Differences in fracture prevalence and in bone mineral density between Chinese and White Canadians: the Canadian Multice
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ORIGINAL ARTICLE
Differences in fracture prevalence and in bone mineral density between Chinese and White Canadians: the Canadian Multicentre Osteoporosis Study (CaMos) S. N. Morin 1,2 & C. Berger 3 & W. Liu 4 & J. C. Prior 5 & A. M. Cheung 6 & D. A. Hanley 7 & S. K. Boyd 8 & A. K. O. Wong 9 & A. Papaioannou 10 & E. Rahme 11 & D. Goltzman 1 & for the CaMos Research Group Received: 2 June 2020 / Accepted: 4 September 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary Fracture determinants differ between Canadians of Chinese and White descent, the former constituting the second largest visible minority group in Canada. The results of this study support the importance of characterizing bone health predictors in Canadians of different ethnicity to improve population-specific fracture prevention and treatment strategies. Purpose We aimed to compare clinical risk factors, bone mineral density, prevalence of osteoporosis, and fractures between Chinese and White Canadians to identify ethnicity-specific risks. Methods We studied 236 Chinese and 8945 White Canadians aged 25+ years from the Canadian Multicentre Osteoporosis Study (CaMos). The prevalence of osteoporosis using ethnicity-specific peak bone mass (PBM), and of prior and incident low trauma fractures were assessed and compared between groups. Linear regressions, adjusting for age and anthropometric measures, were used to examine the association between baseline and 5-year changes in BMD and ethnicity. Results Chinese participants had shorter stature, lower BMI, and lower rate of falls than White participants. Adjusted models showed no significant differences in baseline BMD between ethnic groups except in younger men where total hip BMD was 0.059 g/cm2 (0.009; 0.108) lower in Chinese. Adjusted 5-year BMD change at lumbar spine was higher in older Chinese women and men compared with Whites. When using Chinese-specific PBM, the prevalence of osteoporosis in Chinese women was 2fold lower than when using that of White women The prevalence of fractures was higher in White women compared with Chinese with differences up to 14.5% (95% CI 9.2; 19.7) and 10.5% (95% CI 4.5–16.4) in older White men. Incident fractures were rare in young Chinese compared with White participants and not different in the older groups. Conclusion Our results support the importance of characterizing bone strength predictors in Chinese Canadians and the development of ethnicity-specific fracture prediction and prevention strategies. Keywords Chinese . Osteoporosis . Peak bone mass . Bone mineral density . Fracture . Cohort study
Introduction Osteoporotic fractures cause substantial disability, loss of autonomy, morbidity, and excess mortality. In Canada, they result in acute care, rehabilitation, and long-term care costs that exceed Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11657-020-00822-4) contains supplementary material, which is available to authorized users. * S. N. Morin Suzanne.morin
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