Influence of body habitus and race on bone mineral density of the midradius, hip, and spine in aging women

Osteoporosis and fractures of the hip are less common in black women and in obese white women than in nonobese white women. To determine the effects of race, age, and body weight on bone mineral density (BMD), BMD of the lumbar spine, trochanter, and femoral neck were determined by dual-photon absorptiometry in 131 nonobese white women and 34 nonobese black women, all of whom were within 30% of their ideal body weight, and in 24 obese white women and 27 obese black women, all of whom weighed more than 30% of their ideal body weight and were in the same age range as the nonobese women. All of them were 51 years of age or older, and most of them were postmenopausal. BMD of the midradius was measured by single-photon absorptiometry. Whereas body weight was significantly higher in the black as compared to the white women, the ages of the two groups were not different from each other. BMD declined with age and increased with body weight in both the black and white women at each of the four sites measured. After adjusting for age and weight by covariate analyses, black women had greater BMDs than white women at the midradius, lumbar spine, and femoral neck (p less than 0.001), but not at the trochanter (p = 0.18). The increases in BMD observed in the obese and black women in the present study are consistent with the previous findings that osteoporosis and fractures of the hip are less common in black and in obese white women than in nonobese white women.     

Demonstration that bone mass is greater in black than in white children

Osteoporosis and hip fractures are less common and bone mass is greater in black than in white women. To determine if bone mass is greater in black than in white children, bone mineral density (BMD) of the midradius by single-photon absorptiometry and BMD of the lumbar spine (L1-L4), trochanter, and femoral neck by dual-photon absorptiometry were measured in 20 black boys, 18 black girls, 33 white boys, and 35 white girls between the ages of 7 and 12 years. Mean age (10.4 +/- 0.3 versus 10.2 +/- 0.2 years) and body weight (39 +/- 2 versus 38 +/- 2 kg) in the blacks and whites, respectively, were not different in the two groups, and the ages and weights of the boys and girls were not different from each other. BMD were significantly greater in black than in white children at each site, in the black than in white boys at the trochanter and femoral neck, and in the black than in white girls at each site. In both races, BMD varied directly with age and body weight. Multivariate analysis showed that BMD were greater at the midradius, lumbar spine, trochanter, and femoral neck in the black than in the white children, that BMD of the lumbar spine was greater in the girls than in the boys, and that BMD of the trochanter and femoral neck were greater in the boys than in the girls. There were significant partial correlations between race and BMD and between BMD and body weight at each site, between sex and BMD at the lumbar spine, trochanter, and femoral neck, and between age and BMD at the midradius, trochanter, and femoral neck. Race, sex, age, and body weight together accounted for 49-66% of the variation in bone mass. Thus, BMD of the midradius, spine, and hip are greater in black than in white children, body weight and age are important determinants of bone mass, and some sex differences in bone mass are present at this age.     

Bone mineral in prepubertal children: gender and ethnicity.

Previous reports of gender and ethnic differences in bone mineral in prepubertal children have been inconsistent due to different methodologies, the problematic nature of bone density by dual-energy X-ray absorptiometry (DXA) calculated as the ratio of bone mineral mass to projected bone area (BA), and the generally small study populations. The aim of this study was to test the hypothesis that gender and ethnic differences in bone mineral by DXA are present in prepubertal children. The subjects were 336 healthy Asian, black, and white prepubertal children (172 females and 164 males). Total body bone mineral content (TBBMC) was adjusted for total body BA (TBBA), age, height, and weight. Adjusted mean TBBMC was greater in males than in females (p = 0.01). The gender difference was independent of ethnicity. Adjusted mean TBBMC was different for black compared with nonblack children (p = 0.001). The ethnic difference was a function of TBBA and weight. This study in a multiethnic population of prepubertal children shows (1) a gender difference in TBBMC and (2) an ethnic difference in TBBMC.     

Gender and race differences in bone mass during infancy

The purpose of this study was to determine whether race or gender differences in total body bone mineral content (BMC) are evident within the first 18 months of age. Total body bone mineral measurements were obtained on 64 healthy infants 1–18 months of age. There were no significant differences in age, weight, or height between race and gender groups. Taking into account weight and age, both bone mineral density (BMD) and BMC were greater in male infants compared with female infants (both,P=0.02) and BMD was slightly higher in black infants compared with white infants (P=0.07).     

