Skip to main content

Serum 25-hydroxyvitamin D and bone mineral density among Hispanic men

Abstract

Summary

There are few data on the skeletal health of Hispanic men. We observed differences in vitamin D deficiency and low BMD between Hispanic ethnic subgroups that persisted with adjustment for risk factors. Our data indicate a substantial burden of low BMD and vitamin D deficiency among Hispanic men.

Introduction

Disparities within ethnic groups are generally ignored, but in evolving populations they may have implications for public health. We examined ethnic variation in serum 25-hydroxyvitamin D [25(OH)D] and bone mineral density (BMD) among Hispanic American men.

Methods

Three hundred and fifty-eight Hispanic males 30 to 79 years of age were studied. Logistic regression models assessed variation in odds of vitamin D deficiency (<20 ng/mL) and low BMD (T-score<−1) by ethnicity, with and without adjustment for risk factors (age, smoking, occupation, physical activity, body mass index, and sunlight exposure).

Results

Vitamin D deficiency was most common among Puerto Rican (26%), compared with Dominican (21%), Central American (11%), and South American (9%) men. Percentages with low BMD were: South American (44%), Puerto Rican (34%), Dominican (29%), and Central American (23%). Adjustment for age and risk factors failed to account for Hispanic subgroup differences in vitamin D deficiency and low BMD. Population estimates indicate a substantial burden of low BMD and vitamin D deficiency among Hispanic men.

Conclusions

Our findings underscore the importance of examining the skeletal health of Hispanic subgroups, and suggest that a considerable number of Hispanic men may be at elevated risk of fracture and vitamin D deficiency.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. U.S. Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD

    Google Scholar 

  2. National Institutes of Health (2001) Osteoporosis prevention, diagnosis, and therapy. National Institutes of Health Consensus Development Conference Statement. Jama 285:785–795

    Article  Google Scholar 

  3. Heaney RP (1995) Bone mass, the mechanostat, and ethnic differences. J Clin Endocrinol Metab 80:2289–2290

    PubMed  Article  CAS  Google Scholar 

  4. Orwoll ES, Klein RF (1995) Osteoporosis in men. Endocr Rev 16:87–116

    PubMed  Article  CAS  Google Scholar 

  5. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475

    PubMed  Article  Google Scholar 

  6. U.S. Census Bureau (2004) We the People: Hispanics in the United States. http://wwwcensusgov/ipc/www/usinterimproj/, accessed 9 February 2007

  7. Araujo AB, Travison TG, Harris SS, Holick MF, Turner AK, McKinlay JB (2007) Race/ethnic differences in bone mineral density in men. Osteoporos Int 18:943–953

    PubMed  Article  CAS  Google Scholar 

  8. Baron JA, Barrett J, Malenka D, Fisher E, Kniffin W, Bubolz T, Tosteson T (1994) Racial differences in fracture risk. Epidemiology 5:42–47

    PubMed  Article  CAS  Google Scholar 

  9. Cummings SR, Cauley JA, Palermo L, Ross PD, Wasnich RD, Black D, Faulkner KG (1994) Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Study of Osteoporotic Fractures Research Group. Osteoporos Int 4:226–229

    PubMed  Article  CAS  Google Scholar 

  10. Dawson-Hughes B (2004) Racial/ethnic considerations in making recommendations for vitamin D for adult and elderly men and women. Am J Clin Nutr 80:1763S–1766S

    PubMed  CAS  Google Scholar 

  11. Farmer ME, White LR, Brody JA, Bailey KR (1984) Race and sex differences in hip fracture incidence. Am J Public Health 74:1374–1380

    PubMed  Article  CAS  Google Scholar 

  12. George A, Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2003) Racial differences in bone mineral density in older men. J Bone Miner Res 18:2238–2244

    PubMed  Article  Google Scholar 

  13. Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr., Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489

    PubMed  Article  CAS  Google Scholar 

  14. Looker AC (2002) The skeleton, race, and ethnicity. J Clin Endocrinol Metab 87:3047–3050

    PubMed  Article  CAS  Google Scholar 

  15. Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–777

    PubMed  Article  CAS  Google Scholar 

  16. Tracy JK, Meyer WA, Flores RH, Wilson PD, Hochberg MC (2005) Racial differences in rate of decline in bone mass in older men: the Baltimore men’s osteoporosis study. J Bone Miner Res 20:1228–1234

    PubMed  Article  Google Scholar 

  17. Villa ML (1994) Cultural determinants of skeletal health: the need to consider both race and ethnicity in bone research. J Bone Miner Res 9:1329–1332

    PubMed  CAS  Google Scholar 

  18. Bauer RL (1988) Ethnic differences in hip fracture: a reduced incidence in Mexican Americans. Am J Epidemiol 127:145–149

