Fracture Risk Assessment: Question Six
Your answer is incorrect. The correct answer is C.
If she were African-American with the same risk factors, would her fracture risk be the same?
- Option A Yes
- Option B No, it would be higher
- Option C No, it would be lower
Which ethnic groups are at increased risk for osteoporosis or fractures?
White women account for approximately 75% hip fractures and have the highest age-adjusted fracture incidence. African-American women have higher bone density than white women and are at lower risk for fracture. One prospective cohort study found that African-American women had a fracture incidence up to 30% lower than white women at every BMD level (1). Asian women may have lower peak bone density, but are generally at lower risk of fracture than their white counterparts. Hispanic women seem to have fracture risk a bit lower than white women.
One large cohort study of 197,848 community dwelling postmenopausal women which included 7,784 African Americans, 1,912 Asians, 6,973 Hispanics, 1,709 Native Americans, and 179,470 whites found that African-American women had the highest BMD and Asian women the lowest. Relative risk of fracture compared to white women, after adjusting for weight and BMD, was 0.95 for Hispanics, 0.87 for Native Americans, 0.52 for blacks, and 0.32 for Asians(2).
- Cauley JA, Li-Yung L, Ensrud KE, Zmuda JM, Stone KL, Hochberg MC, Cummings SR. Bone mineral density and the risk of incident nonspinal fractures in black and white women. JAMA 2005; 293: 2102-2108.
- Barrett-Connor E, Siris ES, Wehren LE, Miller PD, Abbott TA, Berger ML, Santora AC, Sherwood LM. Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res 2005; 20(2): 185-194.