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PubMed1996

Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism.

Acquired hypogonadism is being increasingly recognized in adult men. However, the effects of long term testosterone replacement on bone density and body composition are largely unknown. We investigated 36 adult men with acquired hypogonadism (age, 22-69 yr; median, 58 yr), including 29 men with central hypogonadism and 7 men with primary hypogonadism, and 44 age-matched eugonadal controls. Baseline evaluation included body composition analysis by bioimpedance, determination of site-specific adipose area by dual energy quantitative computed tomography scan (QCT) of the lumbar spine, and measurements of spinal bone mineral density (BMD) using dual energy x-ray absortiometry, spinal trabecular BMD with QCT, and radial BMD with single photon absorptiometry. Percent body fat was significantly greater in the hypogonadal men compared to eugonadal men (mean +/- SEM, 26.4 +/- 1.1% vs. 19.2 +/- 0.8%; P < 0.01). The mean trabecular BMD determined by QCT for the hypogonadal men was 115 +/- 6 mg K2HPO4/cc. Spinal BMD was significantly lower than that in eugonadal controls (1.006 +/- 0.024 vs. 1.109 +/- 0.028 g/cm2; P = 0.02, respectively). Radial BMD was similar in both groups. Testosterone enanthate therapy was initiated in 29 hypogonadal men at a dose of 100 mg/week, and the subjects were evaluated at 6-month intervals for 18 months. During testosterone therapy, the percent body fat decreased 14 +/- 4% (P < 0.001). There was a 13 +/- 4% decrease in subcutaneous fat (P < 0.01) and a 7 +/- 2% increase in lean muscle mass (P = 0.01) during testosterone therapy. Spinal BMD and trabecular BMD increased by 5 +/- 1% (P < 0.001) and 14 +/- 3% (P < 0.001), respectively. Radial BMD did not change. Serum bone-specific alkaline phosphatase and urinary deoxypyridinoline excretion, markers of bone formation and resorption, respectively, decreased significantly over the 18 months (P = 0.003 and P = 0.04, respectively). We conclude that testosterone therapy given to adult men with acquired hypogonadism decreases sc fat and increases lean muscle mass. In addition, testosterone therapy reduces bone remodeling and increases trabecular bone density. The beneficial effects of androgen administration on body composition and bone density may provide additional indications for testosterone therapy in hypogonadal men.

Adult↗

PubMedDate not supplied

Clinical utility of spine bone density in elderly women.

It is common clinical practice to obtain a bone density measurement at both the hip and spine to evaluate osteoporosis. With aging, degenerative changes in the lumbar spine may elevate the bone mineral density (BMD) results giving false assurances that the fracture risk at the spine is low. We examined the association of spine osteoarthritis and bone mineral density in 1082 community-dwelling ambulatory older women aged 50-96 years who participated in a 1992-1996 osteoporosis research clinic visit. The BMD was measured at the hip and posteroanterior (PA) and lateral lumbar spine using dual energy X-ray absorptiometry (DXA). Spine osteoarthritis was identified on the PA lumbar spine DXA images by a musculoskeletal radiologist. Forty percent of women had evidence of spine osteoarthritis (OA). Women with spine OA had a mean age of 77.4 yr (95% confidence interval [CI]: 76.5-78.2), were significantly older than women without spine OA (mean age, 66.8 yr; 95% CI: 65.9-67.7), and were more likely to have prevalent radiographic fractures (14.2% vs. 9.5%; p<0.05). Age-adjusted BMD at the femoral neck, total hip, PA spine, and lateral spine was significantly higher in women with spine OA. Women with spine OA were more likely to have osteoporosis by the World Health Organization classification at the femoral neck and total hip than those without spine OA, but less likely based on the PA spine (14.4% vs. 24.5%). Despite higher BMD levels, women with OA of the lumbar spine had higher prevalence of osteoporosis at the hip and more radiographic vertebral fractures. In elderly women 65 yr and older who are likely to have spine OA, the DXA measurement of the spine may not be useful in assessing fracture risk, and DXA of the hip is recommended for identification of osteoporosis.

Absorptiometry, Photon↗

PubMed1992

Sex differences in cancellous and cortical bone strength, bone mineral content and bone density.

