Race and Osteoporosis

Explaining the connections between race and osteoporosis. Race may no longer matter with diagnosis, as bone size should be looked at as well as bone density when determining risks of osteoporotic fracture.

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Until recently, physicians have cited risk factors of low bone mass or osteoporosis to include racial and ethnic background. It has been standard practice by physicians to inform Caucasian and Asian women that they have the highest risk for developing osteoporosis, in comparison to African American and Latino. DXA scans, the gold standard method of determining the diagnosis of osteoporosis and fracture risk, show only the density of the material they are examining. If looking into a bone, the grams/per cubic centimeter is determined, then cross-referenced with age. The dual x-rays in the scan choose a site in the middle of the bone, but no metric is captured looking at the thickness of the bone. Any structural engineering analysis would certainly look at thickness of a material before determining its strength as a material for supporting anything. The most interesting part of this observation is that the variance in data between races and ethnicities directly correlates with thickness of bones, which is why the risk factor for Caucasian and Asian women has existed.

A new UCLA-led study has been examining mixed racial or ethnic background females with a new method of measuring bone health to improve accuracy in the potential diagnosis for an individual’s risk of osteoporosis and bone fracture. With the ever-growing prevalence of mixed race/ethnicity individuals adding thickness as a variable in determining fracture risk is necessary. The UCLA researchers studied the data just under 2,000 females in the U.S. between the ages of 42 and 53 who were of Caucasian, African American, and Asian ethnic backgrounds for 10 years. The researchers then used bone size and body size to factor into DXA scan information to determine a new composite bone strength indication factor. The results of the study indicated that determining fracture risk using a composite value of density and size of bone would improve accuracy in determining fracture risk and general diagnosis of osteoporosis. The researchers note that more research in needed to determine the best methods of developing a combined value.


Ishii, S. Greendale, G. Cauley, J. Crandall, C. Huang, M. Danielson, M. & Karlamangla, A. (2012). Fracture Risk Assessment without Race/Ethnicity Information. Journal of Clinical Endocrinology & Metabolism. October.


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