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Bigué RA, Ribot I, Brickley MB, Kahlon B, Roberts CA. Heterogeneity in experiences of vitamin D deficiency in an early to mid-19th century population from Montreal, Quebec. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 47:1-11. [PMID: 39146828 DOI: 10.1016/j.ijpp.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 06/28/2024] [Accepted: 07/14/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVE To use the prevalence of prenatal/infancy interglobular dentine (IGD) as a proxy for suboptimal vitamin D status and explore its link to mortality, biological sex, cultural behaviours and environmental factors during the end of the pre-industrial/ beginning of the industrial period. MATERIALS 50 skeletons from the St. Antoine cemetery (1799-1854), Montreal, Quebec with a well-preserved first mandibular molar. METHODS Thin sections were prepared for histological examination of IGD in crown dentine. RESULTS IGD prevalence was 74 % (37/50) and not significantly correlated statistically to sex and age-at-death. Most IGD occurred at birth and up to 3 years-old, six individuals were affected in utero, 54 % of the sample (27/50) presented longstanding IGD and six individuals displayed multiple IGD episodes. CONCLUSIONS Prenatal IGD episodes revealed suboptimal maternal vitamin D levels, which, alongside a high frequency of IGD episodes around birth/from birth until a certain age, suggest cultural influences. Multiple and longstanding IGD episodes might also reflect suboptimal seasonal vitamin D attainment. SIGNIFICANCE This study provides in-depth data on IGD within a relatively large archaeological North American sample, proving relevant to epidemiological studies on suboptimal vitamin status in 19th century Montreal. LIMITATIONS The total number of IGD episodes is underestimated due to methodological biases; first-generation migrants in this study could not be identified and excluded from the sample. SUGGESTIONS FOR FURTHER RESEARCH Use of a larger sample with a wider age-at-death range; further research on infants and children to investigate links between growth and lesion formation and visibility.
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Affiliation(s)
- Rose-Ann Bigué
- University of Montreal, Faculty of Arts and Sciences, Department of Anthropology, Canada.
| | - Isabelle Ribot
- University of Montreal, Faculty of Arts and Sciences, Department of Anthropology, Canada
| | - Megan B Brickley
- McMaster University, Faculty of Social Sciences, Department of Anthropology, Canada
| | - Bonnie Kahlon
- McMaster University, Faculty of Social Sciences, Department of Anthropology, Canada
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Snoddy AME, Shaw H, Newman S, Miszkiewicz JJ, Stewart NA, Jakob T, Buckley H, Caffell A, Gowland R. Vitamin D status in post-medieval Northern England: Insights from dental histology and enamel peptide analysis at Coach Lane, North Shields (AD 1711-1857). PLoS One 2024; 19:e0296203. [PMID: 38295005 PMCID: PMC10830048 DOI: 10.1371/journal.pone.0296203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/07/2023] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVES The post-medieval period in Europe saw a dramatic increase in metabolic bone disease related to vitamin D deficiency (VDD). Recent paleopathological work has utilized interglobular dentin (IGD) as a proxy for poor vitamin D status during development, while enamel peptide analysis allows the identification of chromosomal sex in non-adult remains. Here we explore the relationship between sex, the presence of IGD, and macroscopic markers of VDD in an industrial era assemblage from Northeast England. MATERIALS AND METHODS 25 individuals (9 females, 9 males, 9 unknown sex) from the cemetery site at Coach Lane, North Shields (1711-1857) were selected for paleopathological analysis, histological assessment of IGD, and enamel peptide determination of chromosomal sex. RESULTS Ground tooth sections from 21 individuals were of suitable quality for detection of IGD, and enamel peptide analysis confirmed the chromosomal sex of ten individuals. Sixteen individuals (76.1%) exhibited ≥1 episode of IGD. Nine of these (42.8%) exhibited >1 episode and four (19%) exhibited ≥4 episodes in regular intervals. Male sex was significantly associated with the presence of IGD (p = 0.0351; 100% males vs. 54.5% females). Females were more likely to exhibit macroscopic evidence of VDD (45.5% females vs 30% males) but this was not statistically significant. DISCUSSION AND CONCLUSIONS Periods of poor mineral metabolism during childhood appear much more prevalent at Coach Lane than macroscopic evidence suggests. Evidence of seasonal IGD episodes indicates that northern latitude played a major role in poor VD status in the Northeast of England. The significant association of IGD with male sex may be due to sex-related differences in dentinal mineralization or a higher risk of poor VD status in males aged <5 years. More work is needed to establish an evidence-based threshold for pathological levels of IGD before the presence of this feature can confidently be used as a biomarker for poor VD status.
