title: Trabecular bone deficits among Vietnamese immigrants.
abstract: CONCLUSIONS
  Compared to white women, lower areal bone mineral density (aBMD) in middle-aged Vietnamese immigrants is due to reduced trabecular volumetric bone mineral density (vBMD), which in turn is associated with greater trabecular separation along with lower estrogen levels.
  
  
  BACKGROUND
  The epidemiology of osteoporosis in Asian populations is still poorly known, but we previously found a deficit in lumbar spine aBMD among postmenopausal Southeast Asian women, compared to white women, that persisted after correction for bone size. This issue was revisited using more sophisticated imaging techniques.
  
  
  METHODS
  Twenty Vietnamese immigrants (age, 44-79 years) were compared to 162 same-aged white women with respect to aBMD at the hip, spine and wrist, vBMD at the hip and spine by quantitative computed tomography and vBMD and bone microstructure at the ultradistal radius by high-resolution pQCT. Bone turnover and sex steroid levels were assessed in a subset (20 Vietnamese and 40 white women).
  
  
  RESULTS
  The aBMD was lower at all sites among the Vietnamese women, but femoral neck vBMD did not differ from middle-aged white women. Significant differences in lumbar spine and ultradistal radius vBMD in the Vietnamese immigrants were due to lower trabecular vBMD, which was associated with increased trabecular separation. Bone resorption was elevated and bone formation depressed among the Vietnamese immigrants, although trends were not statistically significant. Serum estradiol was positively associated with trabecular vBMD in the Vietnamese women, but their estrogen levels were dramatically lower compared to white women.
  
  
  CONCLUSIONS
  Although reported discrepancies in aBMD among Asian women are mainly an artifact of smaller bone size, we identified a specific deficit in the trabecular bone among a sample of Vietnamese immigrants that may be related to low estrogen levels and which needs further study.
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. melton.j@mayo.edu
authors.forename: L J
authors.initials: LJ
authors.lastname: Melton
authors.forename: M A
authors.initials: MA
authors.lastname: Marquez
authors.forename: L K
authors.initials: LK
authors.lastname: McCready
authors.forename: S J
authors.initials: SJ
authors.lastname: Achenbach
authors.forename: B L
authors.initials: BL
authors.lastname: Riggs
authors.forename: S
authors.initials: S
authors.lastname: Amin
authors.forename: S
authors.initials: S
authors.lastname: Khosla
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology; D001862:Bone Resorption / Q000097:blood / Q000208:ethnology / Q000503:physiopathology; D054242:Emigrants and Immigrants; D004958:Estradiol / Q000097:blood; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D020098:Natriuretic Peptide, C-Type / Q000097:blood; D011884:Radius / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015415:Biomarkers; C480579:amino-terminal pro-C-type natriuretic peptide, human; D020098:Natriuretic Peptide, C-Type; D004958:Estradiol