ALS and PDC of Guam: forty-year follow-up

BACKGROUND

It was noticed in the mid-1950s that the incidence of ALS and parkinsonism--dementia complex (PDC) were much higher on Guam than anywhere else in the world. In 1958, a registry of patients and controls was established to ascertain the familial and genetic aspects of these diseases. Patients and individually matched controls and their relatives were registered from 1958 to 1963. The registry was updated and analyzed in 1998 through 1999.

OBJECTIVE

To ascertain whether first-degree relatives of patients had a higher risk for developing ALS or PDC than relatives of controls.

METHODS

During the period of 1958 to 1963, 126 new patients and 126 individually matched controls and their respective first-degree relatives and spouses were evaluated neurologically and registered. Forty years later, the number of new cases among the patient and control relatives were compared to an expected number of new cases based on the age- and sex-specific incidence of ALS and PDC in the population at large.

RESULTS

From 1958 to 1999, there were 102 new ALS or PDC cases among relatives of patients and 33 among relatives of controls. These values were compared with the derived expected values. There were more observed than expected new cases among patients' relatives, and less observed cases than expected among the controls' relatives.

CONCLUSIONS

Relatives of patients with ALS or PDC have significantly higher risks for developing the disease than the Guamanian population, whereas relatives of controls have significantly lower risks.

TAU as a susceptibility gene for amyotropic lateral sclerosis-parkinsonism dementia complex of Guam

BACKGROUND

A Guam variant of amyotrophic lateral sclerosis (ALS-G) and parkinsonism dementia complex (PDC-G) are found in the Chamorro people of Guam. Both disorders have overlapping neuropathologic findings, with neurofibrillary tangles in spinal cord and brain. The cause of ALS-G-PDC-G is unknown, although inheritance and environment appear important. Because neurofibrillary tangles containing tau protein are present in ALS-G-PDC-G, and because mutations in the tau gene (TAU) cause autosomal dominant frontotemporal dementia, TAU was examined as a candidate gene for ALS-G-PDC-G.

METHODS

TAU was evaluated by DNA sequence analysis in subjects with ALS-G-PDC-G, by linkage analysis of TAU polymorphisms in an extended pedigree from the village of Umatac, and by evaluation of linkage disequilibrium with polymorphic markers flanking and within TAU.

RESULTS

Linkage disequilibrium between ALS-G-PDC-G and the TAU polymorphism CA3662 was observed. For this 2-allele system, PDC and ALS cases were significantly less likely than Guamanian controls to have the 1 allele (4.9% and 2% vs 11.5%, respectively; Fisher exact P =.007). DNA sequence analysis of TAU coding regions did not demonstrate a mutation responsible for ALS-G-PDC-G. Analysis of TAU genotypes in an extended pedigree of subjects from Umatac showed obligate recombinants between TAU and ALS-G-PDC-G. Linkage analysis of the Umatac pedigree indicates that TAU is not the major gene for ALS-G-PDC-G.

CONCLUSIONS

The genetic association between ALS-G-PDC-G implicates TAU in the genetic susceptibility to ALS-G-PDC-G. TAU may be a modifying gene increasing risk for ALS-G-PDC-G in the presence of another, as yet, unidentified gene.

Palmar and plantar pads and flexion creases of genetic polydactyly mice (Pdn)

Attempts to gain a better understanding of the relationship between the epidermal ridge patterns (dermatoglyphics) and flexion creases on the volar aspects of human hands and feet and specific medical disorders led to a search for a suitable animal model, allowing studies of the fetal development of the pertinent structures. A common experimental animal, the rat (Rattus norvegicus), was found to be an excellent candidate, owing to the strong resemblance of the volar pads and flexion creases on its palmar and plantar surfaces to those of human subjects. A hereditary preaxial polydactyly mouse (Pdn) provides an opportunity to study the effects of this malformation on the surrounding morphological structures and, specifically, on the volar pads, i.e., the sites over which the dermatoglyphic patterns develop. The hands and feet of the wild-type (+/+) mice show no anomalies, and their major pad and flexion crease configurations correspond to those of normal rats. The heterozygous (Pdn/+) mice, in spite of having a thumb/big toe with a duplicated distal phalanx on their hands/feet, did not display any alterations in palmar/plantar pads. The homozygous (Pdn/Pdn) mice have a protrusion in the thenar area and one to three supernumerary digits on the preaxial portion of both the hands and feet. The effect of these anomalies was found to be limited to the pad and flexion crease configurations in the preaxial areas; the postaxial sites were not affected. The original number of pads on the thenar/first interdigital areas of Pdn/Pdn mice was apparently identical to that of the +/+ and Pdn/+mice. The preaxial protrusion, however, affected the number, size, and location of the pads observed in the newborn mice, resulting in varying pad configurations, such as fused and scattered pads or a pad cluster formed by gathering the neighboring pads. These pad modifications were induced by the preaxial plantar/palmar protrusion only and were not affected by the presence of supernumerary preaxial digits. In view of the similarities in the morphology and fetal development of human and mouse distal limbs, the present study is relevant to human subjects, particularly to the understanding of the significance of dermatoglyphic variations in individuals with specific medical disorders. Future studies of naturally occurring or experimentally induced limb malformations in mice or rats should provide valuable insights into the development of human hands and feet and into factors contributing to their congenital anomalies.

