Bone mineral density (BMD) predicts fracture risk in white women, but
whether the relationship is similarly applicable to black women is not clear.
Cauley and colleaguesArticle examined the association of BMD
with risk of nonspinal fractures in white and black women in a large prospective
cohort study. In age-adjusted models, they found that black women have a lower
risk of fracture than white women at every level of BMD. In multivariable
analyses, the lower risk of fracture in black vs white women was independent
of BMD and other factors commonly associated with bone health. In an editorial,Article Acheson discusses the limitations of race-based norms for
BMD, factors that may explain differences in fracture risk, and the importance
of individual clinical assessment.