Cross-Sectional Geometry, Bone Strength, and Bone Mass in the Proximal Femur in Black and White Postmenopausal Women

Abstract

Osteoporosis is characterized by both a low bone mass and a disruption of the architectural arrangement of bone tissue, leading to decreased skeletal strength and increased fracture risk. Although there are well-known ethnic differences in bone mass and fracture risk, little is known about possible ethnic differences in bone structure. Therefore, we studied cross-sectional geometry in the hip in a sample of postmenopausal black and white women in order to investigate ethnic differences that might contribute to differences in bone strength and ultimately hip fracture risk. We recruited 371 postmenopausal black and white women who were entering the Women's Health Initiative (WHI) clinical trials in Detroit. Bone density measurements of the proximal femur were done by dual-energy X-ray absorptiometry (DXA) using a Hologic 1000 Plus bone densitometer. The DXA data were used for hip structure analysis, which treats the entire proximal femur as a continuous curved beam from the proximal shaft to the femoral neck. This permits the analysis of cross-sectional geometric properties in two narrow regions corresponding to thin (5 mm) cross-sectional slabs seen on edge. The results indicate significant ethnic differences in bone density, cross-sectional geometry, and dimensional variables. Specifically, the black women have a significantly higher bone density in both locations (10.1% and 4.1% for the neck and shaft, respectively); greater cross-sectional geometric properties in the neck (ranging from 6.1% to 11.6%), but a smaller endocortical diameter in the neck (3.6%). There are fewer significant differences in cross-sectional geometry in the shaft location. Our data suggest that the spatial distribution of bone is arranged in the femoral neck to resist greater loading in black women compared with white women. (J Bone Miner Res 2000;15:1992-1997)

No Difference in Gender-specific Hip Replacement Outcomes

“…Wheatley [19] reported a difference in proximal femoral bone density between black and white women taking weight into consideration as well. Nelson et al [13] found differences between black and white women in terms of bone density in the proximal femur as well as cross-sectional geometric measures of the neck with a smaller endocortical diameter in black female patients. Forensic data on gender-based differences must of necessity take race into account.…”

Correlation between a Bone Resorption Marker and Structural Geometry of the Proximal Femur in Osteoporotic Women Treated with Raloxifene

“…Precision error for parameters at the neck, intertrochanter, and shaft ranged from 0.8% to 4.7%, with a mean of 2.2%. 27,34 Correlations between sNTX and HSA parameters were analysed using Pearson's R, and were considered statistically significant at p<0.05. Correlations were adjusted for age, which strongly influences sNTX and HSA parameters.…”

RETRACTED: The periosteum

“…76 In humans, some of the most obvious are gender (males > females) and race (blacks > whites > asians). 73,86,87 Geographical differences in bone size are also marked, even within racial boundaries. 30 Disorders of bone size expansion, such as childhood illness at critical periods of development, have been proposed to contribute to the variation in adult bone strength and fracture likelihood.…”