Ethnic Differences in Osteoporosis After Cardiac Transplantation.
Cardiac transplantation is associated with a high risk of fracture. African Americans (AAs) are believed to have a lower risk of osteoporosis than Caucasians, but it is not clear whether they are also protected from osteoporosis resulting from the use of glucocorticoids and/or organ transplantation. We examined possible ethnic differences in 33 cardiac transplant recipients (16 AAs) in a cross-sectional analysis. In addition to bone mineral density and vertebral fracture assessment, we also compared biochemical variables, trabecular bone score, total body dual-energy X-ray absorptiometry, and disability. Overall fracture rates were low in both groups, with only 6 total subjects with fractures on vertebral fracture assessment or history of fracture. While T-scores were similar between groups, Z-scores were lower in AA with the difference reaching statistical significance when controlling for important covariates. The trabecular bone score was also lower in AAs than in Caucasians even when adjusting for age and tissue thickness (1.198 ± 0.140 vs 1.312 ± 0.140, p = 0.03). While AAs are generally thought to be protected from osteoporosis, our study instead suggests that AAs may be at higher risk of bone deterioration after cardiac transplantation and may need to be managed more aggressively than suggested by current guidelines.
Department of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, IL, USA. Electronic address: rajesh.jain@uchospitals.edu.
Rajesh K
RK
Jain
Department of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, IL, USA.
Betsy
B
Bennet
Department of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, IL, USA.
Tamara
T
Vokes
D015502:Absorptiometry, Photon; D000328:Adult; D001741:Black or African American; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001823:Body Composition; D015519:Bone Density; D000071556:Cancellous Bone / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D016027:Heart Transplantation; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000208:ethnology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000208:ethnology*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000208:ethnology*; D010281:Parathyroid Hormone / Q000097:blood; D011241:Prednisone / Q000627:therapeutic use; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000208:ethnology*; D013904:Thoracic Vertebrae / Q000293:injuries; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D044465:White People
D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase; D011241:Prednisone
African Americans; cardiac transplantation; ethnic differences; secondary osteoporosis