Pediatric Reference Centiles of Bone Mineral Density and Body Composition of Lower Limbs

Localized neurological diseases such as spina bifida are often accompanied by normal upper limb and spinal bone mineral density (BMD), whereas regional BMD of the lower limbs may be decreased. Therefore, regional BMD measurements may be more accurate to quantify regional bone health. Until now, no pediatric reference centiles of bone mineral density and body composition of the lower extremities are available for Hologic DXA systems. The objective was to generate age-and sex specific reference centiles of DXA scans of lower limbs for Hologic DXA systems. Data from the National Health and Nutrition Examination Survey of the period 1999–2004 (age 8 – 20 years) were used to generate age-specific and sex-specific reference centiles for the non-Hispanic Black, non-Hispanic White and Mexican-American NHANES study population. The LMS method was used to calculate the reference centiles. Data of DXA scans of 2233 non-Hispanic black children (880 females), 1869 non-Hispanic white children (803 females) and 2350 Mexican American children (925 females) were used to create age-specific and sex-specific reference curves. We presented age-and sex-specific reference centiles for regional bone mineral density, bone mineral content, lean body mass and fat mass at the lower limbs for children and adolescents which were ethnicity specific and directly applicable to Hologic QDR-4500A fan-beam densitometer.     

Bone mineral density of proximal femur and spine in Korean children between 2 and 18 years of age

Ethnic factors affect bone mass acquisition during childhood. The aim of our study was to establish normative data for bone mineral content (BMC) and bone mineral density (BMD) in healthy Korean children and adolescents, using 446 lumbar spine scans (224 males and 222 females) and 364 proximal femur scans (181 males and 183 females) of healthy children between ages 2 and 18 years measured by dual-energy X-ray absorptiometry using Hologic QDR Discovery A 2004. There was an increase in both BMC and BMD during early childhood, acceleration during the adolescence spurt, and a slower increase later. Until 11 years of age, both male and female BMC and BMD were not statistically different. There was a rapid increase in both BMC and BMD in females earlier than in males, and later males caught up with the females and overshot the female values. When compared with Canadian children, BMD and BMC of total proximal femur was found to be more and BMD and BMC of total lumbar spine to be less at some ages. Tanner's stage was significantly associated with BMD and BMC of spine and proximal femur in males and BMC of spine in females in the first three Tanner's stages. Height, body weight, fat content, and body mass index influenced BMC and BMD at different sites by variable amount. Hence, the values presented in this study should be used as reference values in Korean children and adolescents.     

Age trends in proximal femur geometry in men: variation by race and ethnicity

Summary Data on bone architecture in diverse male populations are limited. We examined proximal femur geometry in 1,190 black, Hispanic, and white men. Cross-sectional analyses indicate greatest bone strength among black men, and greater age-related differences in bone strength among Hispanic men than other subjects at the narrow neck and intertrochanter regions of the proximal femur. Introduction Although race/ethnic differences in bone mass are well-documented, less is known about differences in bone architecture. We examined proximal femur geometry in a diverse, randomly-sampled population of 1,190 community-dwelling men (age 30–79 y). Methods Dual X-ray absorptiometry scans were obtained for 355 black, 394 Hispanic, and 441 white subjects. Measures were obtained for the narrow neck (NN), intertrochanter (IT) and shaft regions of the proximal femur via hip structural analysis. Analyses considered bone mineral density (BMD, g/cm²), outer diameter (cm), cross-sectional area (CSA, cm²), section modulus (Z, cm³), and buckling ratio (BR). Results were adjusted for height, weight and physical activity level. Results Black subjects exhibited greater age-specific BMD, CSA and Z, than their white counterparts. For instance, at age 50 y, NN BMD was approximately 11% higher among black men (p < 0.001). Hispanic men exhibited sharper age-related differences in NN and IT BMD than did others. IT BMD, for instance, decreased by 2.4% with 10 y age among Hispanic subjects, but had virtually no age trend in others (p < 0.001). Conclusions These results imply greater bone strength among black American men than among their white counterparts, and may indicate elevated fracture risk among older Hispanic American subpopulations. Grant support: The BACH/Bone study was supported by grant AG 20727 from the National Institute on Aging (NIA). The parent study (BACH) was supported by grant DK 56842 from the National Institute of Diabetes and Digestive and Kidney Diseases.     

