Correlates of bone mineral density among postmenopausal women of African Caribbean ancestry: Tobago women's health study

Abstract

Population dynamics predict a drastic growth in the number of older minority women, and resultant increases in the number of fractures. Low bone mineral density (BMD) is an important risk factor for fracture. Many studies have identified the lifestyle and health related factors that correlate with BMD in Whites. Few studies have focused on non-Whites. The objective of the current analyses is to examine the lifestyle, anthropometric and health related factors that are correlated with BMD in a population based cohort of Caribbean women of West African ancestry. We enrolled 340 postmenopausal women residing on the Caribbean Island of Tobago. Participants completed a questionnaire and had anthropometric measures taken. Hip BMD was measured by DXA. We estimated volumetric BMD by calculating bone mineral apparent density (BMAD). BMD was 10% and 20% higher across all age groups in Tobagonian women compared to US non-Hispanic Black and White women, respectively. In multiple linear regression models, 35-36% of the variability in femoral neck and total hip BMD respectively was predicted. Each 16 kilogram (one standard deviation (SD)) increase in weight was associated with 7% higher BMD; and weight explained over 10% of the variability of BMD. Each eight year (1 SD) increase in age was associated with 6% lower BMD. Current use of both thiazide diuretics and oral hypoglycemic medication were associated with 4-5% higher BMD. For femoral neck BMAD, 26% of the variability was explained by a multiple linear regression model. Current statin use was associated with 5% higher BMAD and a history of breast feeding or coronary heart disease were associated with 1-1.5% of higher BMAD. In conclusion, African Caribbean women have the highest BMD on a population level reported to date for women. This may reflect low European admixture. Correlates of BMD among Caribbean women of West African ancestry were similar to those reported for U.S. Black and White women.

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

“…However, over five dozen epidemiologic studies of pre-, peri-, and postmenopausal women have found a neutral effect (16,38,63,158,203,214,215,290,292,299,341,356,368,379,383,397,444,445,448,463,481,506,509,541,547,611,619,625,636,648,683,700,761,828,845,846,861,864,865,869,879,934,935,944,951,969,1020) or a protective effect (25,27,71,…”

O efeito da amamentação na massa óssea de mulheres na pós-menopausa: revisão sistemática de estudos observacionais

“…Dentre os artigos revisados, 33 apresentam delineamento seccional 12,13,[16][17][18][19][26][27][28][29][30][31][32][33][34][35][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] e um foi estudo de coorte. 56 A origem dos estudos se distribuiu entre: Estados Unidos da América -EUA (n=8), Turquia (n=7), China (n=3), Dinamarca (n=2), Japão (n=2), Itália (n=1), Holanda (n=1), Suécia (n=1), Grécia (n=1), Sri Lanka (n=1), Irã (n=1), Reino Unido (n=1), Caribe (n=1), México (n=1), Israel (n=1) e Coréia (n=1).…”

“…Parte deles considerou a variável "amamentação" de maneira dicotômica -sim/não (20,6%) 16,28,33,35,39,41,43 -e os demais, com base na soma do tempo total de prática da amamentação em meses, anos ou semanas (79,4%). Ainda, entre estes últimos houve divergência na consideração do tempo total que durou a amamentação.…”

“…Dos sete estudos que identificaram sua amostra como constituída por mulheres brancas, 16,18,19,33,39,41,43 três relataram associação direta. 16,18,39 Hill et al, 28 autores do único estudo entre mulheres negras, observaram maior DMO entre as que relataram ter amamentado. Rojan-Mejía et al 19 estudaram "mestiças" e observaram maior probabilidade de osteoporose e osteopenia entre as mulheres que amamentaram de 36 a 48 meses na vida -outro fator a ser mais bem estudado.…”

“…22,24 Na menopausa, a perda óssea é intensificada novamente; na fase de transição, essa perda pode chegar a 10% ao ano, enquanto nos homens é mais gradual (0,5% ao ano) e tardia (aproximadamente aos 70 anos). 25 Há divergências entre os estudos que investigaram se a prática da amamentação influencia a massa óssea na pós-menopausa: alguns observaram existir associação direta, 16,18,[26][27][28] outros, inversa 12,[29][30][31][32] e ainda, alguns relataram ausência de associação. 13,[33][34][35] Uma revisão da literatura confirmou a inconsistência de resultados.…”