Trabecular microstructure is influenced by race and sex in Black and White young adults

Popp, K. L.<sup>1,2,3</sup>; Xu, C.<sup>4</sup>; Yuan, A.<sup>1</sup>; Hughes, J. M.<sup>3</sup>; Unnikrishnan, G.<sup>4</sup>; Reifman, J.<sup>4</sup>; Bouxsein, M. L.<sup>1,5</sup>

Affiliations

¹Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA

²Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02155, USA

³Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA

⁴Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, USA

⁵Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, and Department of Orthopedic Surgery, Harvard Medical School, One Overland Street, Boston, MA 02215, USA

Abstract and keywords

Summary: Lower fracture rates in Black men and women compared to their White counterparts are incompletely understood. High-resolution imaging specific to trabecular bone may provide insight. Black participants have enhanced trabecular morphology. These differences may contribute to the lower fracture risk in Black versus White individuals.

Introduction: Lower fracture rates in Black men and women compared to their White counterparts may be explained by favorable bone microstructure in Black individuals. Individual trabecular segmentation (ITS) analysis, which characterizes the alignment and plate- and rod-like nature of trabecular bone using high-resolution peripheral quantitative computed tomography (HRpQCT), may provide insight into trabecular differences by race/ethnic origin.

Purpose: We determined differences in trabecular bone microarchitecture, connectivity, and alignment according to race/ethnic origin and sex in young adults.

Methods: We analyzed HR-pQCT scans of 184 adult (24.2 ± 3.4 years) women (n = 51 Black, n = 50 White) and men (n = 34 Black, n = 49 White). We used ANCOVA to compare bone outcomes, and adjusted for age, height, and weight.

Results: Overall, the effect of race on bone outcomes did not differ by sex, and the effect of sex on bone outcomes did not differ by race. After adjusting for covariates, Black participants and men of both races had greater trabecular plate volume fraction, plate thickness, plate number density, plate surface area, and greater axial alignment of trabeculae, leading to higher trabecular bone stiffness compared to White participants and women, respectively (p < 0.05 for all).

Conclusion: These findings demonstrate that more favorable bone microarchitecture in Black individuals compared to White individuals and in men compared to women is not unique to the cortical bone compartment. Enhanced plate-like morphology and greater trabecular axial alignment, established in young adulthood, may contribute to the improved bone strength and lower fracture risk in Black versus White individuals and in men compared to women.

Keywords: Bone mineral density (BMD); Fracture risk; Gender; High-resolution peripheral quantitative computed tomography (HR-pQCT); Individual trabecular segmentation; Stress fracture risk

Links

DOI: 10.1007/s00198-018-4729-9

PubMed: 30397770

WoS: 000455809500017

History

Received: 2018-05-22

Accepted: 2018-10-01

Online: 2018-11-05

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2020	Mulder B, Stock JT, Saers JPP, Inskip SA, Cessford C, Robb JE. Intrapopulation variation in lower limb trabecular architecture. Am J Phys Anthropol. September 2020;173(1):112-129.
2020	Lee S-H, Kim J-N, Shin K-J, Koh K-S, Song W-C. Three-dimensional microstructures of the intracortical canals in the animal model of osteoporosis. Anat Cell Biol. June 2020;53(2):162-168.
2022	Johannesdottir F, Putman MS, Burnett-Bowie S-AM, Finkelstein JS, Yu EW, Bouxsein ML. Age-related changes in bone density, microarchitecture, and strength in postmenopausal black and white women: the SWAN longitudinal HR-pQCT study. J Bone Miner Res. January 2022;37(1):41-51.
2020	Vieth R. Weaker bones and white skin as adaptions to improve anthropological "fitness" for northern environments [published correction appears in Osteoporos Int. April 2020;31(4):803-804]. Osteoporos Int. April 2020;31(4):617-624.