Effects of age and occupation on cortical bone in a group of 18th-19th century British men

Exploring radiogrammetry beyond the second metacarpal: Using the third, fourth, and fifth metacarpals to quantify cortical bone

OBJECTIVE

Traditional metacarpal radiogrammetry, a method for quantifying cortical bone in metacarpals to identify bone loss, typically relies on the presence of an unaltered or undamaged second metacarpal. This study compares the cortical indices of the second to the third, fourth, and fifth metacarpals to test if an additional metacarpal can be used as substitute when the second metacarpal is not available for study.

METHODS

Hand and wrist radiographs from the Burlington Growth Study, belonging to 56 individuals (28 females; 28 males) between 18 and 20 years old, were included in this study. Cortical indices were calculated for metacarpals two through five. Cortical index differences were statistically compared by sex, and the second metacarpal cortical indices were correlated with those of the third, fourth, and fifth metacarpals.

RESULTS

The third, fourth, and fifth metacarpal cortical indices were all significantly correlated with the second metacarpal cortical indices for both females and males (p < .05). Cortical indices of the second metacarpal were most strongly correlated with those of the third metacarpal (females r = .644, p < .001; males r = .643, p < .001).

CONCLUSION

The results of this study indicate that the third, fourth, or fifth metacarpal may serve as substitutes for cortical index analyses when the second metacarpal is unavailable or unsuitable for analysis. While the second metacarpal should remain the primary choice in radiogrammetry analyses, the third metacarpal is the most suitable alternative for quantitative analyses of cortical bone.

Approaches to osteoporosis in paleopathology: How did methodology shape bone loss research?

OBJECTIVE

This paper will review how different methods employed to study bone loss in the past were used to explore different questions and aspects of bone loss, how methodology has changed over time, and how these different approaches have informed our understanding of bone loss in the past.

MATERIALS AND METHODS

A review and discussion is conducted on research protocols and results of 84 paleopathology publications on bone loss in archaeological skeletal collections published between 1969 and 2021.

CONCLUSIONS

The variety in research protocols confounds accurate meta-analysis of previously published research; however, more recent publications incorporate a combination of bone mass and bone quality based methods. Biased sample selection has resulted in a predominance of European and Medieval publications, limiting more general observations on bone loss in the past. Collection of dietary or paleopathological covariables is underemployed in the effort to interpret bone loss patterns.

SIGNIFICANCE

Paleopathology publications have demonstrated differences in bone loss between distinct archaeological populations, between sex and age groups, and have suggested factors underlying observed differences. However, a lack of a gold standard has encouraged the use of a wide range of methods. Understanding how this array of methods effects results is crucial in contextualizing our knowledge of bone loss in the past.

LIMITATIONS

The development of a research protocol is also influenced by available expertise, available equipment, restrictions imposed by the curator, and site-specific taphonomic aspects. These factors will likely continue to cause (minor) biases even if a best practice can be established.

SUGGESTIONS FOR FUTURE RESEARCH

Greater effort to develop uniform terminology and operational definitions of osteoporosis in skeletal remains, as well as the expansion of time scale and geographical areas studied. The Next-Generation Sequencing revolution has also opened up the possibility of ancient DNA analyses to study genetic predisposition to bone loss in the past.

Ontogenetic changes to bone microstructure in an archaeologically derived sample of human ribs

