Osteoporosis is an important public health concern because of the significant morbidity and mortality associated with osteoporotic fractures. It is well established that ethnic and gender differences influence osteoporosis risk, but the etiology of these differences is not well studied. The goals of this research were to examine correlates of hip bone mineral density (BMD) and rates of bone loss among persons of African ancestry in three complementary analyses.
In the first analysis, correlates of BMD were identified for 1,784 Tobagonian males, aged 40-84 years. BMD was inversely associated with age, height, and history of a broken bone. Lean mass, working on a fishing boat, and diabetes were positively associated with BMD. Correlates explained 25% of the variability in hip and femoral neck BMD.
Correlates of BMD were also identified for 340 postmenopausal Tobagonian females, aged 50-94 years. BMD was positively associated with weight, thiazide diuretics, aspirin, recent back pain, and diabetes. BMD was inversely associated with age, thyroid medication, family history of fracture, and beta-blockers. Correlates explained 37% - 38% of the variability in hip and femoral neck BMD.
Lastly, ethnic differences in rates of bone loss within gender were investigated among 457 Caucasian and 121 African American males and females, aged 65-87 years. Baseline and follow-up BMD was measured four years apart. African American males lost significantly less hip BMD compared to Caucasian males (-0.04% vs. -0.45%), after adjusting for covariates. Longitudinal changes in lean and fat mass explained more variability in rates of bone loss than weight, after adjustment for covariates.
In conclusion, BMD was approximately one standard deviation higher among Tobagonians, despite gender, compared to NHANES data for African American males and females. Correlates of BMD were similar across gender among Tobagonians. Interestingly, older African American females had rates of bone loss that were comparable to Caucasian females, while African American males experienced significantly lower rates of hip bone loss.
With our aging society and longer life expectancies for persons of African ancestry, the public health significance of this research is that osteoporosis may have a greater impact among minorities in the future.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04152005-174219 |
| Date | 14 June 2005 |
| Creators | Hill, Deanna D. |
| Contributors | Clareann H. Bunker, PhD, Jane A. Cauley, DrPH, Gloria L.A. Beckles, MD MSc, Carol E. Baker, PhD, Alan L. Patrick, MD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04152005-174219/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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