{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:18:12Z","timestamp":1790882292535,"version":"4.1.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2005,2,1]],"date-time":"2005-02-01T00:00:00Z","timestamp":1107216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Osteoporosis and 1-year fracture risk were studied in 197,848 postmenopausal American women from five ethnic groups. Weight explained differences in BMD, except among blacks, who had the highest BMD. One SD decrease in BMD predicted a 50% increased fracture risk in each group. Despite similar relative risks, absolute fracture rates differed.<\/jats:p>\n               <jats:p>Introduction: Most information about osteoporosis comes from studies of white women. This study describes the frequency of osteoporosis and the association between BMD and fracture in women from five ethnic groups.<\/jats:p>\n               <jats:p>Materials and Methods: This study was made up of a cohort of 197,848 community-dwelling postmenopausal women (7784 blacks, 1912 Asians, 6973 Hispanics, and 1708 Native Americans) from the United States, without known osteoporosis or a recent BMD test. Heel, forearm, or finger BMD was measured, and risk factor information was obtained; 82% were followed for 1 year for new fractures. BMD and fracture rates were compared, adjusting for differences in covariates.<\/jats:p>\n               <jats:p>Results: By age 80, more than one-fifth of women in each ethnic group had peripheral BMD T scores &amp;lt;\u22122.5. Black women had the highest BMD; Asian women had the lowest. Only the BMD differences for blacks were not explained by differences in weight. After 1 year, 2414 new fractures of the spine, hip, forearm, wrist, or rib were reported. BMD at each site predicted fractures equally well within each ethnic group. After adjusting for BMD, weight, and other covariates, white and Hispanic women had the highest risk for fracture (relative risk \u2018RR\u2019 1.0 \u2018referent group\u2019 and 0.95, 95% CI, 0.76, 1.20, respectively), followed by Native Americans (RR, 0.87; 95% CI, 0.57, 1.32), blacks (RR, 0.52; 95% CI, 0.38, 0.70), and Asian Americans (RR, 0.32; 95% CI, 0.15, 0.66). In age- and weight-adjusted models, each SD decrease in peripheral BMD predicted a 1.54 times increased risk of fracture in each ethnic group (95% CI, 1.48-1.61). Excluding wrist fractures, the most common fracture, did not materially change associations.<\/jats:p>\n               <jats:p>Conclusions: Ethnic differences in BMD are strongly influenced by body weight; fracture risk is strongly influenced by BMD in each group. Ethnic differences in absolute fracture risk remain, which may warrant ethnic-specific clinical recommendations.<\/jats:p>","DOI":"10.1359\/jbmr.041007","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T00:31:36Z","timestamp":1146097896000},"page":"185-194","source":"Crossref","is-referenced-by-count":465,"title":["Osteoporosis and Fracture Risk in Women of Different Ethnic Groups"],"prefix":"10.1093","volume":"20","author":[{"given":"Elizabeth","family":"Barrett-Connor","sequence":"first","affiliation":[{"name":"Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel S","family":"Siris","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois E","family":"Wehren","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D","family":"Miller","sequence":"additional","affiliation":[{"name":"Colorado Center for Bone Research, Lakewood, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A","family":"Abbott","sequence":"additional","affiliation":[{"name":"Merck & Co, Inc., West Point, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc L","family":"Berger","sequence":"additional","affiliation":[{"name":"Merck & Co, Inc., West Point, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur C","family":"Santora","sequence":"additional","affiliation":[{"name":"Merck & Co, Inc., West Point, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis M","family":"Sherwood","sequence":"additional","affiliation":[{"name":"Merck & Co, Inc., West Point, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024013019225278400_bib1","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1093\/ajcn\/50.6.1244","article-title":"Ethnic and genetic differences in bone mass: A review with a hereditary vs. environmental perspective","volume":"50","author":"Pollitzer","year":"1989","journal-title":"Am J Clin Nutr"},{"key":"2024013019225278400_bib2","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1002\/jbmr.5650090817","article-title":"Reference data for bone mass, calciotropic hormones, and biochemical markers of bone remodeling in older (55\u201375) postmenopausal white and black women","volume":"9","author":"Kleerekoper","year":"1994","journal-title":"J Bone Miner Res"},{"key":"2024013019225278400_bib3","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1007\/s001980050093","article-title":"Updated data on proximal femur bone mineral levels of US adults","volume":"8","author":"Looker","year":"1998","journal-title":"Osteoporos Int"},{"key":"2024013019225278400_bib4","doi-asserted-by":"crossref","first-page":"3057","DOI":"10.1210\/jcem.87.7.8654","article-title":"Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors","volume":"87","author":"Finkelstein","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019225278400_bib5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1093\/ije\/dyg024","article-title":"Bone mineral density in postmenopausal Caucasian, Filipina, and Hispanic women","volume":"32","author":"Morton","year":"2003","journal-title":"Int J Epidemiol"},{"key":"2024013019225278400_bib6","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/BF00310400","article-title":"The peak bone mass of Hawaiian, Filipino, Japanese, and white women living in Hawaii","volume":"55","author":"Davis","year":"1994","journal-title":"Calcif Tissue Int"},{"key":"2024013019225278400_bib7","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1002\/jbmr.5650100306","article-title":"Sources of interracial variation in bone mineral density","volume":"10","author":"Cundy","year":"1995","journal-title":"J Bone Miner Res"},{"key":"2024013019225278400_bib8","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s002239900137","article-title":"Body size accounts for most differences in bone density between Asian and Caucasian women. 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