TITLE:
An evaluation of bone mineral density in Australian women of Asian descent.
AUTHOR:
Larcos G, Baillon LG
AFFILIATION:
Department of Nuclear Medicine and Ultrasound, Westmead Hospital, Sydney, New South Wales, Australia.
SOURCE:
Australas Radiol 1998 Nov;42(4):341-3
ABSTRACT:
Asian women have been reported to have lower bone mineral density (BMD) than Caucasians, but this could be due to
body habitus rather than ethnicity. The purpose of the present study was to determine whether Australian women of
Asian descent have intrinsically dissimilar BMD compared to Australian women of Caucasian origin. We compared
Australian Asian (n = 36) and Caucasian (n = 304) women who were referred for bone densitometry and in whom
disorders or medications known to interfere with bone metabolism were excluded. Covariables including age,
postmenopausal status, years since menopause (YSM), alcohol and smoking consumption, family history, current
exercise levels, height, weight, body mass index (BMI) and Asian origin were analysed by multivariate linear regression
to determine the independent predictors of BMD in the spine, hip and distal radius. The BMD in the spine (R2 = 0.31), hip
(R2 = 0.27) and distal radius (R2 = 0.31) were associated with YSM (all sites), postmenopausal status, weight and
smoking (spine and hip), BMI (spine and wrist), family history (hip) and height (wrist). The BMD at these sites were
similar for Asian and Caucasian women after adjusting for these variables. Thus, Asian-Australians have similar BMD
to Caucasian-Australians after adjusting for potential confounding variables. Bone mineral density is independently
related to a number of clinical and lifestyle-related factors, but not ethnicity.
TITLE:
The effect of ethnicity on appendicular bone mass in white, coloured and Indian
schoolchildren.
AUTHOR:
Patel DN, Pettifor JM, Becker PJ
AFFILIATION:
Department of Paediatrics, University of the Witwatersrand and Baragwanath Hospital, Johannesburg.
SOURCE:
S Afr Med J 1993 Nov;83(11):847-53
ABSTRACT:
Ethnic differences in the incidence and prevalence of osteoporosis have been shown throughout the world. In South
Africa the prevalence of osteoporosis is much higher in whites than in blacks. This is surprising, since factors that might
predispose to reduce bone mass are more preponderant in black communities. The present research was undertaken to
determine whether differences in bone mass during the period of bone accretion could explain the difference in the
incidence of osteoporosis. In this paper we report on differences in appendicular bone mass between white, coloured and
Indian children and teenagers (6-18 years) from Johannesburg. The effects of weight, height, puberty and skinfold
thickness on bone mass were also assessed. The bone width (BW) of white boys was greater than that of Indian boys,
while the bone mineral content (BMC) and BMC/BW were greater in white boys than in both Indian and coloured boys.
After adjustment for differences in weight and height, the BW of coloured boys was significantly greater than that of
white boys, while all differences in BMC and BMC/BW became non-significant. For girls there were no significant
differences in bone mass measurements, but after adjustment for height and weight coloured girls had significantly
greater BMC and BMC/BW than either white or Indian girls. This greater weight- and height-adjusted bone mass in
coloured girls is consistent with the impression of a lower incidence of osteoporosis in coloured women than in white
women.
TITLE:
Osteoporosis in India--the nutritional hypothesis.
AUTHOR:
Gupta A
AFFILIATION:
Department of Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
SOURCE:
Natl Med J India 1996 Nov-Dec;9(6):268-74
ABSTRACT:
Osteoporosis, a silently progressing metabolic bone disease that leads to loss of bone mass, is widely prevalent in India
and osteoporotic fractures are a common cause of morbidity and mortality in adult Indian men and women. This review
of the international patterns of osteoporosis reveals two distinctive clinical features of this disease in Indians. Firstly, hip
fractures occur at a relatively earlier age in Indian males and females, compared to their western counterparts; and
secondly, a higher male-to-female ratio suggests that Indian males are at a higher risk for hip fractures. The reasons for
these differences are not known. It is possible that a dietary deficiency of calcium, beginning early in life, leads to a lower
peak bone mass, and consequently osteoporosis at an earlier age. Furthermore, malabsorption of calcium due to a
subclinical deficiency of vitamin D may lead to osteoporosis, without causing osteomalacia. With the increase in life
expectancy, osteoporosis has become a formidable public health problem in India and a multidisciplinary approach is
needed to identify its aetiological factors and devise strategies for mass prevention of calcium and vitamin D deficiency
(possibly by fortification of food with these nutrients). Another issue that needs to be addressed is the social dogma
against hormone replacement therapy in postmenopausal women. These measures, coupled with health education of the
masses, should help promote bone health and control osteoporosis in India.
