Ethnic Differences in Bone Microarchitecture

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Abstract

Purpose of the Review

The aim of this review is to briefly introduce updates in global fracture epidemiology and then to highlight recent contributions to understanding ethnic differences in bone density, geometry and microarchitecture and consider how these might contribute to differences in fracture risk. The review focuses on studies using peripheral quantitative computed tomography techniques.

Recent Findings

Recent studies have contributed to our understanding of the differences in fracture incidence both between countries, as well as between ethnic groups living within the same country. In terms of understanding the reasons for ethnic differences in fracture incidence, advanced imaging techniques continue to increase our understanding, though there remain relatively few studies.

Summary

It is a priority to continue to understand the epidemiology, and changes in the patterns of, fracture, as well as the underlying phenotypic and biological reasons for the ethnic differences which are observed.

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Most cited references 40

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A systematic review of hip fracture incidence and probability of fracture worldwide

J Kanis, Thomas A. Odén, E. McCloskey … (2012)

Summary The country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture were determined on a worldwide basis from a systematic review of literature. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries. Introduction The present study aimed to update the available information base available on the heterogeneity in the risk of hip fracture on a worldwide basis. An additional aim was to document variations in major fracture probability as determined from the available FRAX models. Methods Studies on hip fracture risk were identified from 1950 to November 2011 by a Medline OVID search. Evaluable studies in each country were reviewed for quality and representativeness and a study (studies) chosen to represent that country. Age-specific incidence rates were age-standardised to the world population in 2010 in men, women and both sexes combined. The 10-year probability of a major osteoporotic fracture for a specific clinical scenario was computed in those countries for which a FRAX model was available. Results Following quality evaluation, age-standardised rates of hip fracture were available for 63 countries and 45 FRAX models available in 40 countries to determine fracture probability. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries. Conclusions Worldwide, there are marked variations in hip fracture rates and in the 10-year probability of major osteoporotic fractures. The variation is sufficiently large that these cannot be explained by the often multiple sources of error in the ascertainment of cases or the catchment population. Understanding the reasons for this heterogeneity may lead to global strategies for the prevention of fractures.

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Burden of high fracture probability worldwide: secular increases 2010-2040.

A Odén, E. McCloskey, J Kanis … (2015)

The number of individuals aged 50 years or more at high risk of osteoporotic fracture worldwide in 2010 was estimated at 158 million and is set to double by 2040.

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Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study

Elizabeth J Samelson, Kerry Broe, Hanfei Xu … (2018)

Although areal bone mineral density (aBMD) assessed by dual-energy x-ray absorptiometry (DXA) is the clinical standard for determining fracture risk, most older adults who sustain a fracture have T scores greater than -2·5 and thus do not meet the clinical criteria for osteoporosis. Importantly, bone fragility is due to low BMD and deterioration in bone structure. We assessed whether indices of high-resolution peripheral quantitative CT (HR-pQCT) were associated with fracture risk independently of femoral neck aBMD and the Fracture Risk Assessment Tool (FRAX) score.

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Author and article information

Contributors

Cyrus Cooper: cc@mrc.soton.ac.uk

Journal

Journal ID (nlm-ta): Curr Osteoporos Rep

Journal ID (iso-abbrev): Curr Osteoporos Rep

Title: Current Osteoporosis Reports

Publisher: Springer US (New York )

ISSN (Print): 1544-1873

ISSN (Electronic): 1544-2241

Publication date (Electronic): 17 November 2020

Publication date PMC-release: 17 November 2020

Publication date (Print): 2020

Volume: 18

Issue: 6

Pages: 803-810

Affiliations

[1 ]MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD UK

[2 ]GRID grid.430506.4, National Institute for Health Research Biomedical Research Centre, , University of Southampton and University Hospital Southampton NHS Foundation Trust, ; Southampton, UK

[3 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, National Institute for Health Research Musculoskeletal Biomedical Research Unit, , University of Oxford, ; Oxford, UK

Author information

Kate Ward http://orcid.org/0000-0001-7034-6750

Article

Publisher ID: 642

DOI: 10.1007/s11914-020-00642-y

PMC ID: 7732801

PubMed ID: 33200372

SO-VID: c0c48417-2f33-4be2-891a-9adab817fafd

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 28 October 2020

Funding

Funded by: National Institutes for Health Research Biomedical Research Centre Southampton PHD funding

Funded by: Medical Research Council

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: adult,microarchitecture,quantitative computed tomography,dual-energy x-ray absorptiometry,ethnicity

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: adult, microarchitecture, quantitative computed tomography, dual-energy x-ray absorptiometry, ethnicity

Ethnic Differences in Bone Microarchitecture

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Abstract

Purpose of the Review

Recent Findings

Summary

Related collections

Orthopedics

Most cited references 40

A systematic review of hip fracture incidence and probability of fracture worldwide

Burden of high fracture probability worldwide: secular increases 2010-2040.

Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study

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