An association between an aggrecan polymorphic allele and bilateral hand osteoarthritis in elderly white men: data from the Baltimore Longitudinal Study of Aging (BLSA)

OBJECTIVE

The aggrecan proteoglycan is a major component of articular cartilage and supports the biomechanical function of this tissue. A variable number tandem repeat (VNTR) polymorphism has been discovered recently in a region of the human aggrecan gene that codes for the chondroitin sulfate attachment sites. We examined whether alleles of this polymorphism displayed a non-random association with bilateral hand or knee osteoarthritis (OA) in men from the Baltimore Longitudinal Study of Aging (BLSA).

DESIGN

DNA was obtained from 93 Caucasian men, aged 60 and above, who had bilateral hand and standing knee radiographs read for changes of OA. The DNA was analyzed by polymerase chain reaction (PCR) and/or Southern blotting for the presence of the VNTR alleles.

RESULTS

Bilateral hand OA and knee OA were present in 46 and 30% of the men respectively. The following distribution of alleles was observed: allele 33 (0.5%), 29 (2.2%), 28 (31.7%), 27 (43.0%), 26 (16.7%), 25 (3.2%), 22 (2.2%) and 19 (0.5%). This distribution was similar to that detected in a random population of individuals from a separate study. In multiple logistic regression analysis, adjusting for age and body mass index, the presence of allele 27 was associated with bilateral hand OA with an odds ratio (OR) = 3.23 (95% confidence intervals (CI): 1.24-8.41). No other alleles showed an association with bilateral hand OA and the association between allele 27 and bilateral knee OA was not statistically significant (OR = 1.14; 95% CI: 0.45-2.88).

CONCLUSIONS

These data demonstrate the first association between a human aggrecan gene polymorphic allele and hand OA. This finding supports the concept that genetic factors may play a role in the development and/or progression of some forms of age-onset OA.

Familial aggregation of osteoarthritis: data from the Baltimore Longitudinal Study on Aging

OBJECTIVE

To evaluate the familial aggregation of osteoarthritis (OA) in a cohort of healthy volunteers drawn from a community setting.

METHODS

Hand radiographs obtained between 1978 and 1991 and bilateral standing knee radiographs obtained between 1984 and 1991 were read for changes of OA, using Kellgren-Lawrence (K-L) scales. The hand sites were distal interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, and first carpometacarpal (CMC1) joints. For each joint group, the presence of OA in at least 1 joint in a joint group, the number of affected digits in each joint group, and the sum of the K-L grade across all joints were analyzed. Polyarticular OA was recorded if there were OA findings in 2 of 3 hand joint groups plus 1 or both knees. Data from 167 families with hand radiographs, 157 families with knee radiographs, and 148 families with both hand and knee radiographs were analyzed for sib-sib correlations.

RESULTS

After adjustment for age, sex, and body mass index, clinically relevant sib-sib common correlations were found for OA of the DIP, PIP, and CMC1 joints, for OA at 2 or 3 hand sites, and for polyarticular OA (r = 0.33-0.81) when OA was defined according to the number of affected joints or as the sum of the K-L grade across all joints.

CONCLUSION

These results from a cohort of volunteers drawn from a community setting and ascertained without regard to OA status demonstrate familial aggregation of OA and contribute to the evidence for heritability of OA.

Serum levels of insulin-like growth factor-I are related to age and not to body composition in healthy women and men

BACKGROUND

Aging is accompanied by decreased bone and lean body mass, increased fat mass, and reduced growth hormone (GH) axis function, reflected in diminished levels of insulin-like growth factor-I (IGF-I). Similar changes in body composition occur in nonelderly, GH-deficient adults and are reversible with GH administration, suggesting that diminished GH/IGF-I axis activity may contribute to such age-related changes. To determine the precise pattern of IGF-I decline with age, and to test the hypothesis that this decline is related to concomitant changes in body composition and bone metabolism independent of age, we conducted a cross-sectional survey in 351 healthy participants in the Baltimore Longitudinal Study of Aging.

METHODS

We evaluated relationships among IGF-I, age, and total and regional adiposity, as assessed by body mass index (BMI) and waist-to-hip ratio (WHR); lean body mass, as estimated from urinary creatinine excretion (Crex/ht); bone mineral density (BMD), as assessed by single and dual photon absorptiometry scanning; and circulating levels of parathyroid hormone (PTH), 1,25-(OH)2 D3, 25-OHD, and osteocalcin.