The purpose of this study was to examine sex differences in cancellous and cortical bone strength, bone mineral content (BMC) and bone density of excised cadaver vertebral and phalangeal bones. The samples were age-matched. Bone strength was measured as the mechanical force required to crush or break the bones. Two parameters of bone strength were used on the vertebrae; the force at the first deviation from linearity and the mean force during the consolidation before final failure. The force at first deviation from linearity was not significantly different between the sexes, but there was a significant difference in the consolidation force. The mean men's phalangeal strength was twice that of the women's. BMC and BMC/BW of both types of bone were statistically different between the sexes. Radiographic photodensity measures on the vertebrae showed no sex differences. Cortical diameters of the finger bones were significantly greater in males.

Aged↗

PubMed1997

Bone density in women receiving Norplant implants for contraception.

The aim of this study was to determine whether long-term Norplant uses is associated with changes in bone density. The study group consisted of forty one healthy women aged 19-42 years who had used Norplant for 31.1 +/- 11.2 months with a minimum period of 12 months. Fifty current IUD users constituted the control group. The bone density was measured by dual energy X-ray absorptiometry (DEXA) at the non dominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique. Age, parity, income, weight, height and body mass index (BMI) of both groups were no differences. Our analysis did not find any differences in bone mineral density of distal forearm and ultradistal forearm between Norplant and IUD users (95% CI -0.01, -0.03 and -0.02, 0.02 respectively). Serum estradiol was not different in the two groups (95% CI -24.9, 110). This study revealed that the Norplant implants do not have any adverse effect on bone mineral density.

Adult↗

PubMed2001

Persistently increased bone turnover and low bone density in long-term survivors to kidney transplantation.

AIMS: There are few data on the long-term outcome of bone health in renal transplant recipients. We wanted to evaluate the prevalence of osteoporosis and related clinical fractures in long-term survivals to kidney transplantation. METHODS: We carried out a cross-sectional study of 80 males and 44 females, aged 45 +/- 1 years, who had undergone kidney transplantation (KTx) 55.6 +/- 4.6 months earlier. Patients were treated according to standard immunosuppressive protocols. RESULTS: High parathyroid hormone levels were observed in 55 out of the 124 patients (44.6%) and the prevalence of secondary hyperparathyroidism (SHPT) remained similar even when subjects were grouped according to the time elapsed since transplant. The Z scores for bone alkaline phosphatase, osteocalcin, urinary N telopeptide and galactosyl-hydroxylysine were increased as compared to normal controls, both in males and females (p < 0.05). Bone formation markers normalized, while bone resorption markers remained elevated in these patients even ten years after transplant. Vertebral and femoral osteoporosis were present in 37% and 56% of the patients, respectively, and no tendency toward a recovery in bone mass was seen even in those patients who had survived the longest time since KTx. Clinical fracture rate was 0.006 and 0.031 patient years, before and after KTx, respectively. The number of fractures was lower in patients taking lower mean daily doses of corticosteroids (p < 0.025). PTH levels positively correlated with bone alkaline phosphatase, osteocalcin and N telopeptide. CONCLUSION: In conclusion, bone density is decreased and bone turnover increased even many years after KTx, with persistent SHPT and corticosteroid use being the main pathogenetic factors.

Adult↗

PubMed1996

[The effect of clodronate on bone density in patients with multiple myeloma--a 2-year follow-up of therapeutic effects].

Biphosphonates are used for the treatment of hypercalcaemia as well as in normocalcaemic patients for the long-term inhibition of malignant osteolytic bone processes. In patients with multiple myelomas treated with biphosphonates in randomized studies a reduction of the number of new osteolytic foci was proved and improvement of the quality of life. The objective of the present study was to evaluate the effect of clodronat on the development of bone density in patients with multiple myeloma. In the study since 1993 27 patients were included. In August 1995 22 patients were evaluated who were treated for more than 12 months with clodronat (Bonefos Leiras). The patients were given clodronat in i.v. infusions (five infusions à 600 mg) in three-month intervals. After six-month intervals the amount of hydroxyapatite in the lumbar vertebrae was evaluated by CT densitometry. Statistical testing of trends of assessed bone density values revealed that not even after two years of the disease a statistically significant reduction of the bone density occurs. Treatment was very well tolerated, gastrointestinal problems were an exception. At the onset of the investigation three patients had symptoms of mild tetany, and a decline of the calcaemia below normal values was recorded. As soon as regular administration of calcium preparations was started during clodronat administration, the calcaemia did not decline below normal levels and enhanced neuromuscular irritability did not develop. Clodronat stabilizes the amount of bone mass, reduces pain and also improves the quality of the patients life. It should be included among standard treatment of patients with multiple myeloma.