Correlation between hand and total body bone density in normal Chinese children

Hand bone mineral density (BMD) in adults was found to be significantly correlated with various skeletal sites, including the total body. However, the relationships between hand and total body bone measurements have yet to be explored for children. We conducted a cross-sectional study of 892 normal Chinese children (511 males, 381 females) aged 5-14 years by measuring the BMD and bone mineral content (BMC) at the total hand, upper limb, subtotal body, and total body using dual-energy X-ray absorptiometry (DXA). We found that hand BMD and BMC increased with age for both genders. Female children had significantly higher hand BMD and BMC than males. Age explained more variance in hand BMD for females (R2=0.727) than for males (R2=0.596). For both genders, hand BMD and BMC correlated highly with age, weight, height, total body lean mass, and BMD and BMC at the upper limb, subtotal body, and total body (r=0.730-0.965, p<0.001) and moderately with body mass index and total body fat mass (r=0.525-0.701, p<0.001). Therefore, the hand DXA scan can potentially be a new tool for the clinical assessment of bone health in children.     

Demonstration that bone mineral density of the lumbar spine,trochanter, and femoral neck is higher in black than in white young men

The incidence of osteoporosis and fractures of the hip and spine is lower in black than in white subjects. To determine whether bone mass is increased in black men and to assess the influence of body weight and age, bone mineral density (BMD) of the lumbar spine, trochanter, and femoral neck was measured by dual-photon absorptiometry in 59 normal white men and 40 black men between the ages of 20 and 50 years. Body weight and age were not different from each other in the two groups. BMD of the midradius was measured by single-photon absorptiometry. Multivariate regression was used for independent analysis of each group and for analysis of the two groups together. After adjusting for body weight, age was inversely related to BMD of the femoral neck in both blacks and whites and of the trochanter in blacks. When body weight was analyzed independently of age, it was a positive predictor for BMD of the midradius of black men and of the femoral neck in white men. Despite the racial differences in age and weight on BMD, there were no significant interactions between race and age or race and weight when the data from black and white men were combined. Race had a highly significant effect on BMD of the lumbar spine, trochanter, and femoral neck midradius, and BMD was higher in blacks than in whites at these sites. There were significant declines in BMD with age at the midradius and femoral neck and significant increases in BMD with body weight at the trochanter and femoral neck. Thus, bone mass is higher in black than in white men and the difference in bone mass may contribute to the lower incidence of osteoporosis and fractures in blacks.     

Bone mineral density and mass by total-body dual-photon absorptiometry in normal white and Asian men.

Total body bone mineral density, total body bone mineral mass (TBBM), and bone mineral densities (BMD) in seven different regions of the body were measured in 238 normal men (154 Whites and 84 Asians), age 22-94, using dual-photon absorptiometry. Although Asian men had lower TBBM and BMD in all regions (p less than 0.05) except the arms, when multiple regression was done with body weight, height, and age, no significant differences were found between Asians and Whites for bone measurements. Thus lower bone mineral densities and bone mineral mass in Asian males compared to White males appear to be due to differences in height and weight rather than to ethnic differences. The two groups were combined to derive multiple regression equations for TBBM, total-body BMD, and regional BMD. Age, weight, and height were significant in the multiple regression equations for TBBM, ribs BMD, and legs BMD. Age and weight, but not height, were significant for total-body BMD, trunk BMD, spine BMD, arm BMD, and pelvis BMD. Weight, but neither height nor age, was significant for head BMD. These reference normal bone mineral density and bone mineral mass standards are appropriate for both Asian and White males when adjusted for weight, height, and age.     

