title: Prevalence of osteoporosis and osteopenia among African Americans with early rheumatoid arthritis: the impact of ethnic-specific normative data.
abstract: OBJECTIVE
  To examine the prevalence of osteopenia and/or osteoporosis among African Americans with early rheumatoid arthritis (RA) and to assess the effect of using race/ethnicity-specific normative data.
  
  
  METHODS
  Bone mineral density (BMD) of the hip and spine was assessed in African Americans with early RA. To examine the impact of using different normative data on disease classification, we calculated two sets of T scores, the first using sex-matched reference data from Caucasians and the second using data from African Americans. Osteoporosis was defined as a BMD at either site > or =2.5 SD below the young adult mean. Osteopenia was defined as a BMD > or =1 SD and <2.5 SD below this mean.
  
  
  RESULTS
  Using Caucasian referent data, 33% (n=48) of patients had osteopenia or worse (n=48, 32.9%) and 5% (n=8) were osteoporotic. With the use of African-American normative data, 55% (n=94) were osteopenic or worse, and 16% (n=27) were osteoporotic.
  
  
  CONCLUSIONS
  African Americans with RA are at risk of osteopenia and/or osteoporosis. Different diagnostic classifications may occur in this population based solely on the normative data used for assessing fracture risk. These results underscore the need for a standardized approach in defining osteopenia and osteoporosis in African Americans.
authors.affiliation: Department of Medicine, University of Nebraska Medica Center and Omaha VA Medical Center, Omaha, NE 68198-3025, USA. tmikuls@unmc.edu
authors.forename: Ted R
authors.initials: TR
authors.lastname: Mikuls
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Saag
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Curtis
authors.forename: S Louis
authors.initials: SL
authors.lastname: Bridges
authors.forename: Graciela S
authors.initials: GS
authors.lastname: Alarcon
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Westfall
authors.forename: Sam S
authors.initials: SS
authors.lastname: Lim
authors.forename: Edwin A
authors.initials: EA
authors.lastname: Smith
authors.forename: Beth L
authors.initials: BL
authors.lastname: Jonas
authors.forename: Larry W
authors.initials: LW
authors.lastname: Moreland
mesh_terms: D015502:Absorptiometry, Photon; D001741:Black or African American / Q000706:statistics & numerical data*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000208:ethnology*; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D015995:Prevalence; D012016:Reference Values; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data