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Ethnic differences in bone health.

Zengin A, Prentice A, Ward KA - Front Endocrinol (Lausanne) (2015)

Bottom Line: Variations in body size and composition are likely to contribute to reported differences.Studies are included that were published primarily between 1994 and 2014.A "one size fits all approach" should definitely not be used to understand better ethnic differences in fracture risk.

View Article: PubMed Central - PubMed

Affiliation: Medical Research Council Human Nutrition Research , Cambridge , UK.

ABSTRACT
There are differences in bone health between ethnic groups in both men and in women. Variations in body size and composition are likely to contribute to reported differences. Most studies report ethnic differences in areal bone mineral density (aBMD), which do not consistently parallel ethnic patterns in fracture rates. This suggests that other parameters beside aBMD should be considered when determining fracture risk between and within populations, including other aspects of bone strength: bone structure and microarchitecture, as well as muscle strength (mass, force generation, anatomy) and fat mass. We review what is known about differences in bone-densitometry-derived outcomes between ethnic groups and the extent to which they account for the differences in fracture risk. Studies are included that were published primarily between 1994 and 2014. A "one size fits all approach" should definitely not be used to understand better ethnic differences in fracture risk.

No MeSH data available.


Related in: MedlinePlus

Hip fracture rates for men and women combined in different countries of the world categorized by risk. Where estimates are available, countries are color coded red (annual incidence >250/100,000), orange (150–250/100,000), or green (<150/100,000) (6).
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Figure 1: Hip fracture rates for men and women combined in different countries of the world categorized by risk. Where estimates are available, countries are color coded red (annual incidence >250/100,000), orange (150–250/100,000), or green (<150/100,000) (6).

Mentions: Global data on adults suggest that, compared to age-matched White-American or British/European populations, other ethnic groups have a lower incidence of fracture (Figure 1). There is a >10-fold variation in age-standardized hip fracture risk across 63 countries and a notable divide between Western and Eastern populations (4–6). Most recently, Cauley et al. (5) showed greater variability in incidence and geographic pattern for clinical vertebral fractures than for hip fracture; it should be noted that for radiographically confirmed vertebral fractures the global pattern incidence was similar to that for hip fracture (5). Globally, the lowest fracture rates are in populations with African ancestry (6), but there is a sparcity of data from the African continent, particularly Sub-Saharan Africa (5, 7, 8). In the late 1960s, Solomon et al. described differences between White and Bantu populations in adult fracture incidence to be similar to those reported in North-America between Black- and White-Americans (9). Data from Cameroon suggest similarities to populations from the developed world because women have higher incidence than men of low trauma fracture to the hip and wrist (10). Further data are required to confirm the generalizability of this observation. With a rising life expectancy, increasing “Westernization” of African populations, better survival for individuals with HIV, and increasing non-communicable disease risk fracture incidence is also expected to rise and should be better characterized (5, 7, 10, 11). In Asian populations, a 15-fold increase in hip fracture incidences was reported in studies from Japan and Hong Kong (12, 13). Compared to Western populations, there also appear to be sex differences in the patterns of incidence where in China there were no sex differences and in Thailand, men have greater hip fracture incidence (14, 15).


Ethnic differences in bone health.

Zengin A, Prentice A, Ward KA - Front Endocrinol (Lausanne) (2015)

Hip fracture rates for men and women combined in different countries of the world categorized by risk. Where estimates are available, countries are color coded red (annual incidence >250/100,000), orange (150–250/100,000), or green (<150/100,000) (6).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4362392&req=5

Figure 1: Hip fracture rates for men and women combined in different countries of the world categorized by risk. Where estimates are available, countries are color coded red (annual incidence >250/100,000), orange (150–250/100,000), or green (<150/100,000) (6).
Mentions: Global data on adults suggest that, compared to age-matched White-American or British/European populations, other ethnic groups have a lower incidence of fracture (Figure 1). There is a >10-fold variation in age-standardized hip fracture risk across 63 countries and a notable divide between Western and Eastern populations (4–6). Most recently, Cauley et al. (5) showed greater variability in incidence and geographic pattern for clinical vertebral fractures than for hip fracture; it should be noted that for radiographically confirmed vertebral fractures the global pattern incidence was similar to that for hip fracture (5). Globally, the lowest fracture rates are in populations with African ancestry (6), but there is a sparcity of data from the African continent, particularly Sub-Saharan Africa (5, 7, 8). In the late 1960s, Solomon et al. described differences between White and Bantu populations in adult fracture incidence to be similar to those reported in North-America between Black- and White-Americans (9). Data from Cameroon suggest similarities to populations from the developed world because women have higher incidence than men of low trauma fracture to the hip and wrist (10). Further data are required to confirm the generalizability of this observation. With a rising life expectancy, increasing “Westernization” of African populations, better survival for individuals with HIV, and increasing non-communicable disease risk fracture incidence is also expected to rise and should be better characterized (5, 7, 10, 11). In Asian populations, a 15-fold increase in hip fracture incidences was reported in studies from Japan and Hong Kong (12, 13). Compared to Western populations, there also appear to be sex differences in the patterns of incidence where in China there were no sex differences and in Thailand, men have greater hip fracture incidence (14, 15).

Bottom Line: Variations in body size and composition are likely to contribute to reported differences.Studies are included that were published primarily between 1994 and 2014.A "one size fits all approach" should definitely not be used to understand better ethnic differences in fracture risk.

View Article: PubMed Central - PubMed

Affiliation: Medical Research Council Human Nutrition Research , Cambridge , UK.

ABSTRACT
There are differences in bone health between ethnic groups in both men and in women. Variations in body size and composition are likely to contribute to reported differences. Most studies report ethnic differences in areal bone mineral density (aBMD), which do not consistently parallel ethnic patterns in fracture rates. This suggests that other parameters beside aBMD should be considered when determining fracture risk between and within populations, including other aspects of bone strength: bone structure and microarchitecture, as well as muscle strength (mass, force generation, anatomy) and fat mass. We review what is known about differences in bone-densitometry-derived outcomes between ethnic groups and the extent to which they account for the differences in fracture risk. Studies are included that were published primarily between 1994 and 2014. A "one size fits all approach" should definitely not be used to understand better ethnic differences in fracture risk.

No MeSH data available.


Related in: MedlinePlus