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Affiliation(s)
| | - Heidi Shaw
- Department of Archaeology, Durham University, Durham, United Kingdom
| | - Sophie Newman
- School of History, Classics and Archaeology, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Nicolas A. Stewart
- School of Applied Sciences, University of Brighton, Brighton, United Kingdom
| | - Tina Jakob
- Department of Archaeology, Durham University, Durham, United Kingdom
| | - Hallie Buckley
- Department of Anatomy, University of Otago, Dunedin, Otago, New Zealand
| | - Anwen Caffell
- Department of Archaeology, Durham University, Durham, United Kingdom
| | - Rebecca Gowland
- Department of Archaeology, Durham University, Durham, United Kingdom
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Ives R, Swan K, Humphrey L. Investigating the "scapula sign" as an indicator of rickets. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 41:59-68. [PMID: 37018941 DOI: 10.1016/j.ijpp.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 02/19/2023] [Accepted: 02/25/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE In 1971, Weiss identified a "scapula sign" comprising a defect at the inferior angle of the scapula in juveniles with vitamin D deficiency rickets, but this has been little studied since. This study aimed to explore pathological variation of this defect in juveniles with other skeletal manifestations of vitamin D deficiency rickets. MATERIALS AND METHODS 527 juveniles, aged from birth to 12 years, from two post-medieval British assemblages were macroscopically evaluated to document the range of pathological changes at the inferior angle. Scapula maximum lengths were recorded and supplementary radiographs were assessed. RESULTS Blunting, flattening or squaring of the inferior angle occurred in 34 of 155 (22%) juveniles with other indicators of rickets and occurred frequently in cases of severe active rickets. Coarsening of the border and cupping deformities were identified radiographically, as well as residual defects in healed cases. Scapula lengths in juveniles with active rickets did not consistently deviate from those expected in any age group. CONCLUSIONS The scapula sign is identifiable in some children with rickets. Differential diagnoses of scapula defects are important but the socio-cultural and environmental context of this sample suggests a link to vitamin D deficiency. SIGNIFICANCE This finding expands the range of pathological changes known to occur in rickets, helping to improve recognition of this condition in past groups. LIMITATIONS Small sample sizes prevented observation of the defect in adolescents with rickets. Defects can affect the positioning of standardised scapula length measures, complicating assessments of growth impacts. SUGGESTIONS FOR FUTURE RESEARCH Continued research into the range of skeletal changes that can develop in vitamin D deficiency to improve the identification of this deficiency in past groups.
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Affiliation(s)
- Rachel Ives
- Vertebrates and Anthropology Collections, Natural History Museum, London, UK.
| | - Karen Swan
- Centre for Human Evolution Research, Natural History Museum, London, UK
| | - Louise Humphrey
- Centre for Human Evolution Research, Natural History Museum, London, UK
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Pitre MC, Mant M, Abel T, Wood LJ. Forgotten and found: A case of childhood rickets in the 19th-century settler village of Heuvelton, New York. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 40:77-86. [PMID: 36621088 DOI: 10.1016/j.ijpp.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To evaluate pathological lesions suggesting the presence of rickets and to place the diagnosis into bioarchaeological and historical context. MATERIALS The remains of a 3-year ± 12-month-old child discovered during a rescue excavation in Heuvelton, New York. METHODS We examined the individual macroscopically and conducted a differential diagnosis following established protocols in the palaeopathological literature. RESULTS Bony change on the orbits, mandible, ribs, clavicles, left scapula, humerii, radii, ulnae, femora, tibiae, fibulae (e.g., porosity, diaphyseal thickening, flaring, bowing), and dental lesions were recorded. CONCLUSIONS We demonstrate that the child likely presented with vitamin D deficiency rickets during crawling and as they learned to walk. SIGNIFICANCE This example offers an important contribution to the bioarchaeological literature, as few cases of rickets have been recorded in rural North America using updated diagnostic criteria and little is known of the health and lifeways of early settlers in 19th-century upstate New York. LIMITATIONS It is not possible to ascertain the precise aetiology of this child's rachitic state and to compare this individual with others in the population. SUGGESTIONS FOR FURTHER RESEARCH Examination (and re-assessment) of other North and South American skeletal assemblages for signs of vitamin D deficiency rickets following current bioarchaeological standards.