Adult↗

PubMedDate not supplied

[Modification of bone quality by extreme physical stress. Bone density measurements in high-performance athletes using dual-energy x-ray absorptiometry].

The treatment of osteoporosis is still controversial. Rehabilitation programs which stress strengthening exercises as well as impact loading activities increase the bone mass. On the other side activity level early in life has not been proven to correlate with increased bone mineral content later in life. Little is known on the influence of high performance sports on the bone density especially in athletes with high demands on weight bearing of the spine. In (n = 40) internationally top ranked high performance athletes of different disciplines (n = 28 weight-lifters, n = 6 sports-boxers and n = 6 bicycle-racers) bone density measurements of the lumbar spine and the left hip were performed. The measurements were carried out by dual-photonabsorptiometry (DEXA; QDR 2000, Siemens) and evaluated by an interactive software-programme (Hologic Inc.). The results were compared to the measurements of 21 age-matched male control individuals. In the high performance weight lifters there was an increase of bone density compared to the control individuals of 23% in the Ward's triangle (p < 0.01). The sports-boxers had an increase up to 17% (lumbar spine), 9% (hip) and 7% (Wards' triangle). In the third athletes group (Tour de France-bikers) BMD was decreased 10% in the lumbar spine, 14% in the hip and 17% in the Wards' triangle. Our results show that training programs stressing axial loads of the skeletal system may lead to an increase of BMD in the spine and the hip of young individuals. Other authors findings, that the BMD of endurance athletes may decrease, is confirmed. Nevertheless the bikers BMD-loss of 10 to 17% was surprisingly high.

Absorptiometry, Photon↗

PubMedDate not supplied

[Bone density in children and adolescents with rheumatic diseases. Preliminary results of selective measurement of trabecular and cortical bone using peripheral computerized tomography].

UNLABELLED: Selective measurements of bone mineral density (BMD) of trabecular and cortical bone at the ultradistal radius were made in 27 children with rheumatic diseases and in age- and sex-matched healthy controls using peripheral quantitative computed tomography (pQCT). RESULTS: Mineral density of trabecular bone (-34,5%) and total bone mineral density (-18,9%) differed significantly between patients and controls (p < 0.01). BMD of the cortical bone (-13,6%) did not differ significantly between the groups. There was no difference in BMD in patients with systemic or non-systemic diseases. BMD did not correlate with duration of disease or steroid medication. CONCLUSIONS: Total bone mineral density and trabecular bone density are decreased in children and adolescents with sytemic and non-systemic rheumatic diseases. Age of onset of disease and steroid medication did not correlate with bone mineral density. PQCT has the advantages of low local and no total body radiation, high sensitivity, high reproducibility and selective measurement of different bone compartements. Because selective measurement can be made in metabolically active trabecular bone changes of BMD can be detected at an early stage before the whole bone is affected. With this method therapy for chronic diseases affecting bone density can be initiated and the course of the disease can be followed.

Adolescent↗

PubMedDate not supplied

Effects of raloxifene on bone density, biomarkers, and histomorphometric and biomechanical measures in ovariectomized cynomolgus monkeys.

