TY - JOUR
T1 - Rural versus nonrural differences in BMC, volumetric BMD, and bone size
T2 - A population-based cross-sectional study
AU - Specker, Bonny
AU - Binkley, Teresa
AU - Fahrenwald, Nancy
PY - 2004/12
Y1 - 2004/12
N2 - Despite reports of lower fracture risk among rural versus urban populations, few studies have investigated rural versus urban differences in bone mineral content (BMC) and bone mineral density (BMD). Population differences in cross-sectional bone geometry and understanding lifestyle factors responsible for these differences may reveal insights into the reason for differences in fracture risk. We hypothesized that if lifestyle differences in bone mass, size, and geometry are a result of muscle strength, activity, or dietary differences, Hutterite and rural populations should have greater bone mass compared to nonrural populations. The study population consisted of 1189 individuals: 504 rural Hutterites (188 men), 349 rural individuals (>75% life farming, 184 men), and 336 nonrural individuals (never lived on farm, 134 men) aged 20 to 66 years. BMC, bone area, and areal BMD (aBMD) of the total body (TB), hip, femoral neck (FN), and spine by DXA; volumetric BMD (vBMD) and bone geometry at the 4% and 20% radius; polar stress strain index (pSSI), a measure of bone strength, at the 20% pQCT site; and strength, 7-day activity recall, and 24-h diet recall were collected and compared among groups. Hutterite women and men had greater grip strength compared to rural and nonrural populations (both, P < 0.001). Rural women had greater activity versus Hutterite and nonrural (P < 0.001), while both Hutterite and rural men had greater activity than nonrural (P < 0.001). Hutterite and rural populations tended to have greater BMC and areal size than the nonrural population, while Hutterites had greater BMC and areal size than rural population at some (TB, FN for females only), but not all (proximal hip), sites. Cortical vBMD was inversely associated with periosteal circumference at the 20% radius in women (r = -0.25, P < 0.001) and men (r = -0.28, P < 0.001) and was higher in nonrural versus Hutterite and rural men. Hutterite and rural women and men had greater pSSI at the 20% radius compared to nonrural; inclusion of strength measurements explained population differences among women, but not men. Lifestyle differences did not explain population differences in BMC, aBMD, vBMD, or bone size.
AB - Despite reports of lower fracture risk among rural versus urban populations, few studies have investigated rural versus urban differences in bone mineral content (BMC) and bone mineral density (BMD). Population differences in cross-sectional bone geometry and understanding lifestyle factors responsible for these differences may reveal insights into the reason for differences in fracture risk. We hypothesized that if lifestyle differences in bone mass, size, and geometry are a result of muscle strength, activity, or dietary differences, Hutterite and rural populations should have greater bone mass compared to nonrural populations. The study population consisted of 1189 individuals: 504 rural Hutterites (188 men), 349 rural individuals (>75% life farming, 184 men), and 336 nonrural individuals (never lived on farm, 134 men) aged 20 to 66 years. BMC, bone area, and areal BMD (aBMD) of the total body (TB), hip, femoral neck (FN), and spine by DXA; volumetric BMD (vBMD) and bone geometry at the 4% and 20% radius; polar stress strain index (pSSI), a measure of bone strength, at the 20% pQCT site; and strength, 7-day activity recall, and 24-h diet recall were collected and compared among groups. Hutterite women and men had greater grip strength compared to rural and nonrural populations (both, P < 0.001). Rural women had greater activity versus Hutterite and nonrural (P < 0.001), while both Hutterite and rural men had greater activity than nonrural (P < 0.001). Hutterite and rural populations tended to have greater BMC and areal size than the nonrural population, while Hutterites had greater BMC and areal size than rural population at some (TB, FN for females only), but not all (proximal hip), sites. Cortical vBMD was inversely associated with periosteal circumference at the 20% radius in women (r = -0.25, P < 0.001) and men (r = -0.28, P < 0.001) and was higher in nonrural versus Hutterite and rural men. Hutterite and rural women and men had greater pSSI at the 20% radius compared to nonrural; inclusion of strength measurements explained population differences among women, but not men. Lifestyle differences did not explain population differences in BMC, aBMD, vBMD, or bone size.
KW - Bone density
KW - Bone strength
KW - Diet and bone
KW - Epidemiology
KW - Exercise and bone
UR - http://www.scopus.com/inward/record.url?scp=13844317755&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=13844317755&partnerID=8YFLogxK
U2 - 10.1016/j.bone.2004.09.005
DO - 10.1016/j.bone.2004.09.005
M3 - Article
C2 - 15589221
AN - SCOPUS:13844317755
SN - 8756-3282
VL - 35
SP - 1389
EP - 1398
JO - Bone
JF - Bone
IS - 6
ER -