Dl. Alekel et al., Lifestyle and biologic contributors to proximal femur bone mineral densityand hip axis length in two distinct ethnic groups of premenopausal women, OSTEOPOR IN, 9(4), 1999, pp. 327-338
Although relatively little is known about osteoporotic risk factors in wome
n from the Indian subcontinent, osteoporotic fractures usually occur 10-20
years earlier in Indian men and women compared with their western Caucasian
counterparts. The primary purpose of this cross-sectional study was to det
ermine the relative contributions of ethnicity, reproductive history, body
size (height, weight) and composition, bone turnover, serum 25(OH)vitamin D
-3 [25(OH)D-3], dietary intake (of calcium, fiber and alcohol) and energy e
xpenditure to femoral bone mineral density (BMD) in Indian and Pakistani (I
ndian/Pakistani; n = 47) versus American (n = 47) Caucasians. We also contr
asted femoral BMD and hip axis length in these two distinct groups of preme
nopausal females living in the USA. The Indian/Pakistani (0.875 +/- 0.096)
women had lower (p = 0.0014) femoral BMD (g/cm(2)) than their American (0.9
37 +/- 0.088) counterparts, placing them at greater osteoporotic risk. Howe
ver, the shorter (p = 0.0002) hip axis length (cm) of the Indian/Pakistani
(10.54 +/- 0.57) versus American (11.11 +/- 0.78) Caucasians might attenuat
e hip fracture risk in the former group. Significant contributors to proxim
al femur BMD were maximum non-pregnant lifetime weight, age at menarche, ra
tio of Sigma central-to-peripheral skinfold thicknesses, calcium intake fro
m milk and usual alcohol intake. Although serum 25(OH)D-3 and urinary N-tel
opeptide concentrations did not contribute to femoral BMD in the regression
models, the lower (p <0.0001) serum 25(OH)D3 (33.1 +/- 16.5 vs 64.0 +/- 22
.0 nmol/l) and higher (p = 0.0004) urinary N-telopeptide (45.9 +/- 43.3 vs
18.9 +/- 18.7 nmol BCE/mmol) values in Indian/Pakistani versus American Cau
casians, respectively, coupled with their lower BMD, places the Indian/Paki
stani women at greater osteoporotic risk. These results suggest that a clin
ical trial to increase BMD and reduce osteoporotic risk is warranted in thi
s ethnic group of premenopausal women.