基于限制性立方样条探索儿童青少年的骨密度与骨龄发育的关系

目的 通过回顾性分析重庆地区3 776例儿童、青少年骨密度与骨龄发育的关系,为重庆地区的儿童、青少年生长发育评估提供理论依据。方法 回顾性分析3 776例2015年至2019年间在重庆高康健康管理咨询有限公司进行咨询的儿童、青少年的左腕骨X线骨龄片、骨密度、身高、体重。应用Logistic向前逐步回归模型和限制性立方样条分层分析儿童、青少年骨密度与骨龄发育的关系。 结果 本研究中的儿童、青少年在各年龄段均出现骨龄发育提前,其中四个年龄段的男性和女性的骨龄年龄差差异有统计学意义（P<0.05）。Logistic回归分析发现性别、骨密度同龄比、生活年龄为骨龄发育的独立影响因素。在性别、年龄和BMI分层的各亚组中,骨龄发育提前的概率在骨密度较低段有少量上升然后下降,在骨密度较高段呈上升趋势,在体格消瘦和正常组中最明显;各年龄段的骨龄发育提前趋势相当;随着BMI的增加,超龄发育概率逐渐向0.8~1.0区间靠近。结论 重庆地区儿童、青少年普遍存在骨龄发育提前的现象,这种现象可能与性别、骨密度、肥胖等因素有关。     

Racial difference in the correlates of bone mineral content/density and age at peak among reproductive-aged women

Summary  Racial/ethnic differences were observed in age at peak bone density and their correlates, with whites peaking at least 5 years earlier at the femoral neck than black and Hispanic women. Race-specific standards generated in this study could be useful when interpreting bone densitometry data in young women. Introduction  The influence of race/ethnicity on bone measurements has not been widely examined. This study identifies age and amount of bone accumulated at peak density and their correlates by race/ethnicity. Methods  Bone mineral content (BMC) and bone mineral density (BMD) of the spine and femoral neck were measured by dual X-ray absorptiometry in 708 white, black, and Hispanic reproductive-aged women. Race-specific nonlinear models were used to describe the relationship between age and bone measurements, after adjusting for body weight and height. Log-transformed bone measurements were used to determine predictors based on multiple linear regression. Results  Predictors, which were race and site specific, included age, age at menarche, body weight, height, months of depot medroxyprogesterone acetate use, weight-bearing exercise, and alcohol use. Women of all races gained BMC and BMD at the spine up to 30–33 years of age. BMC and BMD of the femoral neck peaked among white women earlier (≤16 years) than among blacks (BMC 22 years; BMD 21 years) and Hispanics (BMC 29 years; BMD 20 years). Conclusion  Age at peak bone mass and its correlates differ by race/ethnicity. Race-specific standards generated in this study could be useful when interpreting bone densitometry data in young women. This work was supported by the National Institute of Child Health and Human Development grants R01HD39883 and K24HD043659 awarded to ABB and General Clinical Research Centers (GCRC) program, National Center for Research Resources, NIH, M01RR000073.     

Skin color and body size as risk factors for osteoporosis

We compared skin color, body size and bone mineral density (BMD) among three groups of postmenopausal women: 104 healthy black women, 45 healthy white women, and 52 osteoporotic white women with vertebral fractures. Skin color was measured by reflectometry, stature with a Harpenden stadiometer, weight with digital scales, and radial BMD by single photon absorptiometry. There were no significant differences in mean skin color (age-adjusted) between the healthy and osteoporotic white women, although both white groups differed from the black group. There was no significant correlation between skin color and BMD (age- and weight/height-adjusted) in any of the groups. All three groups differed significantly in age-adjusted BMD, although there was less difference between the healthy blacks and whites when covariates (body size, age) were taken into account. We further investigated body size differences by estimating stature at age 55 in all three groups based on our observations that osteoporotic women with vertebral fractures lose height at a rate that is 2.6 times faster than that of healthy aging women. Our analyses indicate that the osteoporotics were not shorter than the normals before the onset of their disease (based on estimated height), and do not have a significantly smaller body mass (weight/height and weight/height²) than the normal white women. Additionally, the osteoporotics are above the ideal body mass index recommended by the National Institutes of Health. We conclude that fair skin is not a risk factor for osteoporosis and that large body size is not protective against the development of osteoporosis, although it may have a salutary effect on BMD in both blacks and whites.     