RESULTS

Serum IGF-I levels declined with age (p < .0001) in both men (r = -.51) and women (r = -.67). In men, the decline was linear, whereas IGF-I levels decreased faster in women < 45 years of age than in older women (p < .01) or in men (p < .001). IGF-I was inversely related to BMI (p < .005), WHR (p < .001), and PTH (p < .01) in women. IGF-I was positively related to BMD of the hip and radius in both genders (p < .0003) and to Crex/ht (p < .0005) and osteocalcin (p < .0001) in men. With increasing age, Crex/ht and BMD decreased (p < .0001) and WHR, PTH, and osteocalcin increased (p < .005) in both genders, whereas BMI increased only in women (p < .005). After adjustment for age, IGF-I was not significantly related to BMI, WHR, Crex/ht, or BMD in either gender. IGF-I was positively related to 1,25-(OH)2 D3 (p < .01) independently of age in women.

CONCLUSIONS

Advancing age, rather than declining serum levels of IGF-I, appears to be a major determinant of life-time changes in body composition and BMD in women and men.

Axial and hip bone mineral density and radiographic changes of osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

To examine the relationship between axial and hip bone mineral density (BMD) and radiographic changes of knee osteoarthritis (OA).

METHODS

BMD of the lumbar spine and/or right hip was measured, using dual photon absorptiometry, in 402 men and 247 women in the Baltimore Longitudinal Study of Aging who had bilateral standing knee radiographs taken between 1984 and 1991. Radiographs were read for features of OA using Kellgren-Lawrence and reliable individual feature scales. The relationship between BMD and radiographic changes of OA was examined using multiple linear regression adjusting for age, body mass index, and smoking. Additional analyses with adjustment for menopausal status and estrogen replacement therapy were performed in a subset of women.

RESULTS

Adjusted mean lumbar spine BMD was higher in subjects with knee osteophytes in both sexes: 1.23 +/- 0.02 vs 1.18 +/- 0.01 g/cm2 (p = 0.02) in men, and 1.12 +/- 0.02 vs 1.08 +/- 0.01 g/cm2 (p = 0.07) in women. There were no differences in levels of adjusted hip BMD by presence of any radiographic features of OA in either men or women.

CONCLUSION

These results show that both men and women with radiographic changes of knee OA, specifically osteophytosis, have higher levels of adjusted spine but not hip BMD.

Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset

OBJECTIVE

To examine the association between hand and knee osteoarthritis (OA) in a community based population.

METHODS

Radiographs of 695 participants aged > or = 40 years in the Baltimore Longitudinal Study of Aging were read for changes of OA, using Kellgren-Lawrence grade > or = 2 as the case definition.

RESULTS

Logistic regression analyses, adjusting for age, gender and body mass index, revealed a significant association between OA in the knee and the following joint groups: distal and proximal interphalangeal (DIP, PIP) and Hand2 (OA in two or more hand joint groups) for grade 2-4 and grade 3-4 disease, and the first carpometacarpal (CMC1) joint for grade 3-4 disease.

CONCLUSION

There is an association between OA in hand sites and the knee. The strength of the associations increases with increasing disease severity. For the PIP site, there is a trend toward increasing strength of association for increasing numbers of affected joints and bilateral disease.

Radial and ulnar cortical thickness of the second metacarpal

Differential bone mass at various skeletal sites, which may be due to mechanical stress exerted by the muscles attached to the bone, has been demonstrated for athletes who exert one limb more than the other. The question arises as to whether this bilateral asymmetry extends to the two sides of the same bone with different muscular attachments. The objectives of this study were to ascertain whether the radial and ulnar sides of the second metacarpal have similar cortical thickness and determine if bone mass decreases equally with age on the radial and ulnar sides. Hand-wrist radiographs were obtained from 201 male and 191 female Caucasian participants of the Baltimore Longitudinal Study of Aging. Differences between radial and ulnar cortical thickness within age groups were tested with Student's t-test and between age groups using analysis of variance. RAdial cortical thickness of the second metacarpal was found to be 11-12% greater in men and 10-12% greater in women than ulnar cortical thickness in both the left and right hands. Age-related changes in radial cortical thickness were evident in both sexes. In men, radial cortex decreased linearly from age 40 to 89. For women, there was a sharp decline in radial thickness from age 50 to age 60. Ulnar cortical thickness declined from age 50 to 60 for women only. Muscle attachment along the radial length of the second metacarpal may influence the accumulation of bone mass on the radial side at younger ages while muscle disuse may precipitate the loss of bone preferentially from the radial side.

