Conradie Magda, Conradie Maria M, Scher Alan T, Kidd Martin, Hough Stephen
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Health Sciences, University of Stellenbosch, P.O. Box 241, Cape Town, 8000, South Africa,
Arch Osteoporos. 2015;10:203. doi: 10.1007/s11657-015-0203-x. Epub 2015 Feb 13.
Black women are generally regarded as being less prone to the development of osteoporosis. This study reports a similar prevalence of morphometric vertebral fractures in black (9.1 %) and white (5.0 %) South African women. Clinical risk factors and bone strength parameters contributed differently to fracture risk in the two ethnic cohorts.
Vertebral fracture represents one of the most common osteoporotic fractures and is a significant cause of morbidity and mortality. Little is known regarding the prevalence of vertebral fractures on the African continent. We therefore prospectively examined the prevalence of vertebral fracture on radiographs of the thoraco-lumbar spine in otherwise healthy community-dwelling older black and white South African women.
Radiographs of the spine (T4-L5) were obtained randomly in 189 women (47 % black), aged 40 years or older, for the analysis of vertebral fracture. Radiographs were evaluated by a single radiologist, blinded to clinical data, using Genant's semi-quantitative method. Clinical risk factors for osteoporosis, risk factors for falls (fall history, quadriceps strength, lateral sway and reaction time), areal and volumetric bone mineral density of the spine and hip, calcaneal ultrasonography (QUS) and vertebral macro-geometry were assessed in the two ethnic groups and the association with prevalent vertebral fractures examined.
Vertebral fracture prevalence in older South African black and white women was similar (9.1 % in black and 5.0 % in white women). In black women, lower body weight and lower areal and volumetric bone mineral density (BMD) at all sites could serve as markers of increased fracture risk. Older age, physical inactivity, lower muscle strength and lower femoral BMD were associated with vertebral fracture risk in whites.
Our findings are noteworthy and the first attempt to compare vertebral fracture risk in women of different ethnicities on the African continent. A similar vertebral fracture risk between black and white women in South Africa must be considered at present to ensure appropriate evaluation in all subjects who present with clinical risk factors for osteoporosis, regardless of ethnicity.
黑人女性通常被认为患骨质疏松症的几率较低。本研究报告了南非黑人（9.1%）和白人（5.0%）女性中形态计量学椎体骨折的患病率相似。临床危险因素和骨强度参数对两个种族队列骨折风险的影响不同。
椎体骨折是最常见的骨质疏松性骨折之一，是发病和死亡的重要原因。关于非洲大陆椎体骨折的患病率知之甚少。因此，我们前瞻性地研究了居住在社区的健康老年南非黑人和白人女性胸腰椎X线片上椎体骨折的患病率。
随机选取189名年龄在40岁及以上的女性（47%为黑人）拍摄脊柱（T4-L5）X线片，用于分析椎体骨折。由一名对临床数据不知情的放射科医生使用Genant半定量方法对X线片进行评估。评估了两个种族组的骨质疏松临床危险因素、跌倒危险因素（跌倒史、股四头肌力量、侧摆和反应时间）、脊柱和髋部的面积骨密度和体积骨密度、跟骨超声检查（定量超声）和椎体宏观几何结构，并研究了它们与椎体骨折患病率的相关性。
南非老年黑人和白人女性的椎体骨折患病率相似（黑人女性为9.1%，白人女性为5.0%）。在黑人女性中，较低的体重以及所有部位较低的面积骨密度和体积骨密度可作为骨折风险增加的标志。在白人中，年龄较大、身体活动少、肌肉力量较低和股骨骨密度较低与椎体骨折风险相关。
我们的研究结果值得关注，这是首次尝试比较非洲大陆不同种族女性的椎体骨折风险。目前必须考虑南非黑人和白人女性之间相似的椎体骨折风险，以确保对所有有骨质疏松临床危险因素的受试者进行适当评估时，无论其种族如何。
