McGill University, Montreal, Quebec, Canada.
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O, Room 3E.11, Montreal, Quebec, H4A 3S5, Canada.
Osteoporos Int. 2022 Dec;33(12):2637-2648. doi: 10.1007/s00198-022-06539-z. Epub 2022 Aug 31.
Most of the published epidemiology on osteoporosis is derived from White populations; still many countries have increasing ethno-culturally diverse populations, leading to gaps in the development of population-specific effective fracture prevention strategies. We describe differences in prevalent fracture and bone mineral density patterns in Canadians of different racial/ethnic backgrounds.
We described prevalent fracture and bone mineral density (BMD) patterns in Canadians by their racial/ethnic backgrounds.
For this cross-sectional analysis, we used the Canadian Longitudinal Study on Aging baseline data (2011-2015) of 22,091 randomly selected participants of Black, East Asian, South or Southeast Asian (SSEA) and White race/ethnic backgrounds, aged 45-85 years with available information on the presence or absence of self-reported prevalent low trauma fractures and femoral neck BMD (FNBMD) measurement. Logistic and linear regression models examined associations of race/ethnic background with fracture and FNBMD, respectively. Covariates included sex, age, height, body mass index (BMI), grip strength and physical performance score.
We identified 11,166 women and 10,925 men. Self-reported race/ethnic backgrounds were: 139 Black, 205 East Asian, 269 SSEA and 21,478 White. White participants were older (mean 62.5 years) than the other groups (60.5 years) and had a higher BMI (28.0 kg/m) than both Asian groups, but lower than the Black group. The population-weighted prevalence of falls was 10.0%, and that of low trauma fracture was 12.0% ranging from 3.3% (Black) to 12.3% (White), with Black and SSEA Canadians having lower adjusted odds ratios (aOR) of low trauma fractures than White Canadians (Black, aOR = 0.3 [95% confidence interval: 0.1-0.7]; SSEA, aOR = 0.5 [0.3-0.8]). The mean (SD) FNBMD varied between groups: Black, 0.907 g/cm (0.154); East Asian, 0.748 g/cm (0.119); SSEA, 0.769 g/cm (0.134); and White, 0.773 g/cm (0.128). Adjusted linear regressions suggested that Black and both Asian groups had higher FNBMD compared to White.
Our results support the importance of characterizing bone health predictors in Canadians of different race/ethnic backgrounds to tailor the development of population-specific fracture prevention strategies.
大多数已发表的骨质疏松症流行病学研究都来自于白种人群；然而，许多国家的民族文化多样性人口不断增加，导致针对特定人群的有效骨折预防策略的发展存在差距。我们描述了不同种族/民族背景的加拿大人中常见骨折和骨密度模式的差异。
我们根据种族/民族背景描述了加拿大常见骨折和骨密度（BMD）模式。
在这项横断面分析中，我们使用了加拿大老龄化纵向研究的基线数据（2011-2015 年），其中包括 22091 名随机选择的黑种人、东亚人、南亚或东南亚人（SSEA）和白种人，年龄在 45-85 岁之间，有或没有自我报告的常见低创伤性骨折和股骨颈 BMD（FNBMD）测量的信息。逻辑回归和线性回归模型分别检查了种族/民族背景与骨折和 FNBMD 的关系。协变量包括性别、年龄、身高、体重指数（BMI）、握力和身体表现评分。
我们确定了 11166 名女性和 10925 名男性。自我报告的种族/民族背景为：139 名黑人、205 名东亚人、269 名 SSEA 人和 21478 名白人。白人参与者比其他组更年长（平均 62.5 岁），BMI 也更高（28.0kg/m），高于两个亚洲组，但低于黑人组。人群加权的跌倒发生率为 10.0%，低创伤性骨折发生率为 12.0%，范围为 3.3%（黑人）至 12.3%（白人），与白人相比，黑人（OR=0.3[95%置信区间：0.1-0.7]）和 SSEA 加拿大人（OR=0.5[0.3-0.8]）的低创伤性骨折调整后比值比（aOR）较低。各组间 FNBMD 均值（SD）差异较大：黑人组为 0.907g/cm（0.154）；东亚组为 0.748g/cm（0.119）；SSEA 组为 0.769g/cm（0.134）；白种人组为 0.773g/cm（0.128）。调整后的线性回归表明，与白人相比，黑人组和两个亚洲组的 FNBMD 更高。
我们的研究结果支持在不同种族/民族背景的加拿大人中确定骨骼健康预测因素的重要性，以便制定针对特定人群的骨折预防策略。