Association of radiographic features of osteoarthritis of the knee with knee pain: data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

To examine the association between self-reported knee pain and radiographic features of osteoarthritis (OA) of the knee.

METHODS

A sample of participants in the Baltimore Longitudinal Study of Aging (452 Caucasian males and 223 Caucasian females) completed questionnaires and underwent a standing radiograph of both knees at the same biennial visit between 1984 and 1989. Radiographs were interpreted using both the Kellgren-Lawrence and individual features scales. Odds ratios were calculated for the association of radiographic features with knee pain after adjustment for age, sex, and body mass index.

RESULTS

Overall, 156 (23%) persons reported ever having knee pain, and 104 (15%) reported current knee pain (within the previous year). Both ever knee pain and current knee pain were significantly associated with the presence of definite knee OA (Kellgren-Lawrence grade > or = 2) and with the presence of all individual features. There was a direct relationship between all measures of severity of radiographic OA and knee pain.

CONCLUSION

These data demonstrate that radiographic features of knee OA are significantly associated with knee pain. The data also support the continued use of the Kellgren-Lawrence grading scale for defining knee OA in population studies.

The association of body weight, body fatness and body fat distribution with osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

To examine the association of body weight, body fatness, and body fat distribution with osteoarthritis (OA) of the knee.

METHODS

Bilateral standing knee radiographs, taken between 1985 and 1991, of 465 Caucasian men and 275 Caucasian women subjects aged 40 and above in the Baltimore Longitudinal Study of Aging were read by one investigator for grade of OA using Kellgren-Lawrence scales. Measures of obesity, assessed at same visit as the last radiograph during this interval, included body mass index, percent body fat, and body fat distribution.

RESULTS

Both men and women with definite knee OA had higher age adjusted mean levels of body mass index, while women only had higher age adjusted mean levels of percent body fat. Both women and men in the highest tertile of body mass index had significantly increased odds of both definite and bilateral knee OA; women in the middle and highest tertile of percent body fat had significantly increased odds of both definite and bilateral knee OA, and men in the highest tertile of waist-hip ratio had significantly increased odds of bilateral knee OA. After adjusting for body mass index, however, the association of percent body fat and waist-hip ratio with knee OA in women and men, respectively, was no longer significant.

CONCLUSION

These data further extend observations that body weight is associated with both definite and bilateral knee OA in both sexes, and support a stronger contribution of mechanical as opposed to systemic factors to explain this association.

Upper extremity bone mass and osteoarthritis of the knees: data from the Baltimore Longitudinal Study of Aging

To examine the association of upper extremity bone mass with osteoarthritis (OA) of the knee, bilateral standing knee radiographs, taken between 1985 and 1991, in 430 Caucasian male and 266 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging, were read by one investigator for grade of OA using Kellgren-Lawrence scales. Several measures of upper extremity bone mass, size, and density, including combined cortical thickness (CCT), total width and percentage of cortical area of the second metacarpal, and bone mineral content (BMC), width, and density of the distal third of the left radius measured with single photon absorptiometry, were assessed at the same visit. In univariate analyses, men and women with definite knee OA were significantly older, men had significantly greater radial width, and women had significantly lower bone mass as measured by both CCT and BMC. After adjustment for age and body weight, however, men with knee OA had significantly higher BMC and radial width while neither of these measures of upper extremity bone mass and size was significantly associated with the presence of definite knee OA in women. Neither measure of upper extremity bone density was significantly associated with definite knee OA in either sex. These data suggest that, although men (but not women) with definite knee OA have significantly higher levels of adjusted radial bone mass and size, subjects with knee OA do not have significantly higher levels of adjusted bone mineral density at either upper extremity site.

Bilateral asymmetry in bone weight at various skeletal sites of the rat

BACKGROUND

Morphological and functional asymmetry in the limbs has generally been regarded as a human characteristic that is of genetic or of both genetic and environmental origin. The aim of this study was to determine the presence of lateral dominance in bone weight of the forelimb of the rat.

METHODS

Wistar rats (77) were used, 45 controls and 32 experimental animals, implanted with a steel weight subcutaneously under the right forelimb. Bones examined for bilateral asymmetry in bone weight were the mandibula, the bones of fore- and hindlimbs, calcaneus, and talus of the tarsus. The weight of each dry bone was measured to the nearest milligram.

RESULTS

Significant bilateral asymmetry in the forelimb was evident in male and female rats, with the left side having more bone mass than the right. Bilateral differences were more pronounced in the females than the male rats. Greater asymmetry was evident in the experimental group compared to the control rats.

CONCLUSIONS

These findings demonstrate that asymmetry is present not only in humans, but also in lower animals such as rats. Greater asymmetry in the experimental rat group is indicative of the influence of environmental factors or physical stress on asymmetry. We conclude that genetics might control the development of asymmetry, but physical stress may alter the functional expression of the asymmetry.

