Abstract
Osteoporosis is an important health issue for older adults, and has been relatively understudied in older men. This study aimed to examine ethnic differences in bone mineral density (BMD), and elucidate the role of bone turnover markers (BTMs), fat and fat biomarkers on these ethnic differences. BMD at the lumbar spine and femoral neck, marrow fat at femoral neck, visceral adipose tissue (VAT) and subcutaneous adipose tissue, bone and fat biomarkers were evaluated in 120 healthy men aged ≥ 60 years. Indians had higher BMD values compared to Chinese at the lumbar spine (β = 20.336, SE = 4.749, p < 0.001) and the femoral neck (eβ = 1.105, SE = 0.032, p < 0.001), after adjusting for BTMs, fat composition and lifestyle choices. Marrow fat, VAT and adiponectin were independent predictors of BMD. However, these factors did not explain the lower BMD observed in older Chinese men. Our findings suggest that older Chinese men are at significant risk of osteoporotic fractures due to lower BMD. Fat appears to be a key factor associated with lower BMD, and warrants further longitudinal studies to elucidate the complex interactions between adipose tissue and bone strength.
Highlights
Osteoporosis is a growing public health challenge worldwide, accounting for approximately 50% of all hip fractures [1] and 5.8 million disability-adjusted life years annually [2]
We found that ethnicity was an important predictor of LSBMD and FN-bone mineral density (BMD) among older men, and the effect remained significant after adjusting for other variables of
FN-BMD bone mineral density at femoral neck, LS-BMD bone mineral density at lumbar spine aModel adjusted for smoking status, osteopontin, marrow fat at left femoral neck and visceral adipose tissue bModel adjusted for smoking status, adiponectin and marrow fat at left femoral neck interest
Summary
Osteoporosis is a growing public health challenge worldwide, accounting for approximately 50% of all hip fractures [1] and 5.8 million disability-adjusted life years annually [2]. Low bone mineral density (BMD) accounted for an estimated 3.7 million years lived with disability in 2015, an increase of 53% from 1990 [3]. Singapore has the highest reported incidence of hip fractures in Asia [6]. There are substantial geographic and ethnic variations in fracture rates around the world. For both men and women, the highest age-adjusted hip fracture rates have been reported in North Europe and America, and lowest in
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