Dr Barrett-Connor serves on advisory committees for and receives research support from Amgen, Eli Lilly, and Merck. Dr Cauley is a consultant for Merck, Merck Speakers Bureau, Eli Lilly, and Novartis and receives research support from Merck, Eli Lilly, Pfizer, and Novartis. All other authors state that they have no conflicts of interest.
Race and Ethnic Variation in Proximal Femur Structure and BMD Among Older Men†
Article first published online: 17 SEP 2007
Copyright © 2008 ASBMR
Journal of Bone and Mineral Research
Volume 23, Issue 1, pages 121–130, January 2008
How to Cite
Marshall, L. M., Zmuda, J. M., Chan, B. K., Barrett-Connor, E., Cauley, J. A., Ensrud, K. E., Lang, T. F., Orwoll, E. S. and for the Osteoporotic Fractures in Men (MrOS) Research Group (2008), Race and Ethnic Variation in Proximal Femur Structure and BMD Among Older Men. J Bone Miner Res, 23: 121–130. doi: 10.1359/jbmr.070908
- Issue published online: 4 DEC 2009
- Article first published online: 17 SEP 2007
- Manuscript Accepted: 12 SEP 2007
- Manuscript Revised: 22 MAY 2007
- Manuscript Received: 6 DEC 2006
- bone QCT;
- ethnic groups;
Femoral neck dimensions and vBMD from QCT were compared among 3305 black, Asian, Hispanic, and white men ≥65 yr of age. All had similar stature-adjusted mean femoral neck volume, but black and Asian men had thicker cortices and higher trabecular vBMD, which may increase bone strength.
Introduction: Hip fracture rates among elderly U.S. black and Asian men are lower than rates among white men. Structural characteristics or volumetric BMD (vBMD), which confer advantages for femoral neck bone strength, may vary by race/ethnicity. However, this topic has not been studied in detail.
Materials and Methods: In a cross-sectional study, dimensions and vBMD in the femoral neck and shaft were obtained from QCT scans among 3305 men ≥65 yr of age in the Osteoporotic Fractures in Men (MrOS) study. Femoral neck measures were cross-sectional area; integral, cortical, and medullary volumes and integral, cortical, and trabecular vBMD. Shaft measures were cross-sectional, cortical, and medullary areas and cortical vBMD. Self-reported race/ethnicity was classified as black, Asian, Hispanic, or white. We used multivariable linear regression models with adjustment for age, height, and body mass index to compare means of the outcome measures in black, Asian, and Hispanic men to those in whites.
Results: All groups had similar femoral neck integral volume. Among black and Asian men, mean cortical volume as a percent of integral volume was 6% greater, integral vBMD was 6-10% greater, and trabecular vBMD was 33-36% greater than means among whites. Shaft cross-sectional area was similar among blacks, but smaller among Asians, compared with whites. However, mean shaft cortical area was greater among blacks but similar among Asians and whites, resulting in mean cortical thickness being 5% greater among black and Asian men. Blacks also had greater mean cortical vBMD in both the femoral neck and shaft.
Conclusions: Black and Asian men ≥65 yr of age have features in the proximal femur that may confer advantages for bone strength. Specifically, greater cortical thickness and higher trabecular vBMD among black and Asian men could help explain the lower hip fracture rates in these populations. Discerning the mechanisms underlying these differences could provide advances for the prevention and treatment of osteoporosis.