There is considerable variation in the gross morphology and tissue properties among the bones of human infants, children, adolescents, and adults. Using 18 known-age individuals (n_female  = 8, n_male  = 9, n_unknown  = 1; birth to 21 years old), from a well-documented cemetery collection, Spitalfields Christ Church, London, UK, this study explores growth-related changes in cortical and trabecular bone microstructure. Micro-CT scans of mid-shaft middle thoracic ribs are used for quantitative analysis. Results are then compared to previously quantified conventional histomorphometry of the same sample. Total area (Tt.Ar), cortical area (Ct.Ar), cortical thickness (Ct.Th), and the major (Maj.Dm) and minor (Min.Dm) diameters of the rib demonstrate positive correlations with age. Pore density (Po.Dn) increases, but age-related changes to cortical porosity (Ct.Po) appear to be non-linear. Trabecular thickness (Tb.th) and trabecular separation (Tb.Sp) increase with age, whereas trabecular bone pattern factor (Tb.Pf), structural model index (SMI), and connectivity density (Conn.D) decrease with age. Sex-based differences were not identified for any of the variables included in this study. Some samples display clear evidence of diagenetic alteration without corresponding changes in radiopacity, which compromises the reliability of bone mineral density (BMD) data in the study of past populations. Cortical porosity data are not correlated with two-dimensional measures of osteon population density (OPD). This suggests that unfilled resorption spaces contribute more significantly to cortical porosity than do the Haversian canals of secondary osteons. Continued research using complementary imaging techniques and a wide array of histological variables will increase our understanding of age- and sex-specific ontogenetic patterns within and among human populations.

The influence of bone loss on the three adult age markers of the innominate

To evaluate the influence of bone loss on the three adult age markers of the innominate, 30 males and 30 females aged between 16 and 80 years coming from the British Coventry collection were analyzed. The pubic symphysis, auricular surface, and acetabulum age variables were evaluated following the descriptions of Schmitt, Buckberry-Chamberlain, and Rissech, respectively. The second metacarpal cortical index was used to evaluate bone loss. Possible sexual differences in metrical variables were explored by a Student t-test taking into account the entire sample. The possible relationships between the cortical index and the three age methods' stages were assessed by the Kruskall-Wallis test and Spearman's correlation coefficient. There were no sexual differences in the cortical index. In general, we observed no significant differences between the cortical index in the different stages of the pubic symphysis, auricular surface, or acetabulum variables in men and women. Most correlation coefficients are negatives, and their absolute values are between 0.001 and 0.44, indicating an extremely low influence of bone loss on the analyzed variables. Our findings suggest little influence of bone loss in the three ageing methods. However, further research on this topic is necessary. This is the first study to analyze the influence of bone loss in the ageing changes undergone by the variables of the three adult age indicators of the innominate taking into account both sexes.

Occupation-dependent loading increases bone strength in men

SUMMARY

Ex vivo analyses of humeri and radii from an anthropological collection and in vivo analyses of the distal radius of retired men indicate that occupation-dependent loading positively influences bone strength by an increase of bone size when young followed by a slowdown of the age-related endocortical and trabecular bone alteration.

INTRODUCTION

Skeleton responds to mechanical stimuli, but it is not established whether chronic loading in the context of occupational activities (OA) influences bone properties. We assessed the impact of occupation-dependent loading on upper limb bone strength.

METHODS

Individuals were classified according to the intensity of physical loading associated with their OA in two models. Ex vivo, computed tomography scans of the humeri and radii of 219 male skeletons (age of death, 20-93 years) from an anthropological collection of the 20th century (Simon collection) were used to determine estimates of bone strength and cross-sectional geometry. In vivo, distal radius were analysed in 180 men enrolled in the Geneva Retirees Cohort study using high-resolution peripheral quantitative computed tomography and finite element analysis.

RESULTS

Heavy-loading OA was associated with higher bone strength in both models. This benefit was associated with higher total area (Tt.Ar), medullary area (Me.Ar) and cortical area (Ct.Ar) in young adult skeletons, but the difference decreased in older age. In older men, the humerus supporting heavy loading had a lower Me.Ar. This effect resulted in greater asymmetries of the Me.Ar and the Ct.Ar/Tt.Ar ratio between the humeri of men with unilateral versus bilateral heavy-loading OA. In vivo, an additional benefit of heavy-loading OA was observed on the distal radius trabecular density and microstructure.

