Socioeconomic status, race, and bone turnover in the Midlife in the US Study

Crandall, Carolyn J.; Miller-Martinez, Dana; Greendale, Gail A.; Binkley, Neil; Seeman, Teresa E.; Karlamangla, Arun S.

doi:10.1007/s00198-011-1736-5

Cited by 16 publications

(12 citation statements)

References 79 publications

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“…However, even results from community‐based studies are conflicting. For instance, in the Midlife in the US Study (MIDUS), low family poverty‐to‐income ratio was associated with higher levels of bone turnover markers (adjusted for age, race, body weight, and clinical site) among men . Combined results from 729 MIDUS men and women showed that lumbar spine BMD was higher with higher childhood SES ( p = 0.009) and in college graduates versus those without college education ( p = 0.01) (independent of race and other covariates).…”

Section: Discussionmentioning

confidence: 99%

Racial/Ethnic and Socioeconomic Differences in Bone Loss Among Men

Araujo

Yang

Suarez

et al. 2014

Journal of Bone and Mineral Research

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As men age, they lose bone and are susceptible to fracture. Despite having lower fracture rates than women, men have worse fractures than women do. Racial/ethnic and socioeconomic status (SES) disparities in fracture rates exist, yet data on rates of bone loss by race/ethnicity and SES among men are limited. We examined annualized percentage change in bone mineral density (%DBMD) at the hip (N ¼ 681), spine (N ¼ 663), and forearm (N ¼ 636) during 7 years of follow-up among men aged 30-79 years at baseline. Multivariable models tested whether race/ethnicity, income, or genetic ancestry predicted annualized %DBMD after controlling for an extensive set of covariates. Annualized %DBMD ranged from À0.65(0.04)% (femoral neck) to þ0.26(0.03)% (1/3 distal radius), and changes were consistent across age groups with the exception of the ultradistal radius, where annualized declines increased with age. Neither self-identified race/ethnicity nor genetic ancestry were associated with annualized %DBMD. In contrast, income was strongly associated (dose-response) with annualized %DBMD at total hip (independent of confounders, self-identified race/ethnicity, and genetic ancestry). Fully adjusted least-square mean change in annualized %DBMD at the total hip were À0.24(0.12)% and À0.16 (0.06)% steeper among men with low and moderate incomes, respectively, than among men with higher incomes (overall p ¼ 0.0293). Results show a linear decline in bone that begins relatively early in life among men, that rates of bone loss do not vary with race/ ethnicity (self-identified or "objectively" measured), and that income plays an important role in relation to bone loss at the hip. These data suggest that fracture risk in men may be driven in part by income-related differences in bone loss, but also, that the known higher fracture risk among white men is not the result of racial/ethnic differences in bone loss, but rather, early life exposures that lead to attainment of higher peak bone mass among minorities.

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Section: Discussionmentioning

confidence: 99%

Racial/Ethnic and Socioeconomic Differences in Bone Loss Among Men

Araujo

Yang

Suarez

et al. 2014

Journal of Bone and Mineral Research

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“…Twenty-eight patients were receiving an SSRI prior to entering the study and discontinued this drug 2 weeks prior to beginning the open-label study treatment. Analyses were conducted in European-Americans only for various reasons: First, differences in bone metabolism were described varying among different populations (e.g., Crandall et al 2012). Second, the allele frequencies typically vary among ethnic groups (Gelernter et al 1997) and population stratification may result in spurious findings.…”

Section: Methodsmentioning

confidence: 99%

Genetic variation in the serotonin transporter and HTR1B receptor predicts reduced bone formation during serotonin reuptake inhibitor treatment in older adults

Garfield

Müller

Kennedy

et al. 2013

The World Journal of Biological Psychiatry

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Objectives Studies have reported an association between serotonin reuptake inhibitors (SRIs) and accelerated bone loss. Genetic variation in the serotonin system might modulate bone metabolism changes during SRI treatment. In a clinical trial we examined functional genetic polymorphisms of serotonin transporter and receptors involved in bone metabolism to determine whether they predict changes in bone metabolism during SRI treatment. Methods In 69 adults (age ≥ 60) participating in a 12-week, open-label trial of the SRI venlafaxine for major depression, serum markers of bone formation (P1NP) and resorption (β-CTX) were assayed before and after treatment. Participants were genotyped for putative high- versus low-expressing polymorphisms in the serotonin transporter (5HTTLPR) and 1B receptor (HTR1B) genes. Results Bone formation was significantly reduced with administration of venlafaxine in participants with the high-expressing 5HTTLPR genotype and those with the low-expressing HTR1B genotype. This primarily occurred in individuals with the combination of the high-expressing 5HTTLPR genotype and the low-expressing HTR1B genotype. Conclusions These preliminary findings indicate that genetic variation in the serotonin receptors predicts changes in bone metabolism during SRI use. If these results are replicated and clinically confirmed, we will have identified a genetic subgroup at high risk for deleterious bone outcomes with the use of SRIs.

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“…Recent studies are now targeting SEP as a risk factor for poor bone health, raising public health concerns. In these studies [3][4][5][6][7][8], low SEP is associated with low bone mineral density (BMD) and/or increased risk of osteoporosis (or osteoporotic fractures), which may be explained by less protective behaviors in low-SEP individuals. Low SEP can negatively influence bone health and increase the risks of osteoporotic fractures, which deteriorate quality of life [9].…”

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confidence: 98%

The Effect of Socioeconomic Position on Bone Health Among Koreans by Gender and Menopausal Status

et al. 2012

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While studies suggest that socioeconomic position (SEP) influences bone health and risk of osteoporotic fracture in postmenopausal women, few studies have simultaneously examined gender and menopause differences as they relate to SEP and bone health. Here, we investigated the relationship between SEP and bone mineral density (BMD) among Korean men, premenopausal women, and postmenopausal women using the BMD data set (n = 9,995) of the Korean National Health and Nutrition Examination Survey IV. The relationship between SEP and BMD was estimated using analysis of covariance (ANCOVA); adjustments were made for age and body mass index (BMI) in the multivariate models. The relationship between SEP and osteoporosis prevalence was estimated using logistic regression. Relative index of inequality (RII) in osteoporosis was estimated using log-binomial regression. ANCOVA (adjusted for age and for age plus BMI) showed a significant positive association between SEP and BMD among men and postmenopausal women. Logistic regression showed a significant negative association between SEP and osteoporosis prevalence among men and postmenopausal women but not in premenopausal women. The RII, estimated by log-binomial regression, showed the impact of SEP on osteoporosis to be significant in men and postmenopausal women (p < 0.05) but not in premenopausal women. Overall, low SEP was associated with both low BMD and high risk of osteoporosis among men and postmenopausal women. Efforts to reduce the economic burden of morbidity and mortality from osteoporosis should target men and postmenopausal women with low SEP.

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Socioeconomic status, race, and bone turnover in the Midlife in the US Study

Cited by 16 publications

References 79 publications

Racial/Ethnic and Socioeconomic Differences in Bone Loss Among Men

Racial/Ethnic and Socioeconomic Differences in Bone Loss Among Men

Genetic variation in the serotonin transporter and HTR1B receptor predicts reduced bone formation during serotonin reuptake inhibitor treatment in older adults

The Effect of Socioeconomic Position on Bone Health Among Koreans by Gender and Menopausal Status

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