However, the possible genetic influence on the Belnacasan molecular weight difference among Asian groups should also be considered. Consistent with the report of Hill et al. [20], Afro-Caribbean men had 10–11% higher hip BMD than African-American men. Hill et al. [20] suggested two possible explanations for higher BMD in Afro-Caribbean men: Firstly, the proportion of European admixture Ipatasertib (25%) among African-American men is more than in Tobago (6%); secondly, Tobago people have more weight-bearing activities due to the lack of

industrialization than US people. As shown in Table 2, there was no change of the difference in BMD among both African origin groups before and after additional adjustment for lifestyle factors including walking. Considering this, it is thought that the proportion of European admixture is more responsible for the difference than weight-bearing activities. The difference in BMD between US Caucasian men vs Asian groups may be explained to a great extent by body size [13, 16], although additional factors may also contribute. Body size has two kinds of implications for

BB-94 BMD. First, it has weight-bearing effects. The range of weight is quite different between Asian and non-Asian groups. Second, height and weight may in part correct for the confounding effect caused by bone size difference between both groups. In previous studies [16, 17], bone mineral apparent density (BMAD) measurements have been used to correct for the differences in bone size. However, recent evidence [37] suggests that BMAD may not address bone size differences appropriately when race/ethnic

Cyclic nucleotide phosphodiesterase groups differ in body size. Moreover, there has been no evidence that estimates of BMAD improve fracture prediction more than using BMD [38]. US Hispanic and US Caucasian men had similar total hip BMD regardless of body size. Travison et al. [15] also showed the similarity in femoral neck BMD between both race/ethnic groups, but NHANES III reported 4.9–5.8% higher femoral neck BMD at age 60–69 and 70–79 in Hispanic men than White men. The lack of clear-cut Hispanic-White differences in BMD may reflect the diversity among Hispanic subpopulations due to differences in admixture and acculturation [15]. There are several limitations to our study. Firstly, due to the smaller number of US Hispanic and US Asian men, we had limited power to find statistically significant differences between these groups and Caucasian men. Secondly, since South Korean subjects were from one area in South Korea, BMD value of this group could be biased from the general Korean populations. However, our South Korean group is very similar in major characteristics to the same aged group from the Korea NHANES, a national health survey. The absolute difference is only 1.1 cm in height, 0.1 kg in weight, and 0.2% in the proportion of current smokers between the Namwon Study and Korea NHANES 2007, and 0.