Case Study: The Boston Area Community Health/Bone Survey
| At a Glance |
Research Question
What are the origins of racial/ethnic differences in musculoskeletal health among men?
NERI's Role
NERI conducted a population-based study of men from three different racial/ethnic groups.
Results
Substantial racial/ethnic differences in bone density were observed, which were explained in part by racial/ethnic differences in lean body mass and other potentially modifiable risk factors.
Funding Institution
This survey is funded by a grant from the National Institute on Aging.
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Falls and fractures cause great pain and suffering in older adults, particularly women. But how does bone strength and the risk of fracture vary by race and age among men? The Boston Area Community Health/Bone (BACH/Bone) Survey aims to find out by conducting an observational research study of musculoskeletal health among 1,219 racially/ethnically diverse men aged 29-80 years. Subjects for this study were recruited from the parent study, BACH. The baseline BACH/Bone examinations occurred between 2002 and 2005. NERI recently received a grant renewal to conduct a second examination of the BACH/Bone Survey cohort. These examinations began in mid-2010.
NERI's Role
The BACH/Bone Survey will illuminate the fundamental causes of racial/ethnic differences in markers of the two primary ‘upstream’ determinants of fracture: loads applied to bone and bone strength. This will be one of the few studies with the ability to compare longitudinal rates of bone loss among men of different racial/ethnic groups. Research subjects will also be scanned with a high-resolution peripheral quantitative computed tomography (HR-pQCT) scanner, which will be used to estimate bone quality on a microscopic level. There are currently very limited data on bone microarchitecture in population-based studies and no data that examine racial/ethnic differences in bone microarchitecture. In addition, a comprehensive assessment of balance, muscle strength, walking speed, and other tests of physical function will be conducted, along with a comprehensive set of serum measurements, including markers of bone metabolism and sex steroids.
The Results
Data from the baseline examination showed substantial racial/ethnic differences in bone density, which were explained in part by racial/ethnic differences in lean body mass and other potentially modifiable risk factors. The identification of risk factors for increased bone loss and poor bone quality among the racial/ethnic groups are two of the primary objectives of the follow-up study. The BACH/Bone Survey is poised to make substantial contributions to our understanding of the elusive mechanisms underlying racial/ethnic differences in bone fragility. Ultimately, the study could provide insights that will inform the development of fracture prevention strategies as well as rational approaches to resource allocation.