The relationship of age and gender to prevalence and pattern of radiographic changes of osteoarthritis of the knee: data from Caucasian participants in the Baltimore Longitudinal Study of Aging

The aim of this study was to estimate the prevalence and pattern of radiographic changes of osteoarthritis (OA) of the knee by age and gender in Caucasian participants in the Baltimore Longitudinal Study of Aging. Bilateral standing weight-bearing radiographs of the knee in 547 male and 351 female subjects (aged 20 and above) were read for changes of knee OA using Kellgren-Lawrence and individual features scales. Prevalence of definite (Kellgren-Lawrence grade > or = 2 changes) knee OA increased with advancing age in both sexes. Approximately 50 percent in both sexes showed bilateral involvement. Men aged 59 and below were more likely to have unilateral impairment than men aged 60 and above; no such differences were found in females. These data demonstrate that age and gender influence both the prevalence and pattern of radiographic changes of knee OA.

Serum levels of insulin-like growth factor in subjects with osteoarthritis of the knee. Data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

To examine the relationship between serum levels of insulin-like growth factor 1 (IGF-1) and osteoarthritis (OA) of the knee.

METHODS

Serum IGF-1 levels were compared in 162 male and 101 female subjects age > or = 20 stratified by presence of radiographic changes of OA of the knee.

RESULTS

Mean serum IGF-1 levels were significantly lower in subjects with knee OA; however, after adjustment for age-related changes in IGF-1 levels, these differences were no longer significant.

CONCLUSION

These data fail to support the hypothesis that serum IGF-1 levels are reduced in subjects with OA of the knee independent of the known age-related changes in these levels.

Appendicular bone mass and osteoarthritis of the hands in women: data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

The association of appendicular bone mass with hand osteoarthritis (OA) was studied in 238 Caucasian female participants aged 40 and above in the Baltimore Longitudinal Study of Aging.

METHODS

Bilateral hand radiographs taken between 1978 and 1991 were read for grade of OA using Kellgren-Lawrence scales. Two measures of appendicular bone mass, percent cortical area of the second metacarpal and bone mineral density of the distal radius measured with single photon absorptiometry, were assessed at the same visit.

RESULTS

Bivariate analyses showed that increasing grade of hand OA was associated with increasing age and decreasing bone mass as measured by both techniques. After adjustment for age and body mass index, however, neither of these measures of appendicular bone mass remained significantly associated with grade of hand OA.

CONCLUSION

Our data fail to support the hypothesis that increased appendicular bone mass is associated with hand OA in women.

Hand dominance and bilateral asymmetry in the structure of the second metacarpal

Bilateral asymmetry in the structure of the second metacarpal was examined in relation to functional hand dominance in a large, clinically nonselected, healthy population sample from the Baltimore Longitudinal Study of Aging. Bilateral bone measurements were made from anteroposterior hand radiographs of a total of 992 individuals, 609 males and 383 females, with an age range of 19-94 years. Hand dominance was determined on the basis of personal impression. Total width and medullary width at the midshaft of the second metacarpal were measured to 0.05 mm using a Helios caliper. These two measurements were used to derive cortical thickness, cortical bone area, periosteal (total) area, medullary area, percent cortical area, and the second moment of area in the mediolateral plane. In both right and left-handed individuals, statistically significant side differences were found in the calculated bone areas and the second moment of area, with the dominant hand being larger. Cortical thickness did not show significant side-related differences for either handedness. These results show that functional handedness leads to periosteal and endosteal expansion of the second metacarpal cortex on the dominant side, increasing bone strength without increasing cortical thickness. This is the first time this pattern of asymmetry has been reported in left-handers as well as right-handers. Our results argue for the primacy of environmental (mechanical) effects in determining bilateral asymmetry of limb bone structural properties.

Palmar and plantar pads and flexion creases of the rat (Rattus norvegicus)

The recent detection of dermal ridge configurations on the volar pads of the rat (Rattus norvegicus) has created opportunities for experimental studies of dermatoglyphics. In the present work, the palmar and plantar surfaces of the rat were studied to establish the feasibility of comparative rat and human dermatoglyphic investigations. The studied features included the volar pads and flexion creases. The number and location of the palmar and plantar pads in the rat were found to be similar to those of humans. The exception was a previously unrecognized small pad on the palms and soles of the rat, located on the radial and tibial side, respectively, of the proximal component of the first interdigital pad. This pad has no parallel in human embryos. Rats were found to have flexion creases in the non-pad areas between the neighboring pads, similar in location and appearance to those of humans. Unlike humans, however, rats also have boundary creases, separating the pad and non-pad areas. The marked similarities in the morphology of the volar areas between rats and humans make the rat ideally suitable for experimental studies of dermatoglyphics and flexion creases. Results of such studies should be applicable to human developmental dermatoglyphics, including those pertaining to medical disorders.

Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fractures Research Group

Results from previous studies of reproductive factors and bone density have been conflicting; some demonstrate a beneficial effect, but others show a detrimental effect on bone density. The present study investigates the association of parity, lactation, and menstruation with radial bone density in 2230 white women, 65 years of age and older. Bone density was assessed by single-photon absorptiometry. Linear multiple regression was utilized to determine if reproductive factors were associated with radial bone density. The number of births, duration of menstrual bleeding, age at menarche, and years menstruating were significant independent predictors of postmenopausal bone density of the radius. A 1.4% increase in distal radius bone density was observed with each additional birth. Women who began menstruation at age 9 had 6.3% higher bone density than women who began at age 16. Women who menstruated for 3 days during each menstrual cycle had 2.8% less distal radius bone density than women who bled for 7 days. Each decade of menstruation was associated with a 2% greater distal radius bone density. No difference in bone density was demonstrated for women who breast-fed and women who did not. Length of the menstrual cycle, amount of menstrual flow, and irregularity of the menstrual cycle were not significantly associated with radial bone mineral density. In conclusion, pregnancy and menstruation are associated with postmenopausal bone density of the radius.

Obesity and osteoarthritis of the hands in women

The association of obesity and body fat distribution with hand osteoarthritis was studied in 317 Caucasian female subjects aged 40 years and above in the Baltimore Longitudinal Study of Aging. Bilateral hand radiographs taken between 1978 and 1991 were read by one investigator for grade of osteoarthritis using Kellgren-Lawrence scales. Possible risk factors, assessed at same visit as the first radiograph during this interval, included age and measures of obesity, per cent body fat, and fat distribution. Results of bivariate analyses showed that increasing grade of hand osteoarthritis was associated with increasing age, greater mean levels of waist-hip ratio and per cent body fat; there was no association with body mass index. After adjustment for age, however, none of these independent variables remained significantly associated with grade of hand osteoarthritis. These data fail to support hypotheses that measures of obesity are associated with hand osteoarthritis in women independent of their known age-related changes.

Potential role of an additive genetic component in the cause of amyotrophic lateral sclerosis and parkinsonism-dementia in the western Pacific

Amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) are neurological degenerative disorders that occur in three high incidence foci in the western Pacific: among the Chamorros of Guam and the Commonwealth of the Northern Marianas Islands, among Japanese on the Kii peninsula of Honshu Island, and among the Auyu and Jakai peoples of southern West New Guinea. Previous studies have implicated both genetic susceptibility and environmental risk factors in the causation and familial clustering of these disorders. The data analyzed consist of 2,026 individuals in nuclear families ascertained on Guam through two mechanisms: (1) nuclear families were included in the study if one or both parents in the family were affected with ALS or PD or both; and (2) a group of "controls" was selected by obtaining nuclear families where neither parent was affected and both had lived through the age of risk. Clinically, ALS and PD are two distinct disorders. However, preliminary analyses indicated that combining all three diagnoses into one affected diagnosis for genetic analyses (thereby assuming any genetic effect on susceptibility to the two disorders was due to the same genetic mechanism) was reasonable. An age, sex and birth cohort-specific liability was defined and segregation analysis was performed under both logistic and normal models for this liability at the time of disease onset. Under either model, purely environmental, Mendelian dominant and Mendelian recessive hypotheses could be rejected, but a two-allele additive major locus hypothesis could not be rejected.

Biochemical parameters associated with low bone density in healthy men and women

A causal role in age-related bone loss has been attributed to alterations in vitamin D status, the bone mineral regulating hormones, and/or renal function. We assessed biochemical parameters of bone metabolism and renal function in healthy subsets of young and old men (n = 191) and women (n = 120) and evaluated the relationships between these parameters and bone mineral density (BMD) in the radius, spine, and femur. There were no significant associations between BMD at any site and serum 25-OHD, 1,25-(OH)2D, PTH, or creatinine clearance in either young men or in young or old women, after controlling for age. In old men, however, lower radius BMD was significantly related to higher PTH and higher 1,25-(OH)2D and marginally related to lower 25-OHD values. In young men, there were unexpected but significant associations between lower femoral neck BMD and higher serum osteocalcin and urinary calcium/creatinine excretion after age adjustment. In old women, lower spine and radius BMD was also significantly correlated with higher serum osteocalcin. In this healthy, vitamin D-replete population, there were significant cross-sectional declines in BMD in the femur in young and old men and at all sites in old women. Elevated remodeling may be an important feature that contributes to reduced femoral BMD in young men and reduced spine and radius BMD in old women. However, compromised renal function or levels of 1,25-(OH)2D or elevated PTH appear to be neither necessary nor relevant as determinants of osteopenia in the spine or femur in these normal, healthy men and women.

