Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct;21(5):592-608.
doi: 10.1007/s11914-023-00805-7. Epub 2023 Aug 5.

Osteoporosis and Fracture Risk among Older US Asian Adults

Joan C Lo  1   2   3 , Wei Yang  4   5 , Jennifer J Park-Sigal  4   6 , Susan M Ott  7
Affiliations
Review

Osteoporosis and Fracture Risk among Older US Asian Adults

Joan C Lo et al. Curr Osteoporos Rep. 2023 Oct.

Abstract

Purpose of review: This review summarizes the current knowledge regarding osteoporosis and fracture among older US Asian adults.

Recent findings: Asian adults have lower (areal) bone density than non-Hispanic White adults and thus are more likely to be diagnosed and treated for osteoporosis, despite their lower risk of hip fracture. The latter may relate to favorable characteristics in hip geometry, volumetric bone density, and bone microarchitecture; lower risk of falls; and other clinical factors. The fracture risk calculator FRAX accounts for the lower risk of hip fracture among US Asian adults. However, data on major osteoporotic fracture risk remain limited. Fracture rates also vary by Asian subgroup, which may have implications for fracture risk assessment. Furthermore, among women receiving bisphosphonate drugs, Asian race is a risk factor for atypical femur fracture, an uncommon complication associated with treatment duration. Recent clinical trial efficacy data pertaining to lower bisphosphonate doses and longer dosing intervals may be relevant for Asian adults. More research is needed to inform osteoporosis care of US Asian adults, including risk-benefit considerations and the optimal duration of bisphosphonate treatment. Greater evidence-based guidance for primary fracture prevention among US Asian adults will ensure health equity in the prevention of osteoporotic fractures.

Keywords: Asian race; Ethnicity; Fracture; Health equity; Osteoporosis; Risk assessment.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest:

Joan Lo reports funding from the National Institute on Aging at the National Institutes of Health. The authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Change in the percentage of Chinese women with T-score ≤−2.5 when bone mineral density T-score is calculated using US Chinese reference data compared to US Non-Hispanic White (NHW) reference data. A much lower percentage of Chinese women are classified with bone mineral density (BMD) T-score ≤ −2.5 when a US Chinese BMD reference [48] is used for T-score calculation compared to the NHW BMD reference [43,48,49]. Figure redrawn from reference (Lo JC, et al. Applying ethnic-specific bone mineral density T-scores to Chinese women in the USA. Osteoporos Int. 2016; 27:3477–3484) with permission.
See this image and copyright information in PMC

References

    1. Budiman A, Ruiz NG. Key facts about Asian Americans, a diverse and growing population. April 29, 2021. Pew Research Institute, Washington, DC. https://www.pewresearch.org/fact-tank/2021/04/29/key-facts-about-asian-a... (accessed May 25, 2023).
    1. Budiman A, Ruiz NG. Asian Americans are the fastest-growing racial or ethnic group in the U.S. April 9, 2021. Pew Research Institute, Washington, DC. https://www.pewresearch.org/fact-tank/2021/04/09/asian-americans-are-the... (accessed May 25, 2023).
    1. Carlson AW. One century of foreign immigration to the United States: 1880–1979. Int Migr. 1985;23(3):309–34. 10.1111/j.1468-2435.1985.tb00322.x - DOI - PubMed
    1. Zong J, Batalova J. Frequently requested statistics on immigrants and immigration in the United States. Migration Immigration Source. March 8, 2017. Migration Policy Institute, Washington, DC. http://www.migrationpolicy.org/print/15856#.WPJLepqgu5s (accessed May 25, 2023).
    1. Largest U.S. Immigrant Groups over Time, 1960-Present. Migration Policy Institute, Washington, DC. https://www.migrationpolicy.org/programs/data-hub/charts/largest-immigra... (accessed May 25, 2023).

Publication types