低。这些结果表明，BMD和骨折风险之间的关系可能在高加索和中国妇女之间存在差异。本提案的总体目标是表征美国华裔女性的面积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、重塑、矿化密度、羟基磷灰石晶体大小和基质性质。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中国女性尽管BMD较低，但似乎对髋部骨折有保护作用。这一新的知识可能使骨折的风险，以更准确地确定在美国华人妇女，并可能允许诊断和治疗指南的发展，是直接相关的美国华人人口。此外，该项目还将使我获得必要的技术和研究方法技能，以发展成为代谢性骨病的独立研究者。

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.