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Differences in femoral neck structure between elderly Caucasian and Chinese populations: a cross-sectional study of Perth–Beijing cohorts

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Abstract

Summary

Structural skeletal differences of the femoral neck of older Beijing-Chinese and Perth-Caucasian women were compared; adjusting for frame size-related differences, Beijing-Chinese have lower periosteal width; however, indices of internal bone distribution suggest that Beijing-Chinese may exhibit increased resistance to fracture that may relate to the reduced hip fracture incidence.

Introduction

Ethnic differences in skeletal structure may relate to differences in hip fracture risk in Chinese and Caucasian populations. 2D mass, size, and structural biomechanics were compared in the two populations.

Methods

Quantitative computed tomography-derived geometric variables were compared in age-matched community-derived female populations, 196 Beijing-Chinese 76.5 ± 4.8 (mean ± SD) years and 237 Perth-Caucasians 77.1 ± 5.0 years. These included scanned area (A), periosteal width (W), bone mineral content (BMC), aBMD, bone cross-sectional area (bCSA), section modulus (Z) and buckling ratio (BR). Assumption-free measures included sigma (σ), related to the distribution of bone in the scanned image previously identified as a predictor of hip fracture, and delta (δ), the center-of-mass displacement from the geometric center.

Results

Compared to Beijing-Chinese, Perth-Caucasians were heavier (Beijing-Chinese 58.7 ± 11.8; Perth-Caucasians 66.1 ± 11.0 kg), taller (154.9 ± 16.7 vs 158.9 ± 6.0 cm), and had higher BMC, A, and W. After adjustment for frame size, BMC was not significantly different but W remained higher in Perth-Caucasians. Differences in variables aBMD, Z, BR, and σ favored higher resistance to failure with Beijing-Chinese before and after adjustment for frame size. δ was similar in both populations; bCSA was higher in Beijing-Chinese before adjustment for frame size but not after.

Conclusions

Bone mass differences in two populations were related to frame size differences. However, femoral neck width remained smaller in Beijing-Chinese suggesting effects of local genetic and environmental factors. In Beijing-Chinese participants compared to Perth-Caucasians, internal bone distribution suggests increased resistance to deformation if exposed to same force that may, in-part, relate to reduced incidence of hip fracture in Beijing-Chinese.

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Acknowledgements

This work was supported by grants from the National Natural Science foundation of China (Grant no: 81071131), the Beijing Bureau of Health 215 program (Grant number: 2013-3-033; 2009-2-03), the Beijing Technology Foundation for Selected Overseas Chinese Scholar and Beijing Talents Fund (Grant no: 2015000021467), and the Capital Characteristic Clinic Project (Grant number: Z141107002514072).

Author information

Author notes

  1. L. Wang and B. C. C. Khoo are the primary authors and they both contributed equally.

Authors and Affiliations

  1. Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China

    L. Wang, X. G. Cheng, Y. B. Su, Z. Guo & K. Li

  2. Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia

    B. C. C. Khoo

  3. School of Physics, University of Western Australia, Nedlands, WA, Australia

    B. C. C. Khoo

  4. School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia

    B. C. C. Khoo, J. R. Lewis & R. L. Prince

  5. Mindways Software, Austin, TX, USA

    K. Brown

  6. Centre for Kidney Research, Children’s Hospital at Westmead School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia

    J. R. Lewis

  7. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

    R. L. Prince

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Correspondence to R. L. Prince.

Ethics declarations

All procedures performed that involved human participants were in accordance with the ethical standards of the institutional and/or national research committee and are approved by the Institutional Review Board from the ethic committees of Beijing Jishuitan Hospital and the University of Western Australia.

Ethics approval

Perth: For the Calcium Intake Fracture Outcomes Study, the Human Ethics Committee of the University of Western Australia approved the study and written informed consents were obtained from all participants (approval number 05/06/004/H50). As this trial commenced and was completed prior to the advent of the clinical trials registry, the trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry ACTRN12615000750583. For the Protein Intake Metabolic Outcomes Study, all procedures followed were in accordance with institutional guidelines and were conducted at the Sir Charles Gairdner Hospital in Perth. The study was approved by the Sir Charles Gairdner Hospital Human Research Ethics Committee, and all participants provided written informed consent. The study was conducted in compliance with the ethical principles of the Declaration of Helsinki and the International Conference on Harmonization Good Clinical Practices Guidelines and registered with the Australian Clinical Trials Registry (Registration Number ACTRN012607000163404).

Beijing: The China Action on Spine and Hip Status (CASH) study, registered in clinicaltrials.gov (NTC 01758770), is an ongoing study led by Cheng and colleagues at Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, China, that utilized the large-scale population-based Prospective Urban Rural Epidemiology (PURE) population. For CASH study, the Human Ethics Committee of Beijing Jishuitan Hospital approved the study (approval number Jilunke Review No. 201512-02).

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Wang, L., Khoo, B.C.C., Cheng, X.G. et al. Differences in femoral neck structure between elderly Caucasian and Chinese populations: a cross-sectional study of Perth–Beijing cohorts. Arch Osteoporos 12, 72 (2017). https://doi.org/10.1007/s11657-017-0366-8

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