Opportunities in population-specific osteoporosis research and management

Excerpt

Until recently, osteoporosis prophylaxis has been focused almost exclusively on postmenopausal white women. This is the group at greatest risk of fracture, and they account for roughly 90% of all osteoporosis-related costs. The lack of emphasis on prevention and treatment activities among non-white women has been decried [1], but it relates to critical gaps in knowledge that have yet to be completely resolved. Thus, risk stratification in osteoporosis management has depended mainly on assessment of bone mineral density (BMD) by dual-energy X-ray absorptiometry. Race-specific hip BMD was described a decade ago from the National Health and Nutrition Examination Survey (NHANES III), but the relation between BMD and fracture risk in non-white populations remains somewhat uncertain, as does the ability of such measurements to accurately predict future fractures in diverse groups [2]. This information is required to better define abnormal BMD levels for non-white women, and for men, as was done years ago for white women by the World Health Organization. …