Skeletal Health Outcomes among US Asian Women

美国亚裔女性的骨骼健康状况

• 批准号: 10665062
• 负责人: Joan C Lo
• 金额: $ 55.53万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665062
• 关键词: Address; Age; Aging; Area; Asian; Asian Americans; Asian population; Black Populations; Bone Density; Calibration; California; Caring; Caucasians; China; Chinese; Clinical; Clinical Management; Counseling; Country; Data; Databases; Diagnosis; East Asian; Electronic Health Record; Epidemiology; Ethnic Origin; Ethnic Population; Event; Femoral Fractures; Femur; Filipino; Fracture; Future; Gender; Health; Healthcare; Hip Fractures; Hip region structure; Hispanic; Hispanic Populations; Home; Hong Kong; Incidence; Integrated Delivery of Health Care; Integrated Health Care Systems; Japanese; Knowledge; Koreans; Neck; Online Systems; Osteoporosis; Outcome; Pharmaceutical Preparations; Philippines; Population; Population Heterogeneity; Prevention; Probability; Race; Recommendation; Reporting; Risk; Risk Assessment; Risk Estimate; San Francisco; South Asian; Southeastern Asia; Subgroup; System; Taiwan; Test Result; Testing; United States Preventative Services Task Force; Update; Variant; Vietnamese; Woman; Wrist; bisphosphonate; diagnostic tool; epidemiology study; ethnic diversity; ethnic minority; fracture risk; hazard; health plan; human old age (65+); humerus; member; men; older patient; osteoporosis with pathological fracture; overtreatment; population based; predictive tools; risk prediction; screening; skeletal; southeast Asian; spine bone structure; stem; tool; treatment optimization

PROJECT SUMMARY/ABSTRACT Both ethnic diversity and the burden of osteoporosis have increased with the aging US population. Asians now comprise 7% of the US and 17% of California’s population, the state in which nearly one third of all US Asians reside. In 2002, the US Preventive Services Task Force updated recommendations for osteoporosis screening to all women age 65 years and older. Because Asians have lower bone density than whites, they have a greater likelihood of being diagnosed with osteoporosis on the basis of their bone density screening test results, yet they have a lower risk of hip fracture. Existing fracture risk calculators consider race/ethnicity in estimating fracture risk, but the inherent assumptions remain largely untested. The most widely used calculator is FRAX, which provides 10-year risk estimates of hip and any one of four major osteoporotic fractures for white, black, Hispanic, and Asian race. For US Asians, an adjustment factor (0.5 for women) is applied during fracture risk calculation, based on epidemiologic studies indicating that US Asian women have a 40-50% lower incidence of hip fracture than white women. However, data for fractures other than hip are limited for Asians, and population fracture data by Asian ethnic subgroups are largely lacking. US Asians comprise a heterogeneous population whose ancestry originates primarily from East, South, and Southeast Asia; in California, the two largest subgroups are Filipino and Chinese. It is notable that using the same age, gender, bone density, and clinical profile, FRAX calculators produce different results for US Asian versus Asians in Hong Kong and Taiwan (both higher), China (similar), and the Philippines (lower). These differences could stem from differences in fracture epidemiology in these countries. A more precise understanding of fracture risk in US Asians is paramount for tailoring their fracture prevention counseling and care. Using data from Kaiser Permanente Northern California, a large integrated healthcare delivery system with membership across Northern California and especially in the San Francisco Bay Area and Sacramento regions (where large numbers of Asians reside), this proposed study will conduct the first large-scale assessment of bone density and fracture outcomes among US Asians and Asian ethnic minorities. Our three primary aims are: (1) to compare the incidence of hip and major osteoporotic fractures for white and Asian men and women and by Asian ethnic minorities; (2) to characterize the association between bone density and fracture risk for Asian women in relation to findings observed for white women; and (3) to examine the predictive accuracy of fracture risk tools for Asian women and to determine whether replacement of existing base population fracture data with Asian-specific fracture data yields more accurate fracture risk prediction for Asians. Findings from this study will provide a more accurate way to calculate fracture risk in US Asians and, in the future, could enable millions of Asian Americans to obtain fracture risk data tailored to their ethnic profile.

项目总结/文摘

项目成果

Differences in proximal humerus and wrist fracture incidence among US Asian subgroups.

美国亚裔亚群之间肱骨近端和腕部骨折发生率的差异。

• DOI: 10.1111/jgs.18408
• 发表时间: 2023
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Lo,JoanC;Lee,DavidR;Chandra,Malini;Zeltser,DavidW;Chu,ClarenceE;Gordon,NancyP;Darbinian,JeanneA;Lee,Catherine
• 通讯作者: Lee,Catherine

Racial and Ethnic Variation in Dementia Prevalence in a Diverse Cohort of Adults with Hip Fracture.

不同髋部骨折成年人群体中痴呆症患病率的种族和民族差异。

• DOI: 10.1007/s11606-023-08578-6
• 发表时间: 2024
• 期刊: Journal of general internal medicine
• 影响因子: 5.7
• 作者: Lee,DavidR;Lo,JoanC;Chandra,Malini;Lee,Catherine;Gilsanz,Paola
• 通讯作者: Gilsanz,Paola