TITLE:
Sources of interracial variation in bone mineral density.
AUTHOR:
Cundy T, Cornish J, Evans MC, Gamble G, Stapleton J, Reid IR
AFFILIATION:
Department of Medicine, University of Auckland Medical School, New Zealand.
SOURCE:
J Bone Miner Res 1995 Mar;10(3):368-73
ABSTRACT:
Many studies have demonstrated significant differences in bone mineral density between various racial groups. Although
it has been suggested that differences in body weight contribute to such interracial variation, the artifactual effect of the
skeletal size inherent in projectional absorptiometry methods has been largely ignored. We have measured bone mineral
density by dual-energy X-ray absorptiometry in the lumbar spine and at three femoral sites in 200 premenopausal
women of Chinese, Indian, European, or Polynesian origin (50 of similar mean age in each group). In the Chinese and
Indian women the measured bone mineral density measurements (g/cm2) were similar, but significantly less, at all sites,
than those of European women (p < or = 0.005). The European women were, however, significantly taller than both the
Chinese and Indian women (p < 0.0001), and when the scale artifact of absorptiometry was removed by dividing the
measured bone mineral density either by the height of the subject, or by the square root of the area over which the X-ray
beam was projected, then the differences in mean bone mineral density between the Chinese, Indian, and European
women were almost completely eliminated. The Polynesian women were significantly more obese (as judged from mean
body mass index) than all the other groups (p < 0.0001) and had significantly greater bone mineral density at all sites than
all the other groups both before (p < 0.0001) and after (p < 0.0001) correcting for the scale artifact.
TITLE:
A comparison of bone mineral density between Caucasian, Asian and Afro-Caribbean
women.
AUTHOR:
Tobias JH, Cook DG, Chambers TJ, Dalzell N
AFFILIATION:
Department of Histopathology, St George's Hospital Medical School, London, U.K.
SOURCE:
Clin Sci (Colch) 1994 Nov;87(5):587-91
ABSTRACT:
1. We analysed the lumbar spine (L2-L4) and femoral neck bone mineral density results of Caucasian (n = 2232), Asian
(Indian sub-continent) (n = 153) and Afro-Caribbean (n = 102) women referred for bone densitometry over a 30 month
period. To assess the risk of osteoporosis, the results of Caucasian and Asian women were compared with those of a
reference Caucasian population supplied by Lunar. 2. Subject characteristics were similar in all three groups, other than
expected ethnic differences in stature and weight. We found that lumbar spine and femoral neck bone mineral density in
Caucasians was lower than in Afro-Caribbeans, but higher than in Asians. Consistent with this, bone mineral density
was also lower in Asians as compared with the reference Caucasian population, both at the lumbar spine and femoral
neck. As a consequence, a higher proportion of Asian women were classified as being at increased risk of osteoporosis
than Caucasian women. 3. Since ethnic differences in skeletal size might influence bone mineral density, we also
obtained values for bone mineral content in Caucasian and Asian women that were corrected for projected skeletal
area, and weight and years since menopause, using regression equations derived from the Caucasian study population.
After this analysis, the difference in bone mineral content between Caucasians and Asians at the lumbar spine
disappeared, while that at the femoral neck persisted. 4. We conclude that the assessment of risk of osteoporosis in Asian
women by comparing bone mineral density with a reference Caucasian population may have limited validity because of
the influence of skeletal size on such measurements.