Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2004 Dec;96(12):1609–1615.

Associates of bone mineral density in older African Americans.

John Robbins 1, Calvin Hirsch 1, Jane Cauley 1
PMCID: PMC2568675  PMID: 15622691

Abstract

OBJECTIVES: To assess correlates of bone mineral density (BMD) in older African Americans. PARTICIPANTS: 189 women and 115 men over age 64. METHODS: Variables investigated: BMD by dual X-ray absorptiometry (DXA), medications, cardiovascular disease risk factors, demographic, lifestyle factors and functional status. Variables showing univariate correlation with BMD (p < or = 0.1) were entered into sex-stratified linear regression models. RESULTS: Age range 67-96 (mean 75). The mean BMD (gm/ cm2 +/- standard deviation) is reported for three sites. Total body: 1.03 (+/- 0.12) in women, 1.21 (+/- 0.11) in men. Spine: 1.05 (+/- 0.24) in women, 1.22 (+/- 0.26) in men. Total hip: 0.85 (+/- 0.15) in women, 1.04 (+/- 0.17) in men. Gender was significantly associated with BMD (t-test, p < 0.001). The R2 for tested variables were highly significant only for weight. Age was only significant for total hip in women (p < 0.05). Each kilogram of weight change was associated with a 5.3-6.8 mg/cm2 change in BMD. CONCLUSIONS: In a population-based cohort of older African Americans, average BMD was significantly greater in men than women. Weight accounted for most of the explained variability (R2) in BMD; age added little to the overall R2. Lower-weight, older African-American men and women are at significantly increased risk for low BMD and, thus, likely to be at greater risk for osteoporotic fracture.

