Abstract
Compared with white women, Asian women have about a 40%–50% and blacks a 50%–60% lower risk of hip fracture, but the reason for this racial difference is not known. Women with a shorter hip axis have a lower risk of hip fracture. To test the hypothesis that a shorter hip axis length could account for the lower risk of hip fracture among Asian and black women, we measured hip axis length in 135 Caucasian, 74 Asian and 50 black women. The mean hip axis lengths of Asian and black women were significantly shorter (1.2 and 0.7 standard deviations, respectively) than that of the whites (p<0.0001). We estimate that, compared with white women, Asians would have a 47% lower risk (95% confidence interval: 32%–63%) and blacks would have a 32% (15%–45%) lower risk of hip fracture because of their shorter hip axis. We conclude that a shorter hip axis length might be a major factor accounting for Asian women's lower risk of hip fracture and might contribute to the lower risk in black women.
Similar content being viewed by others
References
Silverman SL, Madison RE. Decreased incidence of hip fracture in Hispanics, Asians, and Blacks: California hospital discharge data. Am J Public Health 1988;78:1482–3.
Farmer ME, White LR, Brody JA, et al. Race and sex differences in hip fracture incidence. Am J Public Health 1984;74:1374–80.
Ross PD, Norimatus H, Davis JW, Yano K, Wasnich RD, Fujiwara S, Hosoda Y, Melton LJ III. A comparison of hip fracture incidence among native Japanese, Japanese Americans, and American Caucasians. Am J Epidemiol 1991;133:801–9.
Yano K, Wasnich RD, Vogel JM, Heibrun LK. Bone mineral measurements among middle-aged and elderly Japanese residents in Hawaii. Am J Epidemiol 1984;119:751–64.
Russel-Aulet M, Wang J, Thornton JC, Colt EWD, Pierson RN. Bone mineral density and mass in a cross-sectional study of White and Asian women. J Bone Miner Res 1993;8:575–82.
Faulkner KG, Cummings SR, Black DM, Palermo L, Glüer C-C, Genant HK. Simple measurement of femoral geometry predicts hip fracture: The Study of Osteoporotic Fractures J Bone Miner Res 1993;8:1211–7.
Steiger P, Cummings SR, Black DM, Spencer NE, Genant HK. Age-related decrements in bone mineral density in women over 65. J Bone Miner Res 1992;7:625–32.
Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. For the Study of Osteoporotic Fractures Research Group. Bone density at various sites for prediction of hip fractures. Lancet 1993;341:72–5.
Watts NB, Harris ST, Genant HK, et al. Intermittent cyclical etidronate treatment of postmenopausal osteoporosis. N Engl J Med 1990;323:73–9.
Paganini-Hill A, Chao A, Ross RK, Henderson BE. Exercise and other factors in the prevention of hip fracture: The Leisure World Study. Epidemiology 1991;2:16–25.
Farmer ME, Harris T, Madans JH, Wallace RB, Cornoni-Huntley J, White LR. Anthropometric indicators and hip fracture: the HANES I epidemiologic follow-up study. J Am Geriatr Soc 1989;37:9–16.
Meyer HE, Tverdal A, Falch JA. Risk factors for hip fracture in middle-aged Norwegian women and men. Am J Epidemiol 1993;137:1203–11.
Glüer C-C, Cummings SR, Pressman A, Ly J, Glüer K, Faulkner K, et al. Prediction of hip fractures from pelvic radiographs: The Study of Osteoporotic Fractures. J Bone Miner Res 1994 (in press).
Author information
Authors and Affiliations
Consortia
Rights and permissions
About this article
Cite this article
Cummings, S.R., Cauley, J.A., Palermo, L. et al. Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Osteoporosis Int 4, 226–229 (1994). https://doi.org/10.1007/BF01623243
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623243