title: Correlates of bone mineral density among postmenopausal women of African Caribbean ancestry: Tobago women's health study.
abstract: Population dynamics predict a drastic growth in the number of older minority women, and resultant increases in the number of fractures. Low bone mineral density (BMD) is an important risk factor for fracture. Many studies have identified the lifestyle and health-related factors that correlate with BMD in Whites. Few studies have focused on non-Whites. The objective of the current analyses is to examine the lifestyle, anthropometric and health-related factors that are correlated with BMD in a population based cohort of Caribbean women of West African ancestry. We enrolled 340 postmenopausal women residing on the Caribbean Island of Tobago. Participants completed a questionnaire and had anthropometric measures taken. Hip BMD was measured by DXA. We estimated volumetric BMD by calculating bone mineral apparent density (BMAD). BMD was >10% and >25% higher across all age groups in Tobagonian women compared to US non-Hispanic Black and White women, respectively. In multiple linear regression models, 35-36% of the variability in femoral neck and total hip BMD respectively was predicted. Each 16-kg (one standard deviation (SD)) increase in weight was associated with 5% higher BMD; and weight explained over 10% of the variability of BMD. Each 8-year (1 SD) increase in age was associated with 5% lower BMD. Current use of both thiazide diuretics and oral hypoglycemic medication were associated with 4-5% higher BMD. For femoral neck BMAD, 26% of the variability was explained by a multiple linear regression model. Current statin use was associated with 5% higher BMAD and a history of breast feeding or coronary heart disease was associated with 1-1.5% of higher BMAD. In conclusion, African Caribbean women have the highest BMD on a population level reported to date for women. This may reflect low European admixture. Correlates of BMD among Caribbean women of West African ancestry were similar to those reported for U.S. Black and White women.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Deanna D
authors.initials: DD
authors.lastname: Hill
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA. Electronic address: jcauley@edc.pitt.edu.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Clareann H
authors.initials: CH
authors.lastname: Bunker
authors.affiliation: Office of Measurement and Evaluation, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Baker
authors.affiliation: Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Patrick
authors.affiliation: Division of Diabetes Translation, Epidemiology and Statistics Branch, National Center for Chronic Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, 30341, USA.
authors.forename: Gloria L A
authors.initials: GLA
authors.lastname: Beckles
authors.affiliation: Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago.
authors.forename: Victor W
authors.initials: VW
authors.lastname: Wheeler
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Zmuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D017698:Postmenopause; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago / Q000453:epidemiology; D016387:Women's Health