    PubMed  CAS  Google Scholar 

  19. Bauer RL, Deyo RA (1987) Low risk of vertebral fracture in Mexican American women. Arch Intern Med 147:1437–1439

    PubMed  Article  CAS  Google Scholar 

  20. Espino DV, Palmer RF, Miles TP, Mouton CP, Wood RC, Bayne NS, Markides KP (2000) Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. J Am Geriatr Soc 48:1252–1260

    PubMed  CAS  Google Scholar 

  21. Lauderdale DS, Jacobsen SJ, Furner SE, Levy PS, Brody JA, Goldberg J (1998) Hip fracture incidence among elderly Hispanics. Am J Public Health 88:1245–1247

    PubMed  Article  CAS  Google Scholar 

  22. Maggi S, Kelsey JL, Litvak J, Heyse SP (1991) Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1:232–241

    PubMed  CAS  Google Scholar 

  23. Silverman SL, Madison RE (1988) Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California Hospital Discharge Data. Am J Public Health 78:1482–1483

    PubMed  Article  CAS  Google Scholar 

  24. Villa ML, Marcus R, Ramirez Delay R, Kelsey JL (1995) Factors contributing to skeletal health of postmenopausal Mexican-American women. J Bone Miner Res 10:1233–1242

    PubMed  CAS  Article  Google Scholar 

  25. Zingmond DS, Melton LJ 3rd, Silverman SL (2004) Increasing hip fracture incidence in California Hispanics, 1983 to 2000. Osteoporos Int 15:603–610

    PubMed  Article  Google Scholar 

  26. Rumbaut RG (2006) The making of a people. In: Tienda M, Mitchell F (eds) Hispanics and the Future of American Panel on Hispanics in the United States. The National Academies Press, Washington, DC, pp 16–65

    Google Scholar 

  27. Clark P, de la Pena F, Gomez Garcia F, Orozco JA, Tugwell P (1998) Risk factors for osteoporotic hip fractures in Mexicans. Arch Med Res 29:253–257

    PubMed  CAS  Google Scholar 

  28. Elffors I, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Lopes Vaz AA, Lyritis G et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporos Int 4:253–263

    PubMed  Article  CAS  Google Scholar 

  29. Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244

    PubMed  Article  Google Scholar 

  30. McKinlay JB, Link CL (2007) Measuring the Urologic Iceberg: Design and Implementation of The Boston Area Community Health (BACH) Survey. Eur Urol

  31. Washburn RA, Smith KW, Jette AM, Janney CA (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162

    PubMed  Article  CAS  Google Scholar 

  32. Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA (1999) The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 52:643–651

    PubMed  Article  CAS  Google Scholar 

  33. Wallman K (1997) Data on race and ethnicity: Revising the federal standard. Am Stat 31–35

  34. Chen TC, Turner AK, Holick MF (1990) Methods for the determination of the circulating concentration of 25-hydroxyvitamin D. J Nutr Biochem 1:315–319

    PubMed  Article  CAS  Google Scholar 

  35. Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE (2005) Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90:3215–3224

    PubMed  Article  CAS  Google Scholar 

  36. World Health Organization (1994) WHO Technical Report Series 843: Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis: Report of a WHO Study Group. World Health Organization, Geneva

    Google Scholar 

  37. U.S. Census Bureau (2003) 2000 Summary File 4–United States/prepared by the U.S. Census Bureau. http://www.census.gov/Press-Release/www/2003/SF4.html, Accessed: 30 April 2007

  38. Looker AC, Orwoll ES, Johnston CC, Lindsay RL, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768

    PubMed  Article  CAS  Google Scholar 

  39. Hannan MT, Litman HJ, Araujo AB, McLennan CE, McLean RR, McKinlay JB, Chen TC, Holick MF (2008) Serum 25-hydroxyvitamin D and bone mineral density in a racially and ethnically diverse group of men. J Clin Endocrinol Metab 93:40–46

    PubMed  Article  CAS  Google Scholar 

  40. Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B (2000) Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab 85:4125–4130

    PubMed  Article  CAS  Google Scholar 

  41. Binkley N, Krueger D, Cowgill CS, Plum L, Lake E, Hansen KE, DeLuca HF, Drezner MK (2004) Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. J Clin Endocrinol Metab 89:3152–3157

    PubMed  Article  CAS  Google Scholar 

  42. Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF (1999) An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int 9:394–397

    PubMed  Article  CAS  Google Scholar 

  43. Tothill P, Hannan WJ (2000) Comparisons between Hologic QDR 1000W, QDR 4500A, and Lunar Expert dual-energy X-ray absorptiometry scanners used for measuring total body bone and soft tissue. Ann N Y Acad Sci 904:63–71

