The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55348

Nina S. Wampler, DSc, MPH, Division of American Indian and Alaska Native Programs, Department of Psychiatry, University of Colorado Health Sciences Center, PO Box 6508, Mail Stop F800, Nighthorse Campbell Native Health Building, Aurora, CO 80045-0508, 781-275-4391, nina.wampler@uchsc.edu, Clemma Jacobsen, MS, Department of Internal Medicine, University of Washington, 325 Ninth Ave, Box 359780, Harborview Medical Center, Seattle, WA 98104, Jeffrey A. Henderson, MD, MPH, Black Hills Center for American Indian Health, 701 St. Joseph St., Suite 204, Rapid City, SD 57701, Zhao Chen, PhD, MPH, Epidemiology and Biostatistics Division, University of Arizona, 2501 E. Lee St., College of Public Health, Tucson, AZ 85716, Barbara V. Howard, PhD, Medstar Research Institute, 6495 New Hampshire Ave, Suite 201, Hyattsville, MD 20783, and Jacques E. Rossouw, MBChB, FCP(SA), Women's Health Initiative, National Heart, Lung, and Blood Institute, 6705 Rockledge Drive, Suite 300, MSC-7966, Bethesda, MD 20892-7966.

This cross-sectional study compared mean bone mineral density in postmenopausal American Indian /Alaska Native women with a random sample of non-Hispanic White women matched on geographic region in the Women’s Health Initiative Study, a prospective study of postmenopausal women. We analyzed baseline bone mineral density measurements made by dual energy X-ray absorptiometry for total hip, spine, and whole body from 139 American Indian /Alaska Native women and 1431 non-Hispanic White women. The prevalence of osteoporosis was 3.4% for American Indian /Alaska Native women and 5.9% (p = 0.22) for non-Hispanic White women. We found significant interaction of race by body mass index on spine (p = 0.003) and whole body (p = 0.0003) bone mineral density. Controlling for body mass index, age, education, and years of hormone replacement therapy, adjusted mean bone mineral density was similar among women who were underweight, normal or obese. Overweight American Indian/Alaska Native women had slightly lower adjusted mean whole body and spine bone mineral density than overweight non-Hispanic White women: whole body 0.97 vs. 1.03 g/cm² (p = 0 .02) and spine 0.96 vs. 1.03 g/cm² (p = 0.001). Among extremely obese women, adjusted mean total hip bone mineral density was significantly higher in the American Indian/Alaska Native women (1.07 vs. 0.97 g/cm², respectively, p = 0.03). In conclusion, extremely obese American Indian/Alaska Native women may be at lower risk for low bone mineral density and osteoporosis than extremely obese non-Hispanic White women.

Learning Objectives:

At the conclusion of the session, the participant in this session will able to:
• Assess osteoporosis and unadjusted bone mineral density in postmenopausal American Indian/Alaska Native women compared to postmenopausal non-Hispanic White women.
• Articulate the effect of body mass index on adjusted bone mineral density differences between postmenopausal American Indian/Alaska Native women and postmenopausal non-Hispanic White women.
• Assess the potential impact of the findings of bone mineral density differences by body mass index group on recommended osteoporosis screening.

Keywords: Native Americans, Women's Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Women's Health Initiative is a national prospective study of postmenopausal women designed to assess health outcomes such as cardiovascular disease, cancer, and osteoporosis over a 15 year follow-up period.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.