Ethnic and genetic differences in bone mass: a review with a hereditary vs environmental perspective

Pollitzer, William S.; Anderson, John J.B.

doi:10.1093/ajcn/50.6.1244

Cited by 271 publications

(119 citation statements)

References 57 publications

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“…6 Evidence from a review of hereditary versus environmental influences on BMD provides support for a hereditary component in determining peak BMD in young adult women. 7 However, if this is true, it would be difficult to understand why this is expressed more prominently in females compared with males. An evaluation of genetic factors influencing ethnic variations in BMD was outside the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of bone mineral density, calcium, and vitamin D status in the Gujarati and white populations of Leicester

Hamson

Goh

Sheldon

et al. 2003

Postgraduate Medical Journal

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Objectives: To evaluate differences in bone mineral density (BMD), calcium, and vitamin D status between the Gujarati (South Asian) and white populations resident in Leicester and to determine whether this was linked to lifestyle factors. Design: An observational cross sectional study of randomly selected Gujarati and white volunteers aged from 20-40 years. Setting: City of Leicester. Participants: Subjects were randomly selected by age (20-40 years) and ethnicity. A total of 262 individuals volunteered to participate, of which 201 (51 white females, 71 Gujarati females, 37 white males, 42 Gujarati males) were eligible for the study. Main outcome measures: Results of questionnaire, BMD at the hip and lumbar spine, and measurement of serum calcium, albumin, alkaline phosphatase, and 25-hydroxyvitamin D.Results: Male and female white subjects were significantly taller and heavier than their Gujarati counterparts. There was a statistically significant difference in BMD both at the spine (p<0.001) and hip (p<0.001) between the white and Gujarati females with the Gujaratis having a lower BMD. There was a trend for Gujarati males to have a lower BMD at the hip and spine than their white counterparts but these figures did not reach statistical significance. The intensity of cigarette smoking and the amount of alcohol consumption were both higher in the white male and female subjects. Sunlight exposure (>4 hours per day) was significantly higher in white subjects compared with Gujaratis. There were no significant differences in the mean level of serum calcium or alkaline phosphatase between the Gujaratis and whites. A significantly higher proportion (p<0.001) of the Gujarati men and women had a vitamin D level that was not measurable (that is, below the lower limit of the laboratory range of normal). Of those who had a measurable level (that is, in the normal range) mean levels of vitamin D were lower (p<0.05) in the Gujarati men and women. Conclusion: The present study is the first of its kind to note a low BMD in Gujarati subjects of South Asian origin compared with their white counterparts, living in Leicester. This study also confirms the presence of low serum vitamin D levels in Gujaratis. There is a need for more research in South Asians with regard to the collection of normal BMD values. This could provide a more meaningful reference range for identifying South Asians at risk of osteoporotic fractures and may have public health implications of relevance to this ethnic group.

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Section: Discussionmentioning

confidence: 99%

Comparative study of bone mineral density, calcium, and vitamin D status in the Gujarati and white populations of Leicester

Hamson

Goh

Sheldon

et al. 2003

Postgraduate Medical Journal

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“…At the end of the growth period, a large variance in bone mineral density (BMD) 1 and content (BMC), in either the axial or the appendicular skeleton, is observed both in healthy females and males (4)(5)(6)(7)(8). Many genetic and environmental factors have been suggested to influence bone mass accumulation during this period (9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.

Bonjour¹,

Carrié²,

Ferrari³

et al. 1997

J. Clin. Invest.

511

339

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High calcium intake during childhood has been suggested to increase bone mass accrual, potentially resulting in a greater peak bone mass. Whether the effects of calcium supplementation on bone mass accrual vary from one skeletal region to another, and to what extent the level of spontaneous calcium intake may affect the magnitude of the response has, however, not yet been clearly established. In a doubleblind, placebo-controlled study, 149 healthy prepubertal girls aged 7.9 Ϯ 0.1 yr (mean Ϯ SEM) were either allocated two food products containing 850 mg of calcium (Ca-suppl.) or not (placebo) on a daily basis for 1 yr. Areal bone mineral density (BMD), bone mineral content (BMC), and bone size were determined at six sites by dual-energy x-ray absorptiometry. The difference in BMD gain between calcium-supplemented (Ca-suppl.) and placebo was greater at radial (metaphysis and diaphysis) and femoral (neck, trochanter, and diaphyses) sites (7-12 mg/cm 2 per yr) than in the lumbar spine (2 mg/cm 2 per yr). The difference in BMD gains between Ca-suppl. and placebo was greatest in girls with a spontaneous calcium intake below the median of 880 mg/d. The increase in mean BMD of the 6 sites in the low-calcium consumers was accompanied by increased gains in mean BMC, bone size, and statural height. These results suggest a possible positive effect of calcium supplementation on skeletal growth at that age. In conclusion, calcium-enriched foods significantly increased bone mass accrual in prepubertal girls, with a preferential effect in the appendicular skeleton, and greater benefit at lower spontaneous calcium intake.

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“…(15)(16)(17)(18) The racial difference in fracture rates is also consistent with the racial difference in BMD observed in all groups. (2,8,9,(19)(20)(21) Data from NHANES III showed an 11-17% difference in BMD at different sites within the hip for different ages between blacks and whites. Racial differences in BMD were seen in children and adolescents, premenopausal and postmenopausal women, and men Ն20 yr of age.…”

mentioning

confidence: 99%

Vitamin D Economy in Blacks

Cosman

Nieves

Dempster

et al. 2007

Journal of Bone and Mineral Research

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ABSTRACT:The fact that fracture risk is lower and BMD is higher in blacks compared with whites is surprising in light of what is known about vitamin D status in blacks. Mean 25(OH)D levels are lower in blacks than whites at all stages of life, and a greater proportion of blacks meet criteria for vitamin D deficiency. The racial difference in serum 25(OH)D level is primarily caused by increased pigmentation reducing vitamin D production in the skin. In response to lower 25(OH)D levels and lower average calcium intake, blacks have higher average PTH levels and a higher prevalence of secondary hyperparathyroidism (twice the prevalence compared with whites for both sexes). This is associated with higher average levels of 1,25(OH) 2 D and lower urinary calcium excretion but not higher biochemical indices of bone turnover. In fact, in general, biochemical indices of bone formation (particularly osteocalcin levels) are lower in blacks. Bone formation rates assessed histomorphometrically are also lower, although wall thickness is maintained. During a 24-h PTH infusion, increments in levels of three different bone resorption markers are significantly lower in blacks than in whites, providing direct confirmation of the thesis that the black skeleton is resistant to the bone-resorbing effects of PTH, whereas renal sensitivity to PTH is maintained or perhaps even enhanced. Vitamin D supplementation studies in black women have shown inconsistent benefits to BMD. Skeletal and renal adaptations to vitamin D deficiency in blacks might be so effective that vitamin D supplementation might not confer any further benefit to the black skeleton. Benefits of vitamin D supplements in blacks may still play a role, however, in the prevention of other chronic diseases.

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Ethnic and genetic differences in bone mass: a review with a hereditary vs environmental perspective

Cited by 271 publications

References 57 publications

Comparative study of bone mineral density, calcium, and vitamin D status in the Gujarati and white populations of Leicester

Comparative study of bone mineral density, calcium, and vitamin D status in the Gujarati and white populations of Leicester

Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.

Vitamin D Economy in Blacks

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