Dermatoglyphics in sudden infant death syndrome

An analysis of digital and palmar dermatoglyphic patterns was conducted in 173 victims of the sudden infant death syndrome (SIDS). The results expose four dermatoglyphic regions with pattern frequencies differing from those in a control population. These are an excess of Sydney creases, hypothenar patterns, open fields (with fewer vestiges) in interdigital region IV, and arches on all digits (females only). These findings indicate a genetic or early intrauterine environmental influence in SIDS infants. An increased incidence of dysmorphism and anomalies including recognition of specific syndromes support this contention. One could speculate that these dermatoglyphic deviations reflect specific genotypes and/or phenotypes particularly vulnerable to postnatal challenges. Differences in multiple dermatoglyphic categories support the concept of heterogeneity of the SIDS population and multicausality of SIDS.

Estimation of prostatic growth using serial prostate-specific antigen measurements in men with and without prostate disease

Prostate growth curves were estimated from serial prostate-specific antigen (PSA) measurements on frozen sera in three groups of men: (a) 16 men with no prostatic disease by urological history and examination; (b) 20 men with a histological diagnosis of benign prostatic hyperplasia (BPH) who had undergone simple prostatectomy; and (c) 18 men with a histological diagnosis of prostate cancer. The median number of repeated PSA measurements over an 8- to 26-yr period prior to histological diagnosis or exclusion of prostate disease was eight and 11 for noncancer and cancer subjects, respectively. Predicted rates of change in PSA (PSA velocity) were linear and curvilinear for control and BPH subjects, respectively. Subjects with cancer demonstrated both a linear and an exponential phase of PSA velocity. Based on time to double PSA, we estimated the epithelial doubling time for men without prostate disease to range from 54 +/- 13 yr at age 40 to 84 +/- 13 yr at age 70. For men with BPH, doubling times ranged from 2 +/- 13 yr at age 40 to 17 +/- 5 yr at age 85. Subjects with local/regional and advanced/metastatic cancer had similar PSA doubling times of 2.4 +/- 0.6 yr and 1.8 +/- 0.2 yr, respectively. These data are consistent with what is known about prostatic growth with age in men without prostate disease and BPH, and the kinetics of prostate cancer growth. Estimates of prostatic growth rate from changes in PSA may be useful clinically in management of men with prostate disease.

Sex differences in geometry of the femoral neck with aging: a structural analysis of bone mineral data

The greater hip fracture rate among elderly women is generally ascribed to differences in femoral neck strength between the sexes. Strength of a given bone is a function of both its material properties and the magnitudes of mechanical stresses within it. This study examined the hypothesis that these apparent strength differences between the sexes are due to dissimilarities in the restructuring of the femoral neck with age, which result in higher stresses in elderly women. Using Hip Strength Analysis, a computer program developed by the authors, femoral neck cross-sectional geometric properties for stress analyses were derived from bone mineral image data of 409 community living, white subjects ranging from 19 to 93 years of age. Though both sexes show declines in femoral neck bone mineral density (BMD) and cross-sectional area with age, only females show a decline in the cross-sectional moment of inertia (CSMI, a geometric index of bone rigidity). The lack of decline in male CSMI appears to be a result of a small but significant increase in femoral neck girth. Similar age-related changes have been observed in the femoral shaft by others. The net effect of these observed changes is that mechanical stresses in the femoral neck of females appear to increase at three times the rate per decade of those of males. These results lend support to the hypothesis that the higher fracture rate in elderly women is due, at least in part, to elevated levels of mechanical stress, resulting from a combination of greater bone loss and less compensatory geometric restructuring with age.

Factor structure of morphometric variables measured on six metacarpal bones

Morphometry of the second, third and fourth metacarpal bone was performed on hand-wrist radiograms of both hands in a sample of 434 male and 549 female adult subjects. Morphometric data (bone length-L, total diaphysis width-T and medullary canal width-M) and age were processed using principal factor analysis with oblique rotation, separately for males and females. In both sexes three factors accounting for 74.7% of the total variance were extracted, but their patterns of variation differed. Factors-"cumulative environmental-genetic factor", "longitudinal factor", and "transversal factor"-are discussed within the context of their biological meaning affecting the phenotypic formation of metacarpal skeleton in a given population.

Factors associated with osteoarthritis of the hand in males: data from the Baltimore Longitudinal Study of Aging

The association of metabolic and physiologic factors with hand osteoarthritis was studied in 888 Caucasian male subjects aged 17-102 years in the Baltimore Longitudinal Study of Aging. Left-hand radiographs taken between 1958 and 1975 were read by one investigator for grade of osteoarthritis using Kellgren-Lawrence scales. Possible risk factors, assessed at the same visit as the last radiograph during this interval, included age and measures of bone mass, body composition, muscle mass, and muscle strength. Results of bivariate analyses of these cross-sectional data showed that increasing grade of hand osteoarthritis was associated with increasing age; greater mean levels of waist/hip ratio and percentage of body fat; and lower mean levels of percentage of cortical area, grip strength, and forearm circumference. After adjustment for age using residuals from best-fit quadratic regression models, none of these independent variables remained significantly associated with grade of hand osteoarthritis. These data fail to support hypotheses that metabolic and physiologic factors are associated with hand osteoarthritis independent of their known age-related changes.

