Bone Density in an Immigrant Population from Southeast Asia

Marquez, M. A.; Melton, L. Joseph; Muhs, Joan M.; Crowson, C. S.; Tosomeen, Ann; O’Connor, Michael K.; O’Fallon, W. Michael; Riggs, B. Lawrence

doi:10.1007/s001980170083

Cited by 50 publications

(35 citation statements)

References 41 publications

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“…The latter observation reinforces the notion that individuals of particular races should not be viewed as members of a uniform class [56] but rather that efforts should be made to explore differences among the component ethnic groups [31]. Unfortunately, no obvious explanation for differences in bone density between Somali and AA women was found with the limited data available here.…”

Section: Discussioncontrasting

confidence: 39%

“…When bone size was adjusted for, BMAD values at the lumbar spine and femoral neck were actually somewhat greater for Somali than for white women. Likewise, recent studies have shown that adjustment for bone or body size reduces apparent differences in bone density between white and Asian women [31,44,[51][52][53][54][55]. However, this correction did not equilibrate bone density values among those of African heritage, as BMAD values were still significantly greater among AA than Somali women.…”

Section: Discussionmentioning

confidence: 81%

“…However, BMD is not greater in all African populations [22][23][24] even though their fracture rates are still lower than those observed in whites [22,[25][26][27][28][29]. This suggests that the heterogeneity in bone density levels that has been described in Asian populations [30,31] might also exist in populations of African heritage. This possibility has not been adequately addressed since spine or hip BMD has not been assessed in different populations of African heritage using comparable methodology.…”

Section: Introductionmentioning

confidence: 71%

“…In addition, the minority study population was highly selected because it was necessary to use a convenience sample of minority subjects. In particular, the Somali population in Olmsted County, like other migrant groups [31], is a mobile one. As a consequence, there was no adequate population-based sampling frame for nonwhite residents of the community.…”

Section: Discussionmentioning

confidence: 99%

“…Although this segment of the community has grown rapidly in recent years, from about 790 in 1990 to over 3300 in 2000, the minority population is relatively young (90% under 50 years of age) and transient [31]. Thus, we attempted to identify AA subjects by working through a local church with strong ties to the African-American community, keeping in mind that this culture places great importance on religion.…”

Section: Study Subjectsmentioning

confidence: 99%

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Variations in Bone Density among Persons of African Heritage

Melton¹,

Marquez

Achenbach³

et al. 2002

Osteoporos Int

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The epidemiology of bone loss in populations of African heritage is still poorly known. We compared a convenience sample of 47 African-American (AA) residents of Rochester, Minnesota (32 women, 15 men) and 66 recent immigrants from Somalia (all women) with 684 white subjects (349 women, 335 men) previously recruited from an age-stratified random sample of community residents. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 for white subjects and the QDR 4500 for the others; the instruments were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 18% higher in AA ( p<0.001) and 4% lower in Somali ( p = 0.147) than white women. Femoral neck BMD was 27% higher in AA women but also 11% greater in Somali women (both p<0.001) compared with whites. Lumbar spine BMD was 6% higher ( p = 0.132) and femoral neck BMD 21% higher ( p<0.001) in AA than white men. No Somali men were studied. After correcting for bone size differences, both lumbar spine ( p<0.01) and femoral neck BMAD ( p<0.001) were greater for Somali than white women, but the difference between Somali and AA women persisted. Lumbar spine and femoral neck BMAD values also remained significantly greater for AA women (both p<0.001) and men ( p<0.05; p<0.001) compared with whites. Weight was associated with BMAD at both skeletal sites in all groups, but adjustment for differences in weight did not reduce the discrepancy in BMAD values between Somali and AA women or between the latter group and whites. This heterogeneity among different ethnic groups of African heritage may provide an opportunity for research to better explain race-specific differences in bone metabolism.

