Ettinger B, Sidney S, Cummings S R, Libanati C, Bikle D D, Tekawa I S, Tolan K, Steiger P
Division of Research, Kaiser Permanente Medical Care Program, Oakland 94611, USA.
J Clin Endocrinol Metab. 1997 Feb;82(2):429-34. doi: 10.1210/jcem.82.2.3732.
This study tested whether racial differences in bone density can be explained by differences in bone metabolism and lifestyle. A cohort of 402 black and white men and women, ages 25-36 yr, was studied at the Kaiser Permanente Medical Care Program in Northern California, a prepaid health plan. Body composition (fat, lean, and bone mineral density) was measured using a Hologic-2000 dual-energy x-ray densitometer. Muscle strength, blood and urine chemistry values related to calcium metabolism, bone turnover, growth factors, and level of sex and adrenal hormones were also measured. Medical history, physical activity, and lifestyle were assessed. Statistical analyses using t- and chi-square tests and multiple regression were done to determine whether racial difference in bone density remained after adjustment for covariates. Bone density at all skeletal sites was statistically significantly greater in black than in white subjects; on average, adjustment for covariates reduced the percentage density differences by 42% for men and 34% for women. Adjusted bone density at various skeletal sites was 4.5-16.1% higher for black than for white men and was 1.2-7.3% higher for black than for white women. We concluded that racial differences in bone mineral density are not accounted for by clinical or biochemical variables measured in early adulthood.
本研究检验了骨密度的种族差异是否可由骨代谢和生活方式的差异来解释。在北加利福尼亚州凯撒医疗保健计划（一项预付费健康计划）中，对402名年龄在25 - 36岁的黑人和白人男性及女性组成的队列进行了研究。使用Hologic - 2000双能X线骨密度仪测量身体成分（脂肪、瘦肉和骨矿物质密度）。还测量了与钙代谢、骨转换、生长因子以及性激素和肾上腺激素水平相关的肌肉力量、血液和尿液化学值。评估了病史、身体活动和生活方式。使用t检验、卡方检验和多元回归进行统计分析，以确定在对协变量进行调整后骨密度的种族差异是否仍然存在。黑人所有骨骼部位的骨密度在统计学上显著高于白人；平均而言，对协变量进行调整后，男性的密度差异百分比降低了42%，女性降低了34%。黑人男性不同骨骼部位的调整后骨密度比白人男性高4.5 - 16.1%，黑人女性比白人女性高1.2 - 7.3%。我们得出结论，成年早期测量的临床或生化变量无法解释骨矿物质密度的种族差异。
