Abstract
SummaryPeripheral quantitative computed tomography (pQCT) provides biomechanical estimates of bone strength. Rural South Indian men have reduced biomechanical indices of bone strength compared to US Caucasian and Afro-Caribbean men. This suggests an underlying higher risk of osteoporotic fractures and greater future fracture burden among the rural South Indian men.IntroductionGeographical and racial comparisons of bone mineral density (BMD) have largely focused on DXA measures of areal BMD. In contrast, peripheral quantitative computed tomography (pQCT) measures volumetric BMD (vBMD), bone structural geometry and provides estimates of biomechanical strength. To further understand potential geographical and racial differences in skeletal health, we compared pQCT measures among US Caucasian, Afro-Caribbean, and rural South Indian men.MethodsWe studied men aged ≥ 60 years enrolled in the Mobility and Independent Living among Elders Study (MILES) in rural south India (N = 245), Osteoporotic Fractures in Men Study (MrOS) in the US (N = 1148), and the Tobago Bone Health Study (N = 828).ResultsThe BMI (kg/m2) of rural South Indian men (21.6) was significantly lower compared to the US Caucasians (28) and Afro-Caribbean men (26.9). Adjusting for age, height, body weight, and grip strength; rural South Indian men compared to US Caucasians had significantly lower trabecular vBMD [− 1.3 to − 1.5 standard deviation (SD)], cortical thickness [− 0.8 to − 1.2 SD]; significantly higher endosteal circumference [0.5 to 0.8 SD]; but similar cortical vBMD. Afro-Caribbean men compared to US Caucasians had similar trabecular vBMD but significantly higher cortical vBMD [0.9 to 1.2 SD], SSIp [0.2 to 1.4 SD], and tibial endosteal circumference [1 SD],ConclusionsIn comparison to US Caucasians, rural South Indian men have reduced bone strength (lower trabecular vBMD) and Afro-Caribbean men have greater bone strength (higher cortical vBMD). These results suggest an underlying higher risk of osteoporotic fractures and greater future fracture burden among rural South Indian men.
Highlights
Global demographic patterns are changing with accelerated population aging fueled by declining fertility and increased longevity [1]
We focused on the following Peripheral quantitative computed tomography (pQCT) parameters that are physiologically important in skeletal aging: at the 4% site of radius and tibia—trabecular volumetric BMD (vBMD) and Strength Strain Index (SSIp); at the 33% sites of radius and tibia— cortical vBMD, cortical thickness, endosteal circumference, and SSIp. vBMD was chosen as it is an indicator of bone matrix mineralization or mechanical quality of the solid bone tissue
Afro-Caribbeans had lower prevalence of smoking, whereas alcohol consumption was significantly higher in rural South Indian men compared to US Caucasians and Afro-Caribbeans
Summary
Global demographic patterns are changing with accelerated population aging fueled by declining fertility and increased longevity [1]. As per 2010 estimates, 8% of the world’s population (524 million) was 65 years and older and is expected to triple by 2050 [1]. Even though the developed countries have the oldest populations, the majority and rapidly aging populations are from less developed countries [1]. During 2010, about 65% of those aged 60 years and older lived in less developed countries, this is projected to increase to 80% by 2050 [2]. This demographic transition has important social, economic, and public health implications [3].
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