Racial and Ethnic Differences in Bone Mass in Pediatric Populations: A Systematic Review

OBJECTIVES: The purpose of this study was to summarize the evidence regarding possible differences in areal bone mineral density (aBMD) and bone mineral content (BMC) across racial and ethnic groups of children and adolescents. METHODS: A systematic review was conducted using five electronic databases, supplemented by complementary searches of reference lists. Studies should have used dual-energy x-ray absorptiometry to assess bone mass in children and adolescents (aged ≤ 19 years) with no special clinical conditions. RESULTS: Of the 1791 articles initially identified, 26 were included. Whites had lower aBMD/BMC than Blacks in 60.2% (47/78) of the analyzed results. In racial/ethnic groups that did not include Blacks, aBMD/BMC values were lower when compared to Blacks or ethnic groups that included Blacks in 80.0% (8/10) of possible results. Most findings indicated a paucity of evidence regarding differences in aBMD/BMC between Whites and Asians, Pacific Islanders, Hispanics, and Mexican-Americans (percentage of results ≤ 50.0%). CONCLUSIONS: Based on the findings, it can be concluded that White children and adolescents have lower bone mass values compared to their Black peers. Racial and ethnic groups that do not include Black individuals also exhibit lower bone mass values compared to Black children and adolescents. Additionally, there appears to be no difference in bone mass between White children and adolescents and their Asian, Pacific Islander, Hispanic, and Mexican-American counterparts.