title: Racial differences in bone mineral density and fractures in men receiving androgen deprivation therapy for prostate cancer.
abstract: OBJECTIVE
  Whether race influences bone loss and fracture risk during androgen deprivation therapy for prostate cancer is unknown. Using data from a prospective clinical trial we compared bone mineral density and fracture between African-American and Caucasian men receiving androgen deprivation therapy.
  
  
  METHODS
  A total of 516 subjects were in the placebo group of a 2-year randomized placebo controlled fracture prevention trial, and were African-American (68) or Caucasian (448). We compared baseline characteristics, changes in bone mineral density and rates of new fractures between races.
  
  
  RESULTS
  Compared to Caucasian men, African-American men had higher baseline hip bone mineral density (mean ± SD 0.98 ± 0.15 vs 0.91 ± 0.15 gm/m(2), p = 0.001) and similar spine bone mineral density (1.09 ± 0.22 vs 1.11 ± 0.22, p = 0.51). There was no difference in prevalent vertebral fractures between African-American and Caucasian men (7.4% vs 15.0%, p = 0.13). The percentage change in hip bone mineral density at 2 years was similar between African-American and Caucasian men (mean ± SE -2.21% ± 0.59% vs -2.54% ± 0.26%, p = 0.65). Changes in bone mineral density of the lumbar spine were also similar between African-American and Caucasian men (-1.74% ± 0.69% vs -1.30% ± 0.33%, p = 0.64). No new vertebral fractures were reported in African-American men but 2 fractures were reported in Caucasian men.
  
  
  CONCLUSIONS
  In a clinical trial African-American men receiving androgen deprivation therapy for prostate cancer have a greater hip bone mineral density and tended to have fewer prevalent vertebral fractures than Caucasian men. Despite a lower baseline risk of osteoporosis and fracture, African-American men experience a decrease in bone mineral density similar to that of Caucasian men.
authors.affiliation: Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA. amorgans@partners.org
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Morgans
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hancock
authors.forename: K Gary
authors.initials: KG
authors.lastname: Barnette
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Steiner
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Morton
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Smith
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D044383:Black People / Q000706:statistics & numerical data*; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005269:Femur / Q000000981:diagnostic imaging; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000208:ethnology*; D013131:Spine / Q000000981:diagnostic imaging; D015996:Survival Rate; D017312:Toremifene / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American
chemical_list: D000726:Androgen Antagonists; D050071:Bone Density Conservation Agents; D010919:Placebos; D017312:Toremifene