Summary

Most of the published epidemiology on osteoporosis is derived from White populations; still many countries have increasing ethno-culturally diverse populations, leading to gaps in the development of population-specific effective fracture prevention strategies. We describe differences in prevalent fracture and bone mineral density patterns in Canadians of different racial/ethnic backgrounds.

Introduction

We described prevalent fracture and bone mineral density (BMD) patterns in Canadians by their racial/ethnic backgrounds.

Methods

For this cross-sectional analysis, we used the Canadian Longitudinal Study on Aging baseline data (2011–2015) of 22,091 randomly selected participants of Black, East Asian, South or Southeast Asian (SSEA) and White race/ethnic backgrounds, aged 45–85 years with available information on the presence or absence of self-reported prevalent low trauma fractures and femoral neck BMD (FNBMD) measurement. Logistic and linear regression models examined associations of race/ethnic background with fracture and FNBMD, respectively. Covariates included sex, age, height, body mass index (BMI), grip strength and physical performance score.

Results

We identified 11,166 women and 10,925 men. Self-reported race/ethnic backgrounds were: 139 Black, 205 East Asian, 269 SSEA and 21,478 White. White participants were older (mean 62.5 years) than the other groups (60.5 years) and had a higher BMI (28.0 kg/m²) than both Asian groups, but lower than the Black group. The population-weighted prevalence of falls was 10.0%, and that of low trauma fracture was 12.0% ranging from 3.3% (Black) to 12.3% (White), with Black and SSEA Canadians having lower adjusted odds ratios (aOR) of low trauma fractures than White Canadians (Black, aOR = 0.3 [95% confidence interval: 0.1–0.7]; SSEA, aOR = 0.5 [0.3–0.8]). The mean (SD) FNBMD varied between groups: Black, 0.907 g/cm² (0.154); East Asian, 0.748 g/cm² (0.119); SSEA, 0.769 g/cm² (0.134); and White, 0.773 g/cm² (0.128). Adjusted linear regressions suggested that Black and both Asian groups had higher FNBMD compared to White.

Conclusion

Our results support the importance of characterizing bone health predictors in Canadians of different race/ethnic backgrounds to tailor the development of population-specific fracture prevention strategies.

中文翻译：

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骨质疏松症、跌倒和骨折患病率的种族/民族差异：加拿大老龄化纵向研究的横断面分析

概括

大多数已发表的关于骨质疏松症的流行病学都来自白人人群。仍然许多国家的民族文化多样化人口不断增加，导致在制定针对特定人群的有效骨折预防战略方面存在差距。我们描述了不同种族/民族背景的加拿大人普遍骨折和骨矿物质密度模式的差异。

介绍

我们通过种族/民族背景描述了加拿大人普遍的骨折和骨矿物质密度 (BMD) 模式。

方法

对于这个横断面分析，我们使用了加拿大老龄化纵向研究基线数据（2011-2015 年），随机选择了 22,091 名来自黑人、东亚、南亚或东南亚 (SSEA) 和白人种族/族裔背景的参与者，年龄在 45– 85 年有关于存在或不存在自我报告的普遍低创伤骨折和股骨颈 BMD (FNBMD) 测量的可用信息。逻辑和线性回归模型分别检查了种族/民族背景与骨折和 FNBMD 的关联。协变量包括性别、年龄、身高、体重指数（BMI）、握力和身体表现得分。

结果

我们确定了 11,166 名女性和 10,925 名男性。自我报告的种族/民族背景为：139 黑人、205 东亚人、269 SSEA 和 21,478 白人。白人参与者的年龄（平均 62.5 岁）比其他组（60.5 岁）高，并且 BMI（28.0 kg/m ²）高于两个亚洲组，但低于黑人组。跌倒的人群加权患病率为 10.0%，低创伤骨折的患病率为 12.0%，范围从 3.3%（黑人）到 12.3%（白人），黑人和 SSEA 加拿大人的低创伤调整优势比 (aOR) 较低骨折比加拿大白人（黑人，aOR = 0.3 [95% 置信区间：0.1–0.7]；SSEA，aOR = 0.5 [0.3–0.8]）。组间平均 (SD) FNBMD 不同：黑色，0.907 g/cm 2 (0.154)；黑色，0.907 g/cm ² (0.154)；东亚，0.748 g/cm ²(0.119); SSEA，0.769 g/cm ² (0.134)；和白色，0.773 g/cm ² (0.128)。调整后的线性回归表明，与白人相比，黑人和两个亚洲群体的 FNBMD 更高。

结论

我们的结果支持在不同种族/民族背景的加拿大人中表征骨骼健康预测因子以定制针对人群的骨折预防策略的发展的重要性。