The association of bone density and hip fracture risk among Asian women
Authors' conclusion
Among Asian and NHW women, each unit reduction in FN-T-score was associated with ≥ two-fold higher risk of hip fracture that varied by ethnicity. Accounting for T-score differences, Asian women had lower hip fracture risk than NHW women.
Study context
- Population
- Women aged 60–89 years with femoral neck (FN) bone mineral density (BMD) measured in 2000–2019 without prior osteoporosis treatment
- Participants
- 54,294 vs 219,585
- Exposure
- Asian/PI vs non-Hispanic White (NHW) women; hip fracture risk per unit decline in FN BMD T-score
- Asian/PIn = 54,294
- NHWn = 219,585reference
- Outcome
- Incident hip fracture: BMD T-score risk gradient
- Follow-up
- five-year follow-up
Methodological detailsCox proportional hazard models, adjusted for age and time-updated osteoporosis therapy
- Cox proportional hazard models
- Adjusted for age and time-updated osteoporosis therapy
Main finding
As reported in the abstract
Hip fracture per unit T-score reduction
| Group | aHR per unit T-score reduction |
|---|---|
| NHW | 2.11 [2.03-2.20] |
| Chinese | 2.84 [2.11-3.82] |
| Japanese | 2.69 [2.01-3.60] |
| Filipina | 2.22 [1.67-2.97] |
| South Asian | 2.18 [1.19-3.99] |
aHR per unit T-score reduction
NHW2.11 [2.03-2.20]
Chinese2.84 [2.11-3.82]
Japanese2.69 [2.01-3.60]
Filipina2.22 [1.67-2.97]
South Asian2.18 [1.19-3.99]
Observational data: associations, not effects.
Further findings
FN T-score ≤ −2.5 (osteoporosis)
Hip fracture incidence · five-year follow-up
| Outcome | aHR |
|---|---|
| Hip fracture, Asian vs NHW (adjusted for age, T-score, therapy)Chinese, Filipina vs NHW · some attenuation after height adjustment | 0.2-0.3 |
| Hip fracture, Asian vs NHW (adjusted for age, T-score, therapy)Japanese, South Asian vs NHW · some attenuation after height adjustment | 0.4-0.6 |
- FN T-score ≤ −2.5 (osteoporosis): Native Hawaiian/PI 12.6%
- FN T-score ≤ −2.5 (osteoporosis): South Asian 17.4%
- FN T-score ≤ −2.5 (osteoporosis): Chinese, Filipina, Korean 22-23%
- FN T-score ≤ −2.5 (osteoporosis): Japanese 26.7%
- FN T-score ≤ −2.5 (osteoporosis): Vietnamese 30.5%
Original publication
The association of bone density and hip fracture risk among Asian women. Osteoporos Int. Published 22 October 2025. doi:10.
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