Applying ethnic-specific bone mineral density T-scores to Chinese women in the USA

Summary

Caucasian reference data are used to classify bone mineral density in US women of all races. However, use of Chinese American reference data yields lower osteoporosis prevalence in Chinese women. The reduction in osteoporosis labeling may be relevant for younger Chinese women at low fracture risk.

Introduction

Caucasian reference data are used for osteoporosis classification in US postmenopausal women regardless of race, including Asians who tend to have lower bone mineral density (BMD) than women of white race. This study examines BMD classification by ethnic T-scores for Chinese women.

Methods

Using BMD data in a Northern California healthcare population, Chinese women aged 50–79 years were compared to age-matched white women (1:5 ratio), with femoral neck (FN), total hip (TH), and lumbar spine (LS) T-scores calculated using Caucasian versus Chinese American reference data.

Results

Comparing 4039 Chinese and 20,195 white women (44.8 % age 50–59 years, 37.5 % age 60–69 years, 17.7 % age 70–79 years), Chinese women had lower BMD T-scores at the FN, TH, and LS (median T-score 0.29–0.72 units lower across age groups, p?

Conclusion

Use of Chinese American BMD reference data yields higher (ethnic) T-scores by 0.4–0.5 units, with a large proportion of Chinese women reclassified from osteoporosis to osteopenia. The reduction in osteoporosis labeling with ethnic T-scores may be relevant for younger Chinese women at low fracture risk.