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Affiliation(s)
- Mindy C Pitre
- Department of Anthropology, St. Lawrence University, 23 Romoda Drive, 114 Piskor Hall, Canton, NY 13617, United States.
| | - Madeleine Mant
- Department of Anthropology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Timothy Abel
- Consulting Archaeologist, 33512 State Route 26, Carthage, NY, United States.
| | - Linda Johnson Wood
- Heuvelton and Oswegatchie Historian, Heuvelton Historical Association, 83 N State St, Heuvelton, NY 13654, United States
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Perry MA, Edwards E. Differential diagnosis of metabolic disease in a commingled sample from 19th century Hisban, Jordan. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:220-233. [PMID: 34004547 DOI: 10.1016/j.ijpp.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This research attempts a differential diagnosis of skeletal lesions in a commingled sample from Hisban, Jordan, focusing on non-adults in the assemblage. MATERIALS 2,883 well-preserved skeletal elements and 9 relatively complete skulls representing an MNI of 32 non-adults (<18 years old). METHODS All skeletal elements were observed macroscopically and pathophysiological processes underlying any lesions or other anomalies were assessed, followed by a comparative approach to rule out potential diagnoses. RESULTS The skeletal lesions observed were caused by inflammation due to chronic hemorrhaging, marrow hyperplasia due to an increase in hemopoiesis, rapid bone growth, and the impact of biomechanical strain on poorly mineralized elements. Rickets, scurvy, and acquired anemias best fit this pattern of lesions, although inflammation from other sources such as trauma or infection could not be definitively ruled out. CONCLUSIONS The in utero and postnatal environments at Hisban were conducive to the development of vitamin C and D deficiencies from birth until 2 years of age. The analysis of commingled remains requires an ontological shift in the importance of the individual to the population in paleopathology. SIGNIFICANCE This investigation demonstrates the efficacy of a combined biological and comparative approach in differential diagnosis in complicated commingled collections. In addition, it emphasizes the importance of the mother-infant dyad in understanding metabolic disease. LIMITATIONS Histological and radiographic analyses were not included in this diagnostic study due to COVID-19 travel restrictions. SUGGESTIONS FOR FURTHER RESEARCH Isotopic analysis to investigate childhood diet and histological and radiographic analyses to assess survival of deficiencies.
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Affiliation(s)
- Megan A Perry
- Department of Anthropology, East Carolina University, Greenville, NC, 27858, USA.
| | - Emily Edwards
- Department of Anthropology, East Carolina University, Greenville, NC, 27858, USA
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Wölfle J, Bettendorf M, Bechtold-Dalla Pozza S, Binder G, Grasemann C, Reinehr T, Semler O, Dörr HG. Größenwachstum und Knochengesundheit bei Erkrankungen der Wachstumsfuge und des Knochens: Möglichkeiten und Grenzen einer GH-Therapie. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-01024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Zusammenfassung
Hintergrund
Genetische, parakrine und endokrine Faktoren beeinflussen das Größenwachstum und die Knochenmineralisation.
Fragestellung
Wie sind spontanes Größenwachstum und Knochengesundheit von Patienten mit seltenen Knochenerkrankungen? Kann man Wachstum und Knochengesundheit bei diesen Erkrankungen mit Wachstumshormon („growth hormone“ [GH]) verbessern?
Material und Methoden
Ergebnisse eines Expertentreffens mit Literaturrecherche zur Knochengesundheit von mit Kleinwuchs assoziierten ossären Erkrankungen und deren Therapieoptionen.
Ergebnisse
Viele Patienten mit einer Osteogenesis imperfecta sind kleinwüchsig. Eine zusätzliche Gabe von GH hat keinen Einfluss auf die Erwachsenengröße und wird derzeit nicht angewendet. Patienten mit unzureichendem Größenwachstum bei Pseudohypoparathyreoidismus (PHP) können bei Nachweis eines GH-Mangels mit GH behandelt werden und von der Therapie profitieren. Kinder mit X‑chromosomal vererbter hypophosphatämischer Rachitis haben unter der bisherigen Therapie mit Phosphat und Calcitriol einen disproportionierten Kleinwuchs. Randomisierte Therapiestudien mit GH führten zwar zu einer vorübergehenden Verbesserung der Körperhöhe, aber zu keiner signifikanten Verbesserung der Erwachsenenkörpergröße. Bei SHOX-Defizienz ist eine GH-Therapie zugelassen und hinsichtlich Köpergrößenzunahme vergleichbar effektiv wie bei Mädchen mit Ullrich-Turner-Syndrom (UTS). Zusätzlich legen Beobachtungsstudien nahe, dass eine GH-Therapie das bei UTS erhöhte Frakturrisiko reduzieren kann. Entzündung, verminderte körperliche Aktivität und Malnutrition führen bei Patienten mit juveniler idiopathischer Arthritis (JIA) zu einem Kleinwuchs mit Verlust an Muskel- und Knochenmasse. Studien konnten einen positiven Effekt von GH auf Längenwachstum, Dichte, Geometrie und Metabolismus des Knochens sowie auf die Muskelmasse zeigen. Die Therapie mit GH ist bei den Patienten mit JIA nicht zugelassen.
