RISK FOR OSTEOPOROSIS IN BLACK-WOMEN

Models of involutional bone loss and strategies for the prevention of osteoporosis have been developed for white women. Black women have hig her bone densities than white women, but as the black population ages there will be an increasingly higher population of black women with os teoporosis. Strategies should be developed to reduce the risk of black women for fragility fractures. Dual energy X-ray absorptiometry measu rements of the total body, femur, spine, and radius were performed on 503 healthy black and white women aged 20-80 years. Indices of bone tu rnover, the calcitrophic hormones, and radioisotope calcium absorption efficiency were also measured to compare the mechanisms of bone loss. The black women had higher BMD values at every site tested than the w hite women throughout the adult life cycle. Black women have a higher peak bone mass and a slightly slower rate of adult bone loss from the femur and spine, which are skeletal sites comprised predominantly of t rabecular bone. Indices of bone turnover are lower in black women as a re serum calcidiol levels and urinary calcium excretion. Serum calcitr iol and parathyroid hormone levels are higher in black women and calci um absorption efficiency is the same in black and white women, but die tary calcium intake is lower in black women. Black and white women hav e a similar pattern of bone loss, with substantial bone loss from the femur and spine prior to menopause and an accelerated bone loss from t he total skeleton and radius after menopause. The higher values for bo ne density in black women as compared with white women are caused by a higher peak bone mass and a slower rate of loss from skeletal sites c omprised predominantly of trabecular bone. Low-risk strategies to enha nce peak bone mass and to lower bone loss, such as calcium and vitamin D augmentation of the diet, should be examined for black women. The r isk vs. benefits of hormonal replacement therapy should be determined, especially in older women.