Osteoporosis : exploring characteristics amongst non-Hispanic Black women associated with low bone mass (ostepenia) and osteoporosis, who are thus more likely to suffer osteoporotic injuries in the future

Non-Hispanic Black women have higher bone mass and lower rates of osteoporosis; however, age-related bone loss occurs at rates equal to other races. Osteopenia or osteoporotic occurs at greater age for non-Hispanic black women and may increase their risk of poor outcomes post an osteoporotic injury. It is important to determine what clinical characteristics or assessment standards to use to predict who may be more likely to develop osteopenia or osteoporosis in this population. A retrospective database analysis of NHANES 4-year survey cycle: 2007-208 and 2009-2010 to examine characteristics associated with low bone mass and osteoporosis in non-Hispanic Black females aged 20 and older. Evaluation of standard bone mineral density (BMD) T-scores compared to mean referent value for young, healthy non-Hispanic black females BMD scores. A total of 190 (20.7%) non-Hispanic Black females had osteopenia or osteoporosis compared to 770 (32.3%) non-Hispanic white females(p<.0001). Among non-Hispanic Black females, osteopenia and osteoporosis were associated with being aged 50 or older (ORadj = 2.8, p=0.0003), less than a high school education (ORadj = 1.6, p=0.02) and menopause (ORadj = 2.0, p=0.0036). Osteopenia or osteoporosis was less likely if obese (ORadj = 0.5, p=0.003). Each increased year in age, total femur BMD declined 0.43 points (<.0001) and 0.38 points (<.0001) for spinal BMD. When the non-Hispanic Black referent was used, 91 (9.9%) had BMD classifications that worsen to osteopenia or osteoporosis: they were older (p<.0001), menopausal (p<.001), not obese (p<.001), experienced a hip fracture (p<.0001), taking diabetes (p<.001) or cardiovascular medication (p<.01) or had a close relative with asthma (p<.001). Calculation of BMD T-score using the referent mean value for young (20-29-year-olds), healthy non-Hispanic Black females instead of the standard for non-Hispanic white females were more sensitive in detecting additional individuals with low bone mass (osteopenia) or osteoporosis. Use of the standardized BMD and FRAX may be of limited utility in distinguishing those within a low-risk population, who may be at greater risk. Use of a non-Hispanic Black specific measure may lead to earlier detection and intervention in this population.Ph.D.Includes bibliographical reference