Madhusmita Misra1,2, Kathryn E Ackerman3,4, Miriam A Bredella5, Fatima Cody Stanford6, Alexander T Faje3, Alexandra Nordberg3, Nicholas P Derrico7, Mary L Bouxsein7,8. 1. Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, BUL 457, Boston, MA, 02114, USA. mmisra@mgh.harvard.edu. 2. Pediatric Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. mmisra@mgh.harvard.edu. 3. Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, BUL 457, Boston, MA, 02114, USA. 4. Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA. 5. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. 6. MGH Weight Center, Medicine-Gastrointestinal Unit, Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA. 7. Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA. 8. Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA.
Abstract
BACKGROUND: Previous studies have demonstrated that an individual's race and ethnicity are important determinants of their areal bone mineral density (aBMD), assessed by dual-energy X-ray absorptiometry. However, there are few data assessing the impact of race on bone microarchitecture and strength estimates, particularly in older adolescent girls and young adults. We hypothesized that bone microarchitecture and strength estimates would be superior in Blacks compared to White and Asian American adolescent girls and young adults of similar age based on reports of higher aBMD in Blacks. METHODS: We assessed BMD using dual-energy X-ray absoptiometry (DXA), bone microarchitecture at the distal radius and distal tibia using high-resolution peripheral quantitative computed tomography (HRpQCT) and estimated measures of bone strength using micro-finite element analysis (FEA) in 35 White, 15 Asian American, and 10 Black girls 14-21 years. RESULTS: After controlling for height, most DXA measures of aBMD and aBMD Z scores were higher in Black girls compared with Whites and Asian Americans. HRpQCT and FEA showed that at the distal radius, Blacks had greater cortical perimeter, cortical area, trabecular thickness, trabecular BMD, estimated failure load, and stiffness than the other two groups. For the distal tibia, trabecular number and BMD were higher in Blacks than Asian Americans. CONCLUSIONS: Particularly at the distal radius, adolescent and young adult White and Asian American girls have less favorable bone microarchitecture and lower bone strength than Blacks, possibly explaining the lower risk of fracture seen in Blacks. LEVEL OF EVIDENCE: Level II.
BACKGROUND: Previous studies have demonstrated that an individual's race and ethnicity are important determinants of their areal bone mineral density (aBMD), assessed by dual-energy X-ray absorptiometry. However, there are few data assessing the impact of race on bone microarchitecture and strength estimates, particularly in older adolescent girls and young adults. We hypothesized that bone microarchitecture and strength estimates would be superior in Blacks compared to White and Asian American adolescent girls and young adults of similar age based on reports of higher aBMD in Blacks. METHODS: We assessed BMD using dual-energy X-ray absoptiometry (DXA), bone microarchitecture at the distal radius and distal tibia using high-resolution peripheral quantitative computed tomography (HRpQCT) and estimated measures of bone strength using micro-finite element analysis (FEA) in 35 White, 15 Asian American, and 10 Black girls 14-21 years. RESULTS: After controlling for height, most DXA measures of aBMD and aBMD Z scores were higher in Black girls compared with Whites and Asian Americans. HRpQCT and FEA showed that at the distal radius, Blacks had greater cortical perimeter, cortical area, trabecular thickness, trabecular BMD, estimated failure load, and stiffness than the other two groups. For the distal tibia, trabecular number and BMD were higher in Blacks than Asian Americans. CONCLUSIONS: Particularly at the distal radius, adolescent and young adult White and Asian American girls have less favorable bone microarchitecture and lower bone strength than Blacks, possibly explaining the lower risk of fracture seen in Blacks. LEVEL OF EVIDENCE: Level II.
Entities:
Keywords:
Failure load; Finite element analysis; Microarchitecture; Race
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