Original ArticleRacial Disparity in Fracture Risk between White and Nonwhite Children in the United States
Section snippets
Methods
The Bone Mineral Density in Childhood Study (BMDCS) is a multicenter longitudinal study examining bone accretion in a racially diverse cohort of 1554 healthy boys and girls, aged 6-17 years, recruited from July 2002 to November 2003 at 5 medical centers in the US.7 Consent and assent were obtained from parents/guardians and participants following approved institutional review board protocols. Eighty-four children who did not return for follow-up were excluded from the analysis. Thus, 1470
Results
The characteristics of the study sample are described in Table I. The 693 nonwhites included 342 blacks, 247 Hispanics, 104 Asians, and 84 identified as “other.” The mean length of follow-up was 5.0 ± 1.5 years with the majority of subjects (908/1470, 62%) completing 6 years. A total of 212 subjects reported 257 fractures; 176 subjects sustained a single fracture incident, 30 sustained 2 fracture incidents, and 6 sustained ≥3 fracture incidents. The average age at first fracture was 13.7 ± 2.9
Discussion
The results of this multicenter prospective study provide strong evidence that race/ethnicity is a major determinant of fracture risk in healthy children living in the US. We found a much higher fracture rate in non-Hispanic white children compared with children of other ancestry. These differences were independent of chronologic age, skeletal age, body mass, and degree of sexual maturation. On average, healthy boys and girls of European descent had more than twice the fracture risk of healthy
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Supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NO1-HD-1-3228, NO1-HD-1-3329, NO1-HD-1-3330, NO1-HD-1-3331, NO1-HD-1-3332, and NO1-HD-1-3333). The authors declare no conflicts of interest.