    PubMed  CAS  Article  Google Scholar 

  44. Cooper GS, Umbach DM (1996) Are vitamin D receptor polymorphisms associated with bone mineral density? A meta-analysis. J Bone Miner Res 11:1841–1849

    PubMed  CAS  Google Scholar 

  45. Fang Y, van Meurs JB, d’Alesio A, Jhamai M, Zhao H, Rivadeneira F, Hofman A, van Leeuwen JP, Jehan F, Pols HA, Uitterlinden AG (2005) Promoter and 3¢-untranslated-region haplotypes in the vitamin d receptor gene predispose to osteoporotic fracture: the rotterdam study. Am J Hum Genet 77:807–823

    PubMed  Article  CAS  Google Scholar 

  46. Harris SS, Eccleshall TR, Gross C, Dawson-Hughes B, Feldman D (1997) The vitamin D receptor start codon polymorphism (FokI) and bone mineral density in premenopausal American black and white women. J Bone Miner Res 12:1043–1048

    PubMed  Article  CAS  Google Scholar 

  47. Nelson DA, Vande Vord PJ, Wooley PH (2000) Polymorphism in the vitamin D receptor gene and bone mass in African-American and white mothers and children: a preliminary report. Ann Rheum Dis 59:626–630

    PubMed  Article  Google Scholar 

  48. Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80:1678S–1688S

    PubMed  CAS  Google Scholar 

  49. Chen TC, Chimeh F, Lu Z, Mathieu J, Person KS, Zhang A, Kohn N, Martinello S, Berkowitz R, Holick MF (2007) Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Arch Biochem Biophys 460:213–217

    PubMed  Article  CAS  Google Scholar 

  50. Choudhry S, Coyle NE, Tang H, Salari K, Lind D, Clark SL, Tsai HJ, Naqvi M, Phong A, Ung N, Matallana H, Avila PC, Casal J, Torres A, Nazario S, Castro R, Battle NC, Perez-Stable EJ, Kwok PY, Sheppard D, Shriver MD, Rodriguez-Cintron W, Risch N, Ziv E, Burchard EG (2006) Population stratification confounds genetic association studies among Latinos. Hum Genet 118:652–664

    PubMed  Article  Google Scholar 

  51. Hanis CL, Hewett-Emmett D, Bertin TK, Schull WJ (1991) Origins of U.S. Hispanics. Implications for diabetes. Diabetes Care 14:618–627

    PubMed  Article  CAS  Google Scholar 

  52. Binkley NC, Schmeer P, Wasnich RD, Lenchik L (2002) What are the criteria by which a densitometric diagnosis of osteoporosis can be made in males and non-Caucasians? J Clin Densitom 5(Suppl):S19–27

    PubMed  Article  Google Scholar 

  53. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE (2005) Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health 26:367–397

    PubMed  Article  Google Scholar 

  54. Melton LJ 3rd, Marquez MA, Achenbach SJ, Tefferi A, O’Connor MK, O’Fallon WM, Riggs BL (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13:551–559

    Article  Google Scholar 

  55. Bonilla C, Shriver MD, Parra EJ, Jones A, Fernandez JR (2004) Ancestral proportions and their association with skin pigmentation and bone mineral density in Puerto Rican women from New York city. Hum Genet 115:57–68

    PubMed  Article  Google Scholar 

  56. Leslie WD, Tsang JF, Caetano PA, Lix LM (2007) Effectiveness of bone density measurement for predicting osteoporotic fractures in clinical practice. J Clin Endocrinol Metab 92:77–81

    PubMed  Article  CAS  Google Scholar 

  57. Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259

    PubMed  CAS  Google Scholar 

  58. Khosla S, Melton LJ (2007) Osteopenia. N Engl J Med 356:2293–2300

    PubMed  Article  CAS  Google Scholar 

Download references

Acknowledgements

The BACH/Bone Survey was supported by grant AG 20727 from the National Institute on Aging (NIA). The parent study (BACH) was supported by grant DK 56842 from the National Institute of Diabetes and Digestive and Kidney Diseases. Additional support from MO RR00533.

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. B. Araujo.

Additional information

Grant Support: The BACH/Bone Survey was supported by grant AG 20727 from the National Institute on Aging (NIA). The parent study (BACH) was supported by grant DK 56842 from the National Institute of Diabetes and Digestive and Kidney Diseases. Additional support from MO RR00533.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Araujo, A.B., Travison, T.G., Esche, G.R. et al. Serum 25-hydroxyvitamin D and bone mineral density among Hispanic men. Osteoporos Int 20, 245–255 (2009). https://doi.org/10.1007/s00198-008-0652-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-008-0652-9

Keywords

  • Bone densitometry
  • Epidemiology
  • Hispanic
  • Men
  • Population study
  • Vitamin D