Racial diversities in lifespan bone mass: findings from the China BCL Study and US NHANES

Bone mass at different life stages is instrumental for developing effective, long-term osteoporosis prevention strategies.

We aimed to investigate the developmental patterns of bone mass across the entire lifespan among the Chinese population and to compare these patterns with those of different racial groups, including Whites, Blacks and Mexicans in the US population.

A population-based study.

Our study analyzed data from the China Body Composition Life-course (2013-2023) Study and the United States National Health and Nutrition Examination Survey (2005-2018). We measured bone mineral content (BMC) and density (BMD) using dual-energy X-ray absorptiometry at various anatomical sites, including the whole-body (WB), lumbar spine, total hip and femoral neck.

In the Chinese population, WB BMC and BMD increased rapidly during childhood and adolescence, with males and females achieving approximately 90.6% and 95.7% of their respective peak bone mass. Peak bone mass for WB, total hip and femoral neck BMC/BMD occurred generally between the ages of 21 and 30, whereas the lumbar spine BMD peak occurred approximately a decade later. After reaching the peak, a gradual bone loss was observed from ages 30 to 40, with an acceleration post age 40, especially in females. Comparative analyses indicated that Chinese individuals exhibited the lowest bone mass levels and accrual rates over their lifespan, followed successively by Whites, Mexicans and Blacks.

By exploring bone mass changes and racial disparities among the Chinese and US populations, this study emphasizes the need for establishing sex- and ethnic-specific public health strategies to prioritize bone health throughout the entire life course.