OBJECTIVE: The purpose of this study was to determine the effect of raloxifene on bone density, strength, metabolism, and histomorphometric characteristics in ovariectomized cynomolgus monkeys. DESIGN: A prospective, longitudinal study was designed to examine the effects of conjugated equine estrogens (0.04 mg/kg, CEE) and raloxifene (1 or 5 mg/kg, R1 and R5, respectively) on bone density, biomarkers, histomorphometry, and strength. Control groups included ovariectomized and sham-operated monkeys. Treatment was initiated the day after ovariectomy and continued for 24 months. Bone biomarker data were collected at baseline and every 3 months after surgery. Bone mass was determined at baseline and every 6 months after ovariectomy. Iliac biopsies were collected at baseline and 16 months postovariectomy, and the second lumbar vertebra and left midshaft femur collected at necropsy were examined histomorphometrically. Bone biomechanical properties were determined for the right femur and vertebrae. RESULTS: Compared with the placebo-treated ovariectomized monkeys, the high-dose raloxifene group had lower levels of alkaline phosphatase, tartrate-resistant acid phosphatase, urinary CrossLaps (collagen degradation products), and greater bone mass in the lumbar vertebrae. In the endocortical compartment, the high-dose raloxifene group had significantly lower mineralizing surface, mineral apposition rate, and bone formation rate in the iliac biopsy collected at 16 months and lower bone formation rate in the second lumbar vertebra. Within the midshaft femur, low-dose raloxifene significantly decreased the osteonal and total bone formation rates and also prevented the decrease in Young's modulus induced by ovariectomy in the midshaft femur. CONCLUSIONS: High-dose raloxifene prevented the development of osteopenia in the ovariectomized monkey by reducing bone turnover, albeit to a lesser extent than CEE. Histomorphometric and biomarker data suggest that mechanisms underlying the effect of raloxifene differ somewhat from that of CEE.

Absorptiometry, Photon↗

PubMed2004

Effects of long-term intervention with Lactobacillus helveticus-fermented milk on bone mineral density and bone mineral content in growing rats.

BACKGROUND: Lactobacillus helveticus-fermented milk has been shown to increase calcium absorption compared to ordinary sour milk. In the present study the possible effect of L. helveticus-fermented milk on bone was studied in growing rats. METHODS: Spontaneously hypertensive male rats, which develop an osteoporotic bone disorder with age, were randomized into 5 groups (n = 10) receiving milk fermented with L. helveticus 16H and, as reference drinks, milk fermented with L. helveticus and Saccharomyces cerevisiae, sour milk, skim milk or water, for 14 weeks. After the intervention bone mineral density and bone mineral content were measured by dual-energy X-ray absorptiometry. The femur weight, length and volume were measured before ashing. From the ashes the weight and mineral content were assessed. RESULTS: As the body weight gain differed significantly between the groups, the results were related to the body weight. The L. helveticus-fermented milk intervention significantly increased the bone mineral density and bone mineral content compared to the sour milk, skim milk and water interventions. The mean values of the bone mineral density and bone mineral content were higher in the L. helveticus-fermented milk group compared to the Saccharomyces-fermented milk group but the difference was not statistically significant. CONCLUSION: L. helveticus-fermented milk increases bone mineral density and bone mineral content in relation to body weight in the long-term feeding of growing rats. The mechanism of L. helveticus remains to be discovered.

Absorptiometry, Photon↗

PubMed2002

Reference data for bone density and body composition measured with dual energy x ray absorptiometry in white children and young adults.

AIMS: To obtain normative data on bone mineral density and body composition measured with dual energy x ray absorptiometry (DXA) from early childhood to young adulthood. METHODS: Cross sectional results from 444 healthy white volunteers (4-20 years) in the Netherlands were combined with the results from 198 children who agreed to participate in the follow up study approximately four years later. DXA (Lunar, DPXL) of lumbar spine and total body was performed to assess bone density and body composition. RESULTS: Bone density and lean body mass (LBM) increased with age. Maximal increase in bone density and LBM occurred around the age of 13 years in girls and approximately two years later in boys. Bone density of total body and lumbar spine showed an ongoing slight increase in the third decade. Mean fat percentage in boys remained at 10.5% throughout childhood, but increased in girls. CONCLUSIONS: Most of the skeletal mass in lumbar spine and total body is reached before the end of the second decade, with a slight increase thereafter. This study provides reference values for bone density and body composition measured with DXA for children and young adults.

Absorptiometry, Photon↗

PubMed1989

Effects of tamoxifen on spinal bone density in women with breast cancer.

Bone densitometry (L2-L4) was performed on 10 postmenopausal women with breast cancer after 0, 6, and 12 months of tamoxifen treatment; the results were compared with data from 10 normal controls. The patients and controls differed significantly at 6 (P less than .05) and 12 (P less than .003) months. The tamoxifen group showed a nonsignificant mean gain in bone mineral density after 6 and 12 months of treatment (+0.024 +/- 0.014 and +0.022 +/- 0.018 g/cm2, respectively), whereas the controls showed a nonsignificant mean loss of bone mass at 6 months (-0.012 +/- 0.018 g/cm2) and a statistically significant loss of bone density after 12 months (-0.024 +/- 0.01 g/cm2). These preliminary data suggest that tamoxifen use is associated with preservation of bone mass during the first year of treatment.