CONCLUSION

Repeated occupation-dependent loading positively influences bone strength by an increase of bone size when young followed by a slowdown of the age-related endocortical and trabecular bone alteration. These data supports the necessity to promote bone health in the context of sedentary occupation.

Bone-formers and bone-losers in an archaeological population

Objectives

Recent biomedical research suggests that, in modern human populations, individuals may vary in their inherent tendency toward bone formation at skeletal and extra‐skeletal locations. However, the nature of this phenomenon is incompletely understood, and the extent to which it might apply to past populations is unclear. It is hypothesized that if there is inter‐individual variation in some overall tendency toward bone formation in skeletal and extra‐skeletal sites then there should be a positive relationship between ligamentous ossification and thickness of cortical bone. This work is a test of this hypothesis in an archaeological population.

Materials and Methods

The study material comprises adult skeletons (N = 137 individuals) of documented age at death from 18th to 19th century London. It examines the relationship between bone deposition in the anterior longitudinal ligament (ALL) in the thoracic spine and cortical index (CI) at the metacarpal measured by radiogrammetry.

Results

Controlling for the potential confounders age, sex, skeletal completeness, occupation (males) and parity (females), there was a positive association between ossification into the ALL and CI. This reflects lesser medullary cavity width in those showing ALL ossification.

Discussion

Ligamentous ossification in the axial skeleton and peripheral cortical bone status are linked, individuals with ALL ossification showing lesser resorption of cortical bone at the endosteal surface. This is consistent with the idea of inter‐individual variation in some general bone‐forming/bone‐losing tendency in this 200 year old study population, but there was no evidence of a link between ALL ossification and increased skeletal subperiosteal bone deposition. Am J Phys Anthropol 159:577–584, 2016. © 2015 The Authors American Journal of Physical Anthropology Published by Wiley Periodicals, Inc.

Age-associated reduction in cortical bone in males, trends from the third century AD to the present day

Osteoporosis is increasingly recognised as a health threat in the ageing male. Risk factors for osteoporosis appear to have increased through time. This study investigates the hypothesis that lifestyle changes (e.g. increasing sedentism, tobacco use) over the past 1,800 years have resulted in greater age-related reduction in cortical bone in males in more recent compared with earlier times in England. Skeletons (N = 215) from three English archaeological sites dating from the third to nineteenth century AD, together with comparison with a modern reference population, are used to investigate this hypothesis. Metacarpal cortical thickness is used as a measure of cortical bone status. Results of this cross-sectional study do not support the above hypothesis but instead suggest that patterns of age-related reduction in cortical bone in males have remained stable over an 1,800 year period.

Bone Mineral Density in Children From Anthropological and Clinical Sciences: A Review

Bone mineral density (BMD) is a frequent topic of discussion in the clinical literature in relation to the bone health of both adults and children. However, in archaeological and/ or anthropological studies the role of BMD is often cited as a possible factor in the poor skeletal preservation which can lead to an under-representation of juvenile skeletal remains. During skeletal development and growth throughout childhood and adolescence changes take place in both the size and shape of bones and these changes also result in the increasing of mineral content. BMD can be affected by many factors, which include, age, genetics, sexual maturation, amount of physical activity and dietary calcium. This paper aims to review the clinical and anthropological literature on BMD and discuss the numerous methods of measurement and how the availability of certain methods such as Dual-energy x-ray absorptiometry (DEXA) and quantitative computed tomography (QCT) can influence the study of bone density in archaeological skeletal collections and also the future potential for forensic anthropological studies.

Interpreting skeletal growth in the past from a functional and physiological perspective

The study of juvenile skeletal remains can yield important insights into the health, behavior, and biological relationships of past populations. However, most studies of past skeletal growth have been limited to relatively simple metrics. Considering additional skeletal parameters and taking a broader physiological perspective can provide a more complete assessment of growth patterns and environmental and genetic effects on those patterns. We review here some alternative approaches to ontogenetic studies of archaeological and paleontological skeletal material, including analyses of body size (stature and body mass) and cortical bone structure of long bone diaphyses and the mandibular corpus. Together such analyses can shed new light on both systemic and localized influences on bone growth, and the metabolic and mechanical factors underlying variation in growth.

