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Calcified Tissue International

, Volume 104, Issue 2, pp 145–151 | Cite as

Large Bone not Necessarily High Bone Mineral Density: Evidence from a National Survey

  • Francis TayieEmail author
  • Chen Wu
Original Research
  • 26 Downloads

Abstract

There is scarcity of population-level data on the bone areal size (BA) that produces the highest bone mineral density (BMD), and how BA relates to BMD among racial groups. We use population-level data to estimate the BA that coincide with the highest BMD among racial groups in the United States. A total of 7425 participants, age 18–75 years, whose BA and BMD were measured in the United States National Health and Nutrition Examination Survey (NHANES) 2009–2014, were assessed in this study. Multiple regression models were used to estimate race-specific relationships between BA and BMD. The critical BA that associates with the highest (peak) BMD among racial groups adjusted for confounders was estimated. Results showed a curvilinear relationship between BA and BMD at the population level such that BMD increases with BA at lower values and then decreases after a peak value. Races combined, BA of about 45 cm2 seems to correspond to a peak femur BMD in this sample. The peak BMD was different among racial groups. The BA at which BMD peaks was lower among blacks and Mexicans compared to whites. We conclude that femur BMD increases up to a critical femur BA and then decreases thereafter. Persons with femur BA at or close to the critical value may tend to have higher than average BMD.

Keywords

Bone mineral density Critical bone size Femur bone areal size Peak bone mineral density Race bone mineral density 

Notes

Acknowledgements

Our sincere gratitude goes to the United States Centers for Disease Control and Prevention of the Department of Health and Human Services for making the NHANES datasets publicly available for use by professionals.

Compliance with Ethical Standards

Conflict of interest

Francis Tayie and Chen Wu have no conflict of interest regarding this article publication.

Human and Animal Rights and Informed Consent

The Research Ethics Review Board of the National Center for Health Statistics approved the survey procedures and obtained informed consent from all participants.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Southeast Missouri State UniversityCape GirardeauUSA

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