Aged↗

PubMed2002

Longitudinal follow-up of bone density and body composition in children with precocious or early puberty before, during and after cessation of GnRH agonist therapy.

We studied bone mineral density (BMD), bone metabolism, and body composition in 47 children with central precocious puberty (n = 36) or early puberty (n = 11) before, during, and after cessation of GnRH agonist. Bone density and body composition were measured with dual energy x-ray absorptiometry and expressed as SD scores. Bone age and biochemical parameters of bone turnover were assessed. Measurements were performed at baseline, after 6 months, and on a yearly basis thereafter. Mean lumbar spine BMD SD scores for chronological age were significantly higher than zero at baseline and decreased during treatment. Lumbar spine bone mineral apparent density and total body BMD did not differ from normal at baseline and showed no significant changes during treatment. In contrast, BMD SD scores for bone age were significantly lower than zero at baseline and at cessation of therapy. Two years after therapy, bone mineral apparent density and BMD SD scores for bone age and chronological age did not differ from normal. Markers of bone turnover decreased during treatment, mainly in the first 6 months. Patients had increased percentage of fat and lean body mass at baseline. After an initial increase of percentage body fat during treatment, percentage body fat decreased and normalized within 1 yr after cessation of treatment. Our longitudinal analysis suggests that peak bone mass or body composition will not be impaired in patients with precocious or early puberty after GnRH agonist therapy.

Aging↗

PubMed1997

Cigarette smoking, sex hormones and bone density in women.

It is known that among women over the age of 65, bone mineral density is lower, and the risk of hip fracture higher, in smokers than non-smokers. We report a study in 1334 health pre- and post-menopausal women aged 35-64 years, to determine whether this effect can be attributed to lower oestrogen levels in smokers. Among 676 premenopausal women forearm bone density was no lower in smokers (95% confidence interval 1% lower, 4% higher). Among 543 postmenopausal women who had not used hormone replacement therapy (HRT) for more than a year there was no statistically significant difference, but the lower confidence interval was consistent with a lower bone density in older smokers (by 8% at age 55-59, 16% at age 60-64). Measurements in 194 postmenopausal women not taking HRT showed that oestrone and oestradiol were similar in smokers and non-smokers, as were cortisol and FSH, LH and prolactin. Meta-analysis of the present study and previous studies confirmed significantly higher levels in smokers of the androgens DHEAS (by 37%) and androstenedione (by 34%). Oestrogens were no lower in smokers, and the lower confidence limit excluded more than a trivial effect of smoking in lowering oestrogen. These results indicate that the recognised lower bone density in elderly smokers cannot be explained by an effect of smoking on oestrogen, since in premenopausal women bone density is no lower in smokers and in postmenopausal women oestrogens are no lower in smokers. The data suggest a balance between higher androgen levels but lower rates of conversion of androgens to oestrogens in smokers. The effect of smoking on bone may be due to impaired response of bone and other target organs to oestrogen, or to actions independent of oestrogen.

Adult↗

PubMed1997

Reduced bone density in patients with inflammatory bowel disease.

BACKGROUND: Reduced bone mineral density in patients with inflammatory bowel disease is thought to be due to disturbances in calcium homeostasis or the effects of corticosteroid treatment. AIMS: To assess the prevalence and mechanism of reduced bone mineral density in 79 patients with inflammatory bowel disease (44 with Crohn's disease, 35 with ulcerative colitis) who did not have significant risk factors for low bone densities. METHODS: Dual x ray absorptiometry was used to measure bone mineral density and serum and urinary markers of osteoblast (alkaline phosphatase, procollagen 1 carboxy terminal peptide and osteocalcin) and osteoclast (pyridinoline, deoxypyridinoline, and type 1 collagen carboxy terminal peptide) activities to assess bone turnover. RESULTS: There was a high prevalence of low bone mineral density (prevalence of T scores < -1.0 from 51%-77%; T scores < -2.5 (osteoporosis) from 17%-28%) with hips being more often affected than vertebrae (p < 0.001). Reduced bone mineral density did not relate to concurrent or past corticosteroid intake, or type, site, or severity of disease. Whereas calcium homeostasis was normal, bone markers showed increased bone resorption without a compensatory increase in bone formation. CONCLUSIONS: The greater prevalence of reduced hip bone mineral density, as opposed to vertebral, mineral density and the pattern of a selective increase in bone resorption contrasts with that found in other known causes of metabolic bone disease.