百色壮族中老年人骨密度和体成分的特点及其相关性分析

目的测量并探讨百色壮族中老年人群的骨密度、身体成分的特点以及随年龄变化的规律,为改善少数民族地区老龄人口健康状况提供科学依据。方法随机抽取620名(男性248名,女性372名)百色壮族健康中老年人作为研究对象。测量受试者的右足跟骨密度,以及身高、体重、和身体成分(身体质量指数、腰臀比、去脂体重、肌肉量、脂肪量、体脂肪率)。运用SPSS17.0软件进行统计学处理。结果百色壮族中老年骨密度与身高、体重、腰臀比、去脂体重、肌肉量均随年龄增长逐渐降低,而脂肪量、体脂肪率在各年龄组间之间无显著差异。同年龄组男性的骨密度和身高、体重、去脂体重、肌肉量均明显高于女性,而女性的脂肪量、体脂肪率则明显高于男性。结论百色壮族中老年人的骨密度与年龄呈负相关线性关系,与体重、身高、脂肪量、体脂肪率、去脂体重、肌肉量均呈正相关线性关系。     

Relationships of percent body fat and percent trunk fat with bone mineral density among Chinese, black, and white subjects

Summary  

We examined ethnic difference in the association of body fat and trunk fat with bone mineral density (BMD) among Chinese, white, and black subjects. We found that, with greater body and trunk fat, both white and black subjects were more likely to have a low BMD than Chinese subjects.     

Femur neck bone mineral density and fracture risk by age,sex, and race or Hispanic origin in older US adults from NHANES III

Summary

We provide the first reference values for bone mineral content and bone mineral density according to age and sex in Iranian children and adolescents. The prevalence of hypovitaminosis D was high, and levels of physical activity were low in our sample. Multiple regression analyses showed age, BMI, and Tanner stage to be the main indicators of bone mineral apparent density.

Purpose

Normal bone structure is formed in childhood and adolescence. The potential determinants which interact with genetic factors to influence bone density include gender, nutritional, lifestyle, and hormonal factors. This study aimed to evaluate bone mineral content (BMC) and the bone mineral density (BMD) and factors that may interfere with it in Iranian children.

Methods

In this cross-sectional study, 476 healthy Iranian children and adolescents (235 girls and 241 boys) aged 9–18 years old participated. BMC and BMD of the lumbar spine, femoral neck, and total body were measured by dual-energy X-ray absorptiometry using a Hologic Discovery device, and bone mineral apparent density (BMAD) of the lumbar spine and the femoral neck were calculated.

Results

We present percentile curves by age derived separately for BMC, BMD, and BMAD of the lumbar spine, left femoral neck, and total body excluding the head for boys and girls. Maximum accretion of BMC and BMD was observed at ages of 11–13 years (girls) and 12–15 years (boys).The prevalence of hypovitaminosis D was high and physical activity was low in our participants. However, in multiple regression analyses, age, BMI, and Tanner stage were the main indicators of BMD and BMAD

Conclusion

These normative data aid in the evaluation of bone density in Iranian children and adolescents. Further research to evaluate the evolution of BMD in Iranian children and adolescents is needed to identify the reasons for significant differences in bone density values between Iranian populations and their Western counterparts.     

Gender differences in bone density at different skeletal sites of acquisition with age in Chinese children and adolescents

Bone mass acquisition from different genders and races of children and adolescents may vary. To explore gender- and age-related differences in bone mineral density (BMD) measurements in Chinese children and adolescents, we used the dual-energy X-ray absorptiometry (DXA) bone densitometer to take BMD measurements at the posteroanterior (PA) and lateral spine, hip, and forearm in 1286 healthy children and adolescents, ranging from 6 to 24 years of age. Our results show a correlation between BMD measurements taken from different skeletal sites and from different ages of subjects. Male data were best fit to a power regression model, yielding the largest determinant coefficients (R ²), whereas S regression was the best fitting model for females. In individuals younger than 17 years of age, the rate of BMD accumulation in the PA spine is more rapid in females than in males, whereas in individuals older than 19 years of age, the converse was found to be true. In children younger than 14 years of age, BMD measurements, taken from the lateral spine, the neck and trochanter of the femur, and the total hip, correlated with age similarly in both genders. Additionally, in measurements taken from the forearm ultradistal and 1/3 region, BMD measurements from similar ages of both genders are similar. With increasing age, BMD measurements in males become significantly higher than those of females. However, volumetric BMD (vBMD) measurements from both genders show good uniformity at the lateral spine with a near overlap of the two models. Our findings suggest that vBMD acquisition measurements in Chinese children and adolescents show no gender differences, with gender differences only demonstrated in areal BMD (aBMD) measurements taken from different skeletal sites.     

