Medical & Clinical Reviews

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Academic Osteoporosis Journals

Peak bone mass (usually achieved by 25 years of age) is essential to bone health and is associated with a potential risk of osteoporosis. Achieving peak bone mass is also a function of genetics and environmental factors including physical activity levels, muscle and fat mass (or bone loading patterns), and nutritional status (calcium intakes and vitamin D status) and may be related to sex and ethnicity [1–5]. Some racial/ethnicity differences in bone mineral density (BMD) for women are well documented. Asian women have a lower areal bone mineral density (aBMD), assessed by 2-dimensional dual-energy X-ray absorptiometry (DXA) scans, but higher volumetric bone mineral density (vBMD), obtained from 3-dimensional peripheral quantitative computed tomography (pQCT) scans that also differentiate cortical and trabecular bone, compared to Caucasian women [3, 6, 7]. In addition, Asian women have lower rates of hip and forearm fractures but similar risk for vertebral fractures as Caucasian women [8]. These incongruous findings are difficult to understand since it has been reported that both pre- and postmenopausal Chinese American women generally have a smaller bone size (DXA), yet thicker cortical and trabecular bone compartments (pQCT), and architecturally stronger bone, at least at the radius and tibia, and therefore display lower fracture rates at peripheral sites compared to Caucasians. However, one limitation to these findings is that these Chinese American women could have been born in the United States

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