Absorptiometry, Photon↗

PubMed2003

Image processing and analysis program for measurement of bone density changes in reference and follow-up standardized extraoral oblique lateral cephalometric radiographs of the mandible.

OBJECTIVES: The aim of this study was to develop an image processing and analysis program for peri-implant bone density measurements of the mandible using extraoral radiographs, which includes a correction for the variable projection of the soft tissues of the face. METHODS: The measurement procedure is based on pairs of reference and follow-up extraoral oblique lateral cephalometric radiographs (OLCRs) of patients with endosseous implants in the anterior part of the atrophic edentulous mandible. The procedure consists of image acquisition, correction for radiographic variation using an aluminium wedge (i.e. film exposure and development) and transformation of the grey values into aluminium-equivalent values. After correction for variation in the projection of the soft tissues of the face using internal calibration fields, the actual peri-implant bone density measurements are performed. RESULTS: The soft tissue projection correction significantly reduces the variation between radiographs owing to the position of the soft tissues. CONCLUSIONS: It is concluded that the described image processing and analysis program, in combination with extraorally made OLCRs, is a valuable technique for measurement of peri-implant bone density changes of the mandible. With minor adaptations, the program can be used for other semi-edentulous patients.

Absorptiometry, Photon↗

PubMed1990

Importance of measurement of bone density in the management of osteoporosis.

Bone mass is the primary, although not the only, determinant of fracture. Over the past few years a number of noninvasive techniques have been developed to more sensitively quantitate bone mass. These include radiogrammetry (RG) and radiographic photodensitometry (RD), single and dual photon absorptiometry (SPA and DPA), quantitative computed tomography (QCT), and single and dual-energy X-ray absorptiometry (SEXA and DEXA). These techniques provide bone mass quantitation at the spine, wrist, hip and total body skeletal sites that are the principal areas usually involved in osteoporosis. The evaluation of the aetiology, progression, and treatment of osteoporosis has been clearly improved with the use of these methods. It is the intent of this review to discuss the pros and cons of these techniques, in particular their applications to the detection and management of osteoporosis.

Absorptiometry, Photon↗

PubMed2003

Areal and volumetric bone density in Hong Kong Chinese: a comparison with Caucasians living in the United States.

It is a common perception that Asians have lower bone density than Caucasians. However, such relationships could be confounded by bone size. In this study, the skeletal status of a convenience sample of 482 men and 887 women living in Hong Kong is compared with published data for Caucasians living in Rochester, Minnesota. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for the lumbar spine and proximal femur, using the Hologic QDR 2000 instrument. Cross-calibration was performed by measuring a common phantom, and the Hong Kong data were adjusted by a multiplication factor. Lumbar spine and femoral neck BMD and BMAD of Chinese men and women were all significantly lower ( P<0.001 by t-test) than those of Caucasians, but the differences in BMAD were on average only about half the size of the differences in BMD. For instance, in postmenopausal Chinese women, BMD at the femoral neck and lumbar spine were 15.2% and 18.8% lower respectively, but BMAD at the femoral neck and lumbar spine were only 7.8% and 12.4% lower respectively. Similar trends were observed in men. After adjusting for age, body height and weight, the difference in BMAD between Caucasians and Chinese was further reduced and only statistically significant among postmenopausal women and among men younger than age 50 years for the lumbar spine. For instance, the adjusted BMAD in postmenopausal Chinese women at the femoral neck and lumbar spine were 3.9% ( P=0.03 by ANCOVA) and 7.3% ( P<0.001 by ANCOVA) lower respectively, while the adjusted BMAD at the lumbar spine for Chinese men younger than 50 years was 11.7% lower ( P<0.01 by ANCOVA). Predictors of BMAD in Hong Kong Chinese women include body weight, age at menarche, cigarette smoking, and oral contraceptive use ( P<0.001), while body weight was the only independent predictor of BMAD in Hong Kong Chinese men ( P<0.001). We conclude that bone density is lower in Hong Kong Chinese men and women than in Caucasians, although such differences were attenuated by adjustments for bone size, body weight and height.

Adult↗