Longitudinal changes of bone density and bone resorption in hyperthyroid girls during treatment.

Low bone mineral density (BMD) and increased bone turnover are common features of untreated hyperthyroidism in adult patients. The effect of treatment on BMD is still controversial. BMD and bone metabolism in hyperthyroid children have not been thoroughly investigated. In the present study, we measured spinal and whole body BMD by dual-energy X-ray absorptiometry in a group of 13 girls (aged 5.0-14.9 years) at diagnosis of hyperthyroidism. The bone resorption rate was assessed by urine measurement of N-terminal telopeptide of type I collagen (NTX). Hyperthyroid patients have been studied longitudinally during treatment. BMD values and NTX urine concentrations have been also determined in 155 healthy Caucasian girls (aged 2.4-24.2 years). Spinal and whole body bone density measurements were significantly lower compared with healthy controls in untreated hyperthyroid girls, after correction for differences in age and anthropometric measurements (p 相似文献   

Regional and total body bone mineral content,bone mineral density,and total body tissue composition in children 8–16 years of age

Summary Normative values for total body bone mineral content (TBBM) and total body bone mineral density (TBMD) were derived from measurements on 234 children 8–16 years of age. In addition, bone mineral content (BMC) and bone mineral density (BMD) values for selected regions of interest and soft tissue (bone free lean and fat) for the total body are presented. Bone mineral and soft tissue values were determined by dual energy X-ray absorptiometry (DXA) using a Hologic QDR-2000 in the array mode. Results of a stepwise multiple regression analysis revealed a significant correlation between bone-free lean tissue (BFLT) and BMD (r² = 0.80) in girls. Adding age to the equation accounted for an additional 2% of the variance (P < 0.05) and height accounted for another 1% of the variance (P < 0.05). Body weight and fat tissue (FT) did not account for any additional variance. In boys BFLT correlated significantly with BMD (r² = 0.75;P < 0.05); none of the other predictor variables accounted for additional variance. No significant differences were found in TBBM or TBMD between boys and girls at any age. There was a significant overall gender effect for only three regions of interest. Boys had greater BMC in the head region and had greater BMD in the upper limbs, but post hoc analysis revealed no significant differences for any specific age groups. Girls had greater overall BMD in the pelvis, but this difference was only significant at the 15–6-year age group. The changes in BFLT and FT over the age ranges were consistent with the growth literature.The normative values can be applied to the assessment of children and adolescents with health problems that may impact on the skeleton as well as to research studies investigating bone mineral development in children.     

Measurement of bone mineral density of lumbar spine and whole body in low-birth-weight infants: comparison of two methods

In the present study, we compared lumbar spinal and whole-body bone mineral density (BMD) measurements to determine which is more suitable for evaluating the bone mineral status of low-birth-weight (LBW) infants. Lumbar spinal and whole-body BMD were assessed simultaneously in a prospective series including 152 Japanese LBW infants (birth weight 453–2400 g, gestational age 24–38 weeks) from the age of 40 weeks post-conception to 2 years of age. Lumbar spinal BMD at 40 weeks post-conception was significantly correlated with birth weight (r = 0.74; P < 0.0001), but whole-body BMD was not correlated with birth weight. No correlation was found between lumbar spinal and whole-body BMD at 40 weeks post-conception. However, after 40 weeks post-conception, a significant correlation was found between lumbar spinal and whole-body BMD (r = 0.65; P < 0.0001). For infants with a body weight of 4 kg or less at the time of measurement, no correlation was found between lumbar spinal and whole-body BMD. However, for infants with a body weight above 4 kg, a significant correlation was found between lumbar spinal and whole-body BMD (r = 0.65; P < 0.0001). Thus, lumbar spinal BMD is more suitable than whole-body BMD for evaluation of the bone mineral status of LBW in early infancy. Therefore, lumbar spinal BMD should be used for serial evaluation of changes in the bone mineral status of LBW infants. Received: April 6, 2000 / Accepted: June 16, 2000