Full text

PDF
1609

Images in this article

1610Figure 1
on p.1610
1612Figure 2
on p.1612

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aloia J. F., Vaswani A., Delerme-Pagan C., Flaster E. Discordance between ultrasound of the calcaneus and bone mineral density in black and white women. Calcif Tissue Int. 1998 Jun;62(6):481–485. doi: 10.1007/s002239900465. [DOI] [PubMed] [Google Scholar]
  2. Andresen E. M., Malmgren J. A., Carter W. B., Patrick D. L. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994 Mar-Apr;10(2):77–84. [PubMed] [Google Scholar]
  3. Aspray T. J., Prentice A., Cole T. J., Sawo Y., Reeve J., Francis R. M. Low bone mineral content is common but osteoporotic fractures are rare in elderly rural Gambian women. J Bone Miner Res. 1996 Jul;11(7):1019–1025. doi: 10.1002/jbmr.5650110720. [DOI] [PubMed] [Google Scholar]
  4. Barrett J. A., Baron J. A., Karagas M. R., Beach M. L. Fracture risk in the U.S. Medicare population. J Clin Epidemiol. 1999 Mar;52(3):243–249. doi: 10.1016/s0895-4356(98)00167-x. [DOI] [PubMed] [Google Scholar]
  5. Black D. M., Reiss T. F., Nevitt M. C., Cauley J., Karpf D., Cummings S. R. Design of the Fracture Intervention Trial. Osteoporos Int. 1993;3 (Suppl 3):S29–S39. doi: 10.1007/BF01623005. [DOI] [PubMed] [Google Scholar]
  6. Cummings S. R., Nevitt M. C., Browner W. S., Stone K., Fox K. M., Ensrud K. E., Cauley J., Black D., Vogt T. M. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995 Mar 23;332(12):767–773. doi: 10.1056/NEJM199503233321202. [DOI] [PubMed] [Google Scholar]
  7. Devine A., Dick I. M., Heal S. J., Criddle R. A., Prince R. L. A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporos Int. 1997;7(1):23–28. doi: 10.1007/BF01623455. [DOI] [PubMed] [Google Scholar]
  8. Dibba B., Prentice A., Laskey M. A., Stirling D. M., Cole T. J. An investigation of ethnic differences in bone mineral, hip axis length, calcium metabolism and bone turnover between West African and Caucasian adults living in the United Kingdom. Ann Hum Biol. 1999 May-Jun;26(3):229–242. doi: 10.1080/030144699282732. [DOI] [PubMed] [Google Scholar]
  9. Ensrud K. E., Lipschutz R. C., Cauley J. A., Seeley D., Nevitt M. C., Scott J., Orwoll E. S., Genant H. K., Cummings S. R. Body size and hip fracture risk in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Am J Med. 1997 Oct;103(4):274–280. doi: 10.1016/s0002-9343(97)00025-9. [DOI] [PubMed] [Google Scholar]
  10. Farmer M. E., White L. R., Brody J. A., Bailey K. R. Race and sex differences in hip fracture incidence. Am J Public Health. 1984 Dec;74(12):1374–1380. doi: 10.2105/ajph.74.12.1374. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Frost H. M. The Utah paradigm of skeletal physiology: an overview of its insights for bone, cartilage and collagenous tissue organs. J Bone Miner Metab. 2000;18(6):305–316. doi: 10.1007/s007740070001. [DOI] [PubMed] [Google Scholar]
  12. Hannan M. T., Felson D. T., Anderson J. J. Bone mineral density in elderly men and women: results from the Framingham osteoporosis study. J Bone Miner Res. 1992 May;7(5):547–553. doi: 10.1002/jbmr.5650070511. [DOI] [PubMed] [Google Scholar]
  13. Karagas M. R., Lu-Yao G. L., Barrett J. A., Beach M. L., Baron J. A. Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Am J Epidemiol. 1996 Apr 1;143(7):677–682. doi: 10.1093/oxfordjournals.aje.a008800. [DOI] [PubMed] [Google Scholar]
  14. Lewinsohn P. M., Seeley J. R., Roberts R. E., Allen N. B. Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Aging. 1997 Jun;12(2):277–287. doi: 10.1037//0882-7974.12.2.277. [DOI] [PubMed] [Google Scholar]
  15. Looker A. C., Orwoll E. S., Johnston C. C., Jr, Lindsay R. L., Wahner H. W., Dunn W. L., Calvo M. S., Harris T. B., Heyse S. P. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res. 1997 Nov;12(11):1761–1768. doi: 10.1359/jbmr.1997.12.11.1761. [DOI] [PubMed] [Google Scholar]
  16. Looker A. C., Wahner H. W., Dunn W. L., Calvo M. S., Harris T. B., Heyse S. P., Johnston C. C., Jr, Lindsay R. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8(5):468–489. doi: 10.1007/s001980050093. [DOI] [PubMed] [Google Scholar]
  17. Looker A. C., Wahner H. W., Dunn W. L., Calvo M. S., Harris T. B., Heyse S. P., Johnston C. C., Jr, Lindsay R. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8(5):468–489. doi: 10.1007/s001980050093. [DOI] [PubMed] [Google Scholar]
  18. Melton III L. J., Marquez M. A., Achenbach S. J., Tefferi A., O'Connor M. K., O'Fallon W. M., Riggs B. L. Variations in bone density among persons of African heritage. Osteoporos Int. 2002 Jul;13(7):551–559. doi: 10.1007/s001980200072. [DOI] [PubMed] [Google Scholar]
  19. Orwoll E. S., Bauer D. C., Vogt T. M., Fox K. M. Axial bone mass in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1996 Jan 15;124(2):187–196. doi: 10.7326/0003-4819-124-2-199601150-00001. [DOI] [PubMed] [Google Scholar]
  20. Pescatello Linda S., Murphy Donna M., Anderson Daren, Costanzo Dino, Dulipsingh Latha, De Souza Mary Jane. Daily physical movement and bone mineral density among a mixed racial cohort of women. Med Sci Sports Exerc. 2002 Dec;34(12):1966–1970. doi: 10.1097/00005768-200212000-00016. [DOI] [PubMed] [Google Scholar]
  21. Pruzansky M. E., Turano M., Luckey M., Senie R. Low body weight as a risk factor for hip fracture in both black and white women. J Orthop Res. 1989;7(2):192–197. doi: 10.1002/jor.1100070206. [DOI] [PubMed] [Google Scholar]
  22. Robbins J., Hirsch C., Whitmer R., Cauley J., Harris T. The association of bone mineral density and depression in an older population. J Am Geriatr Soc. 2001 Jun;49(6):732–736. doi: 10.1046/j.1532-5415.2001.49149.x. [DOI] [PubMed] [Google Scholar]
  23. Ross P. D. Osteoporosis. Frequency, consequences, and risk factors. Arch Intern Med. 1996 Jul 8;156(13):1399–1411. doi: 10.1001/archinte.156.13.1399. [DOI] [PubMed] [Google Scholar]
  24. Sebastian A. Thiazides and bone. Am J Med. 2000 Oct 1;109(5):429–430. doi: 10.1016/s0002-9343(00)00582-9. [DOI] [PubMed] [Google Scholar]
  25. Silverman S. L., Madison R. E. Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California Hospital Discharge Data. Am J Public Health. 1988 Nov;78(11):1482–1483. doi: 10.2105/ajph.78.11.1482. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Steiger P., Cummings S. R., Black D. M., Spencer N. E., Genant H. K. Age-related decrements in bone mineral density in women over 65. J Bone Miner Res. 1992 Jun;7(6):625–632. doi: 10.1002/jbmr.5650070606. [DOI] [PubMed] [Google Scholar]
  27. Sugiyama Toshihiro, Yamaguchi Akira, Kawai Shinya. Effects of skeletal loading on bone mass and compensation mechanism in bone: a new insight into the "mechanostat" theory. J Bone Miner Metab. 2002;20(4):196–200. doi: 10.1007/s007740200028. [DOI] [PubMed] [Google Scholar]
  28. Taylor H. L., Jacobs D. R., Jr, Schucker B., Knudsen J., Leon A. S., Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31(12):741–755. doi: 10.1016/0021-9681(78)90058-9. [DOI] [PubMed] [Google Scholar]
  29. van Staa T. P., Leufkens H. G. M., Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int. 2002 Oct;13(10):777–787. doi: 10.1007/s001980200108. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES