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Should Treatment Thresholds Vary by Race?

Louise S. Acheson, MD, MS

JAMA. 2005;293:2151-2154.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Age, female sex, slender body habitus, and white race are well-known risk factors for osteoporotic fractures.¹ Middle-aged and older black men and women have higher bone mass and substantially lower fracture rates than whites.² Partly because of their reduced risk, blacks have only recently been included in prospective studies of osteoporosis with measurements of bone mineral density (BMD) and fracture incidence.^2-3

Bone mineral density is highly predictive of fracture risk in white women.⁴ A criterion for diagnosing osteoporosis is a BMD of 2.5 or more SDs below the mean for healthy young adults (T score –2.5).⁵ These norms are sex-specific to account for the substantially higher BMD and lower fracture risk in men compared with women.⁶ In 2001 a panel of experts, convened by the International Society for Clinical Densitometry, concluded that too few data were available to recommend using separate, race-specific norms of BMD . . . [Full Text of this Article]

Author Affiliation: Family Medicine Research Division, Case Western Reserve University, Cleveland, Ohio.

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