Ethnic Differences in Bone Microarchitecture
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EPIDEMIOLOGY AND PATHOPHYSIOLOGY (D SHOBACK AND G EL-HAJJ FULEIHAN, SECTION EDITORS)
Ethnic Differences in Bone Microarchitecture Ruth Durdin 1,2 & Camille M Parsons 1 & Elaine Dennison 1,2 & Nicholas C Harvey 1,2 & Cyrus Cooper 1,2,3 & Kate Ward 1,2 Accepted: 28 October 2020 # The Author(s) 2020
Abstract Purpose of the Review The aim of this review is to briefly introduce updates in global fracture epidemiology and then to highlight recent contributions to understanding ethnic differences in bone density, geometry and microarchitecture and consider how these might contribute to differences in fracture risk. The review focuses on studies using peripheral quantitative computed tomography techniques. Recent Findings Recent studies have contributed to our understanding of the differences in fracture incidence both between countries, as well as between ethnic groups living within the same country. In terms of understanding the reasons for ethnic differences in fracture incidence, advanced imaging techniques continue to increase our understanding, though there remain relatively few studies. Summary It is a priority to continue to understand the epidemiology, and changes in the patterns of, fracture, as well as the underlying phenotypic and biological reasons for the ethnic differences which are observed. Keywords Adult . Microarchitecture . Quantitative computed tomography . Dual-energy X-ray absorptiometry . Ethnicity
Introduction Demographic shifts towards older populations are occurring in countries worldwide [1]. Across the globe, osteoporotic fractures remain a substantial healthcare burden; in order to prevent fractures and therefore lessen their associated burden, it is important to understand why these differences exist. The risk of fragility fracture is underpinned by low bone mineral density, but past evidence shows other aspects of bone strength also contribute to fracture risk. The aim of this review is therefore to present updates on global, and ethnic, patterns This article is part of the Topical Collection on Epidemiology and Pathophysiology * Cyrus Cooper [email protected] 1
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
2
National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
3
National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
of fracture incidence and to describe ethnic differences in bone microarchitecture, exploring the potential underlying bone phenotype for these differences.1
Global and Ethnic Variation in Fracture Incidence Worldwide, there is an approximately 10-fold range in hip fracture incidence rates [2]. For women, countries with the highest annual age-standardised hip fracture incidences included Denmark, Sweden and Austria; the lowest included Morocco, Ecuador and Tunisia. Recent additions to the global literature include data reporting
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