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Section: Discussioncontrasting

confidence: 39%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Study Subjectsmentioning

confidence: 99%

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Variations in Bone Density among Persons of African Heritage

Melton¹,

Marquez

Achenbach³

et al. 2002

Osteoporos Int

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Changing epidemiology of hepatitis B in a U.S. community

et al. 2004

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Despite a reduction in newly acquired hepatitis B virus (HBV) infections since the mid1980s, HBV remains an important cause of liver disease in the U.S. We report the prevalence of chronic HBV infection in a U.S. community and describe demographic and clinical characteristics. The Rochester Epidemiology Project records healthcare encounters of residents of Olmsted County, Minnesota. For all cases with a potential diagnosis of hepatitis B in this database, complete medical records were reviewed to identify subjects who met the inclusion criteria, i.e., a clinician diagnosis of chronic HBV infection and a laboratory record of positive hepatitis B surface antigen (HBsAg). There were 191 residents with chronic HBV infection in the community, consisting of 53% Asian, 29% African, 13% Caucasian, and 5% other or unknown race. The overall age-and sex-adjusted prevalence of HBV in this community was 0.15% in 2000. The race-specific prevalence was highest among Asians (2.1%), followed by African Americans (1.9%). The prevalence among Caucasians was 0.02%. Overall, 86% were born outside the U.S., 98% of whom were non-Caucasian. A total of 131 residents were tested for HBV replicative status, of whom 27% had viral replication. Of those tested for aminotransferases (n ‫؍‬ 184), 28% had an abnormal value at least once. In a multivariable regression analysis, replicative status was the most influential (odds ratio [OR] ‫؍‬ 5.98, P < .01) factor associated with abnormal aminotransferase values, followed by male gender (OR ‫؍‬ 3.69) and age greater than 40 years (OR ‫؍‬ 2.32 per decade). In conclusion, in this Midwestern community, chronic HBV infection was predominantly seen in immigrants from endemic parts of the world. (HEPATOLOGY 2004;39:811-816.)

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Areal and volumetric bone density in Hong Kong Chinese: a comparison with Caucasians living in the United States

et al. 2003

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It is a common perception that Asians have lower bone density than Caucasians. However, such relationships could be confounded by bone size. In this study, the skeletal status of a convenience sample of 482 men and 887 women living in Hong Kong is compared with published data for Caucasians living in Rochester, Minnesota. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for the lumbar spine and proximal femur, using the Hologic QDR 2000 instrument. Cross-calibration was performed by measuring a common phantom, and the Hong Kong data were adjusted by a multiplication factor. Lumbar spine and femoral neck BMD and BMAD of Chinese men and women were all significantly lower ( P<0.001 by t-test) than those of Caucasians, but the differences in BMAD were on average only about half the size of the differences in BMD. For instance, in postmenopausal Chinese women, BMD at the femoral neck and lumbar spine were 15.2% and 18.8% lower respectively, but BMAD at the femoral neck and lumbar spine were only 7.8% and 12.4% lower respectively. Similar trends were observed in men. After adjusting for age, body height and weight, the difference in BMAD between Caucasians and Chinese was further reduced and only statistically significant among postmenopausal women and among men younger than age 50 years for the lumbar spine. For instance, the adjusted BMAD in postmenopausal Chinese women at the femoral neck and lumbar spine were 3.9% ( P=0.03 by ANCOVA) and 7.3% ( P<0.001 by ANCOVA) lower respectively, while the adjusted BMAD at the lumbar spine for Chinese men younger than 50 years was 11.7% lower ( P<0.01 by ANCOVA). Predictors of BMAD in Hong Kong Chinese women include body weight, age at menarche, cigarette smoking, and oral contraceptive use ( P<0.001), while body weight was the only independent predictor of BMAD in Hong Kong Chinese men ( P<0.001). We conclude that bone density is lower in Hong Kong Chinese men and women than in Caucasians, although such differences were attenuated by adjustments for bone size, body weight and height.

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Bone Density in an Immigrant Population from Southeast Asia

Cited by 50 publications

References 41 publications

Variations in Bone Density among Persons of African Heritage

Variations in Bone Density among Persons of African Heritage

Changing epidemiology of hepatitis B in a U.S. community

Areal and volumetric bone density in Hong Kong Chinese: a comparison with Caucasians living in the United States

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