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Lower Cortical Porosity and Higher Tissue Mineral Density in Chinese American Versus White Women
Authors:Stephanie Boutroy  Marcella D Walker  X Sherry Liu  Donald J McMahon  George Liu  X Edward Guo  John P Bilezikian
Affiliation:1. College of Physicians and Surgeons, Columbia University, New York, NY, USA;2. McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA;3. Department of Medicine, New York Downtown Hospital, New York, NY, USA;4. Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
Abstract:Asian women have lower rates of hip and forearm fractures compared to other racial groups despite lower areal bone mineral density (aBMD). We have demonstrated microarchitectural differences, including greater cortical thickness (Ct.Th) and cortical volumetric BMD (Ct.BMD), in Chinese American versus white women. Yet it is not known whether greater Ct.BMD in Chinese American women is a result of greater tissue mineral density (TMD) or reduced cortical porosity (Ct.Po). Using an advanced segmentation algorithm based on high‐resolution peripheral quantitative computed tomography (HR‐pQCT) images, we tested the hypothesis that Chinese American women have better cortical skeletal integrity owing to lower Ct.Po and higher Ct.TMD compared with white women. A total of 78 Chinese American women (49 premenopausal and 29 postmenopausal) and 114 white women (46 premenopausal and 68 postmenopausal) were studied. Premenopausal Chinese American versus white women had greater Ct.Th, Ct.BMD, and Ct.TMD at both the radius and tibia, and decreased Ct.Po (p < 0.05). A similar pattern was observed between postmenopausal Chinese American and white women. As expected, postmenopausal versus premenopausal women had lower Ct.BMD at the radius and tibia in both races (p < 0.001). Ct.Po largely increased between premenopausal and postmenopausal women, whereas Ct.TMD decreased by 3% to 8% (p < 0.001) in both races. Age‐related differences in Ct.Po and Ct.TMD did not differ by race. In summary, both reduced Ct.Po and greater Ct.TMD explain higher Ct.BMD in Chinese American versus white women. Thicker and preserved cortical bone structure in Chinese American women may contribute to greater resistance to fracture compared to white women. © 2014 American Society for Bone and Mineral Research.
Keywords:RACE  HR‐PQCT  MICROARCHITECTURE  CHINESE  WHITE  CORTICAL POROSITY  TISSUE MINERAL DENSITY  AGE‐RELATED DIFFERENCES
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