Skeletal growth and the changing genetic landscape during childhood and adulthood

Growth, development, and decline of the human skeleton are of central importance to physical anthropology. All processes of skeletal growth (longitudinal growth as well as gains and losses of bone mass) are subjected to environmental and genetic influences. These influences, and their relative contributions to the phenotype, can be asserted at any stage of life. We present here the gross phenotypic and genetic landscapes of four skeletal traits, and show how they vary across the life span. Phenotypic sex differences are found in bone diameter and cortical index (a ratio of cortical thickness over bone diameter) at a very early age and continue throughout most of life. Sexual dimorphism in summed cortical thickness and bone length, however, is not evident until shortly after the pubertal growth spurt. Genetic contributions (heritability) to these skeletal phenotypes are generally moderate to high. Bone length and bone diameter (which both scale with body size) tend to have the highest heritability, with heritability of bone length fairly stable across ages (with a notable dip in early childhood) and that of bone diameter peaking in early childhood. The bone traits summed cortical thickness and cortical index that may better reflect bone mass, a more plastic phenomenon, have slightly lower genetic influences, on average. Results from our phenotypic and genetic landscapes serve three key purposes: 1) demonstration of the integrated nature of the genetic and environmental underpinnings of skeletal form, 2) identification of periods of bone's relative sensitivity to genetic and environmental influences, 3) and stimulation of hypotheses predicting the effects of exposure to environmental variables on the skeleton, given variation in the underlying genetic architecture.

Osteoporosis: an evolutionary perspective

Increased life expectancy has led to an overall aging of the population and greater numbers of elderly people. Therefore, the number of people with osteoporosis has increased substantially, accompanied with an epidemic of hip fractures. Osteoporosis is an age-related systemic condition that naturally occurs, among mammals, only in humans. Osteoporosis is known to be highly heritable. However, assuming a genetic determinant for this post-reproductive disease to be transmitted from one generation to the next is counter-intuitive, based on the principles of human evolution, I will attempt to provide an explanation of the phenomenon from the point of view of evolution, selection, and changed environment in humans, which contributed to human longevity, while on other hand, contribute to diseases of civilization, including osteoporosis. There is a need to delve into evolution of human species in search for adaptive patterns to a specific environment that humans are operating in the last couple of millennia, to clarify whether "good" and "bad" genes exist, and how to find and correct them. The answer to the above questions will help us to identify causes of the current epidemic of osteoporosis and to pin-point a tailored treatment.

Intraskeletal variability in bone mass

For methodological or other reasons, a variety of skeletal elements are analyzed and subsequently used as a basis for describing general bone loss and mass. However, bone loss and mass may not be uniform within and among skeletal elements of the same individual because of biomechanical factors. We test the hypothesis that a homogeneity in bone mass exists among skeletal elements of the same individual. Measures indicative of bone mass were calculated from the midshafts of six skeletal elements from the same individuals (N = 41). The extent of intraskeletal variability in bone mass (relative cortical area) was then examined for the entire sample, according to age, sex, and pathological status. The results of the analysis showed that all measures reflect a heterogeneity in bone mass (P </= 0.001). Specifically, differences were observed between the bones of the upper limb and those of the lower limb. Both sexes showed intraskeletal variability in bone mass, but the difference between the sexes is not significant (P = 0.509). When the sample is subdivided according to age, all groups show intraskeletal variability in bone mass, but the difference did not differ significantly among the groups (P = 0.217). However, significant differences in intraskeletal variability are observed between individuals below and above the age of 50. Pathological individuals show intraskeletal variability in bone mass, but the difference between the pathological and non-pathological groups is not significant (P = 0.095). These results indicate that the bone mass of any particular skeletal element is intricately tethered to its specific mechanical loading environment.

