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Abstract
Differences in osteoporotic hip fracture incidence between American whites and blacks
and between women and men are considered to result, in part, from differences in bone
mineral density and geometry at the femur. The aim of this study was to quantify differences
in femoral bone density and geometry between a large sample of healthy American white
and black women and men.
Healthy American white (n=612) and black (n=164) premenopausal women, aged 23 to 57
years, and healthy American white (n=492) and black (n=169) men, aged 20 to 63 years,
had volumetric bone mineral density (vBMD) and geometry variables measured at the
femur by computerized tomography (CT), and areal bone mineral density (aBMD) at femoral
neck measured by dual X-ray absorptiometry (DXA).
American blacks had higher vBMD at the femoral neck and femoral shaft cortex than
American whites whereas femoral axis length and femoral neck area were not different.
Men had lower vBMD at the femoral neck and femoral cortex than women but had greater
femoral axis length and femoral neck area than women. The higher aBMD in American
blacks than whites persisted after correction for measured area whereas the higher
aBMD in men than women disappeared.
At the femoral neck, American whites have lower bone density than American blacks
but similar geometry. Women have higher bone density than men in both races but have
smaller geometry variables. The differences in bone density may account in part for
the differences in hip fracture incidence between American blacks and whites, whereas
the differences in femur size may account for the differences in hip fracture rates
between men and women.