Are Asians at higher risk for osteoporosis?

Does being Asian-American really increase your risk of fracture? Being “Asian or Asian-American” always figured high on the standard list of osteoporosis risk factors. So naturally, one is led to think that Asians and Asian-Americans are at high risk for osteoporotic fracture—particularly Asian-American women who are in or past menopause.

When we actually look at the fracture statistics, however, we find that postmenopausal Asian-American women have the lowest fracture rate of women in any US ethnic group. In a study of nearly 200,000 women, Asian-Americans were found to experience one-third the osteoporotic fractures of Caucasian and Hispanic women, and they even fractured much less than Native American and African-American women.

So, why is being Asian-American always listed as a big risk factor for osteoporosis? This is because Asian-Americans are generally thinner and have lower bone density than other ethnic groups. Yet the study shows that although they have lower bone density, they still fracture much, much less often.

This interesting paradox supports my long-standing position that bone mineral density is not a good predictor of fracture risk. As I have been saying for years now, many factors influence fracture risk, not just bone density. In fact, over half of all women who fracture do not have very low bone density.

To learn about the variety of risk factors contributing to osteoporotic fracture, take a look at my article, Rethinking the Causes of Osteoporosis.

Reference:

Barrett-Conner, E. et al. 2005. Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res, 20(2):185-194.