Schlussfolgerungen
Bei den genannten Knochenerkrankungen muss jede Wachstumsstörung individuell betrachtet werden. Neben dem Größenwachstum kann sich die GH-Therapie je nach Indikation positiv auf Stoffwechsel, Mineralsalzgehalt und Knochendichte auswirken. Zugelassene Indiktionen für eine GH-Therapie liegen bei PHP nur bei einem GH-Mangel und bei Patienten mit intrauterinem Kleinwuchs (SGA) und UTS/SHOX-Mangel vor. Neben einer Zunahme des Wachstums sollte eine Verbesserung der Knochengesundheit im Kindes- und Jugendalter als Zielparameter einer GH-Therapie diskutiert werden.
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Berger SM, Griffin JS, Dent SC. Phenotypes and pathways: Working toward an integrated skeletal biology in biological anthropology. Am J Hum Biol 2020; 33:e23450. [PMID: 32511865 DOI: 10.1002/ajhb.23450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/01/2020] [Accepted: 05/17/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Steph M Berger
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jacob S Griffin
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sophia C Dent
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, USA
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Saad RK, Akiki VC, Rahme M, Ajjour S, Assaad M, El-Hajj Fuleihan GA. Time trends and predictors of hypovitaminosis D across the life course: 2009-2016. Metabolism 2020; 105:154138. [PMID: 31923385 DOI: 10.1016/j.metabol.2020.154138] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/18/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE We investigated prevalence, determinants, seasonal changes, and time trends in hypovitaminosis D. We derived a desirable serum 25-hydroxy-vitamin D (25OHD) level in adults/elderly by evaluating the 25OHD-parathyroid hormone (PTH) exponential relationship. METHODS We analyzed serum 25OHD data from a large laboratory database (N = 151,705), from a major academic medical center in Lebanon, from 2009 to 2016. We used cross calibration formulas to convert measured 25OHD levels to LC-MS/MS equivalents based on our external quality assurance protocols. RESULTS 6% of the population were children (mean age 11 ± 5 years, 56% girls), 68% were adults (44 ± 13 years, 71% women), and 25% were elderly (74 ± 6 years, 59% women). The prevalence of hypovitaminosis D, in the entire population, was 39%, 29% and 23% at 25OHD cutoffs of 20 ng/ml, 15 ng/ml, and 12 ng/ml, respectively, across all years. Using multivariate analysis, predictors of 25OHD levels below 12, 15 and 20 ng/ml were younger age, male sex, winter months, and inpatient status both in adults and elderly. In children, older age, female sex, winter months, and inpatient status, predicted levels below 15 ng/ml and 20 ng/ml, but only older age, female sex, and winter months predicted levels below 12 ng/ml. There was a significant steady annual increase in 25OHD levels between 2009 and 2016 of 0.9 ng/ml/year (95% CI: 0.7, 1.0) in children, 1.2 ng/ml/year (1.2, 1.3) in adults and 2.6 ng/ml/year (2.6, 2.8) in the elderly. Using best fit non-linear regression models, on a subset of adults and elderly in whom concomitant 25OHD and PTH data was available (N = 4025), PTH levels plateaued at a serum 25OHD level of 26.1 ng/ml. CONCLUSION Secular increase in serum 25OHD levels is observed in Lebanon, but hypovitaminosis D is still prevalent. Our data provides basis for a desirable 25OHD level above 26 ng/ml in adult and elderly Lebanese individuals.
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Affiliation(s)
- Randa K Saad
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Vanessa C Akiki
- Department of Internal Medicine, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Maya Rahme
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sara Ajjour
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Assaad
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghada A El-Hajj Fuleihan
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon; Department of Internal Medicine, American University of Beirut-Medical Center, Beirut, Lebanon.
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Exploring Patterns of Appositional Growth Amongst Urban Children. BIOARCHAEOLOGY AND SOCIAL THEORY 2020. [DOI: 10.1007/978-3-030-53417-2_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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