Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, United States.
J Bone Miner Res. 2024 Sep 2;39(9):1296-1305. doi: 10.1093/jbmr/zjae117.
Using 1998-2022 Women's Health Initiative (WHI) data, our study provides contemporary fracture data by race and ethnicity, specifically focusing on Hispanic and Asian women. Fractures of interest included any clinical, hip, and major osteoporotic fractures (MOFs). We utilized the updated race and ethnicity information collected in 2003, which included seven Asian and five Hispanic origin groups. We computed crude and age-standardized fracture incidence rates per 10 000 woman-years across race and ethnic categories and by Asian and Hispanic origin. We used Cox proportional hazards model, adjusting for age and WHI clinical trial arm, to evaluate the risk of fracture (1) by race compared to White women, (2) Asian origin compared to White women, (3) Hispanic compared to non-Hispanic women, and (4) Asian and Hispanic origins compared the most prevalent origin group. Over a median (interquartile range) follow-up of 19.4 (9.2-24.2) years, 44.2% of the 160 824 women experienced any clinical fracture, including 36 278 MOFs and 8962 hip fractures. Compared to White women, Black, Pacific Islander, Asian, and multiracial women had significantly lower risk of any clinical and MOFs, while only Black and Asian women had significantly lower hip fracture risk. Within Asian women, Filipina women had 24% lower risk of any clinical fracture compared to Japanese women. Hispanic women had significantly lower risk of any clinical, hip, and MOF fractures compared to non-Hispanic women, with no differences in fracture risk observed within Hispanic origin groups. In this diverse sample of postmenopausal women, we confirmed racial and ethnic differences in fracture rates and risk, with novel findings among within Asian and Hispanic subgroups. These data can aid in future longitudinal studies evaluate contributors to racial and ethnic differences in fractures.
利用 1998-2022 年妇女健康倡议(WHI)的数据,我们的研究按种族和族裔提供了当代骨折数据,特别关注西班牙裔和亚裔女性。感兴趣的骨折包括任何临床、髋部和主要骨质疏松性骨折(MOF)。我们利用 2003 年收集的最新种族和族裔信息,其中包括七个亚洲和五个西班牙裔起源群体。我们计算了各种族和族裔类别以及按亚洲和西班牙裔起源的每 10000 名女性年的粗发病率和年龄标准化发病率。我们使用 Cox 比例风险模型,根据年龄和 WHI 临床试验臂进行调整,评估了(1)与白人女性相比的骨折风险,(2)与白人女性相比的亚洲起源的骨折风险,(3)与非西班牙裔女性相比的西班牙裔的骨折风险,以及(4)与最常见的起源群体相比的亚洲和西班牙裔起源的骨折风险。在中位数(四分位间距)为 19.4(9.2-24.2)年的随访中,160824 名女性中有 44.2%经历了任何临床骨折,包括 36278 例 MOF 和 8962 例髋部骨折。与白人女性相比,黑人、太平洋岛民、亚洲人和多种族女性的任何临床和 MOF 的风险明显较低,而只有黑人女性和亚洲女性的髋部骨折风险明显较低。在亚洲女性中,菲律宾女性的任何临床骨折风险比日本女性低 24%。与非西班牙裔女性相比,西班牙裔女性的任何临床、髋部和 MOF 骨折风险明显较低,而在西班牙裔起源群体中没有观察到骨折风险的差异。在这个多样化的绝经后女性样本中,我们证实了骨折发生率和风险存在种族和族裔差异,并在亚洲和西班牙裔亚组中发现了新的发现。这些数据可以帮助未来的纵向研究评估导致种族和族裔骨折差异的因素。
JAMA Netw Open. 2025-4-1
Cochrane Database Syst Rev. 2022-2-10
Am J Obstet Gynecol MFM. 2023-5
J Am Acad Child Adolesc Psychiatry. 2024-12-24
Curr Osteoporos Rep. 2023-10
J Am Geriatr Soc. 2023-10
Womens Midlife Health. 2022-1-4
J Bone Miner Res. 2021-10
J Bone Miner Res. 2012-11
Health Serv Res. 2012-4-19