Are bone losers distinguishable from bone formers in a skeletal series? Implications for adult age at death assessment methods

Clinical studies indicate that genetic factors play a crucial role in primary osteoarthritis and osteoporosis. In addition, it has been suggested that these two diseases are inversely related. Within a population, one can find two sub-groups: the "bone formers" and the "bone losers". The changes to the joint surfaces used to assess adult age at death are related to the loss of bone substance and to bone formation (osteophytes). The modification of these indicators with age differs between bone formers and bone losers. Therefore, age-at-death assessment methods should make use of two standards, one for each sub-group. A preliminary study examining the possibility of distinguishing those who lose cortical bone from those who show signs of bony formation was conducted on a series of skeletons from Portugal, dating to the end of 19th century and the beginning of the 20th. Bone loss was evaluated using the cortical index (CI) of the second metacarpal on X-rays. The presence of osteophytes on dry bones was assessed macroscopically. Our study indicates that females' CI decreases with age, whereas the presence of osteophytes is strongly related to age in both sexes. But we have failed to find the inverse relationship between osteophytes and bone loss. Our study, however, shows that within a population, some individuals are not likely to develop osteophytes.

Age-related cortical bone loss in women from a 3rd–4th century AD population from England

Age-dependent cortical bone loss in adult females from a skeletal assemblage from 3rd-4th century AD England was studied using metacarpal radiogrammetry. Results showed reduced peak cortical bone thickness compared with modern subjects, and the magnitude of cortical bone loss in older females compared with their younger counterparts was greater than that documented for a modern reference population. An elevated prevalence of fractures classically associated with osteoporosis was also observed in the over-50-year cohort. The severity of osteoporosis in this group is difficult to explain in terms of extraneous factors relating to 3rd-4th century lifestyles. Given the important genetic component in osteoporosis, the results may indicate some inherent susceptibility in this particular population to the disease, and ways in which this possibility might be further explored are suggested.

Analysis of quantitative methods for rib seriation using the Spitalfields documented skeletal collection

Accurate rib seriation is essential in forensic anthropology and bioarchaeology for determination of minimum numbers of individuals, sequencing trauma patterns to the chest, and identification of central ribs for use in age estimation. We investigate quantitative methods for rib seriation based on three metric variables: superior (anterior) costo-transverse crest height (SCTCH), articular facet of the tubercle-to-angle length (AFTAL), and head-to-articular facet length (HAFL). The sample consists of complete but unseriated sets of ribs from 133 individuals from the documented (known age and sex) and undocumented skeletal collections of Christ Church Spitalfields, London. This research confirms the results of an earlier study (Hoppa and Saunders [1998] J. Forensic. Sci. 43:174-177) and extends it with the application of two new metric traits and further analyses of sex differences. Analyses of variance showed that SCTCH and AFTAL are significantly associated (P < 0.001) with rib number. Tukey tests of pairwise rib comparisons revealed that for two dimensions (SCTCH and AFTAL), the central ribs (3rd-6th) are significantly distinct from each other (P < 0.05). Using simple ranking of either the SCTCH or AFTAL traits, the proportion of correctly identified ribs within +/-1 position was 80%, compared to initial seriation using morphological methods (Dudar [1993] J. Forensic. Sci. 28:788-797; Mann [1993] J. Forensic. Sci. 28:151-155). Significant sex dimorphism was also identified for these two traits. Analysis of the HAFL trait produced somewhat equivocal results, suggesting that this variable is not reliable for rib seriation. The variable SCTCH proves to be the most useful dimension for seriation, and shows that all but the 7th-9th ribs can be distinguished from others in the sequence, with important results for the 4th rib, where ranking allowed identification in 86% of cases, consistent with morphological methods for intact ribs.