A longitudinal study of osteoarthritis of the hand: the effect of age

Osteoarthritis is the most ubiquitous rheumatic disease worldwide. Although its prevalence in various populations has been well documented, few studies have evaluated the longitudinal radiographic progression of the disease, especially as it is expressed in the interphalangeal joints of the hand. In this longitudinal study, left hand-wrist X-rays of 386 white male participants of the Baltimore Longitudinal Study of Aging followed for at least 5 years with two or more visits were examined for prevalence and progression of osteoarthritis of the distal and proximal interphalangeal joints of the hand. As other studies have shown, we found that the prevalence of osteoarthritis in both distal and proximal interphalangeal joints becomes progressively higher as the age of the subjects increases. Using the life table method of analysis we studied the progression of osteoarthritis as defined by the following criteria: (1) an increase in the severity of radiographic changes of the joints previously affected and (2) an increase in the number of new joints affected. The results indicated that osteoarthritis in both the distal and proximal interphalangeal joints progresses at a faster rate in the older population than in individuals less than 60 years of age. Furthermore, osteoarthritis in the interphalangeal joints progresses at the same rate whether the starting point was a Kellgren grade of 0 (no disease) or 1 (doubtful). We therefore conclude that grade 1 is an intermediate step in the inexorable progression of osteoarthritis of the interphalangeal joints and not synonymous with grade 0, as it has been customarily interpreted.

Dermatoglyphics in the identification of women either with or at risk for breast cancer

Fingerprints and palm prints were studied in 78 breast cancer patients, 391 patients at increased risk for developing breast cancer, and 64 control patients for the purpose of finding a pattern that would identify those women with breast cancer or those who are predisposed to its development. A pattern of 6 or more digital whorls was identified more frequently in women with breast cancer than in those without the disease (P less than 0.01). This finding was independent of known risk factors for breast cancer and was present in 28% of the cancer patients. No correlation was noticed between palm prints and breast cancer. The positive predictive value of 6 or more digital whorls was comparable to that of mammography and that of breast biopsy. With increasing age there was an increase in the positive predictive value associated with 6 or more digital whorls. It is concluded that digital dermatoglyphics may have a future role in identifying women either with or at increased risk for breast cancer such that either risk reduction measures or earlier therapy may be instituted.

The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives

The decline of strength with age has often been attributed to declining muscle mass in older subjects. To investigate factors which might influence changes in strength across the life span, grip strength and muscle mass (as estimated by creatinine excretion and forearm circumference) were measured in 847 healthy volunteers, aged 20-100 years, from the Baltimore Longitudinal Study of Aging. Cross-sectional and longitudinal results concur that grip strength increases into the thirties and declines at an accelerating rate after age 40. However, the grip strength of 48% of subjects less than 40 years old, 29% of individuals 40-59 years old, and 15% of subjects older than 60 did not decline during the average 9-year follow-up. Grip strength is strongly correlated with muscle mass (r = .60, p less than .0001). However, using multiple regression analysis, grip strength is more strongly correlated with age (partial r2 = .38) than muscle mass (partial r2 = .16). Additionally, a residuals analysis demonstrates that younger subjects are stronger and older subjects are weaker than one would predict based on their muscular size. Thus, while strength losses are partially explained by declining muscle mass, there remain other yet undetermined factors beyond declining muscle mass to explain some of the loss of strength seen with aging.

Embryological development and prevalence of digital flexion creases

The embryological development and morphology of digital flexion creases were studied in 178 human embryos and fetuses 6-20 weeks of gestational age. The results suggest the existence of two types of digital flexion creases, that differ from each other in their development. The regular creases, with the exception of the distal crease of the proximal interphalangeal creases, and the oblique and extra creases of the irregular creases, develop concurrently with the appearance of the digital pads by about 11 weeks of gestation. The remaining creases, i.e., the distal crease of the proximal interphalangeal creases and the accessory crease develop later unrelated to the pads but, apparently, secondary to the flexion movements of the hand. Our observations further suggest that, because of their high frequencies, the oblique creases on the ulnar side of digits I and II and on the radial side of digit V and the extra creases on the proximal phalanx of digits I, III, and IV should be considered as "regular" creases. Previously unreported pads were also found on the middle phalanges at about 11 weeks of gestation. Unlike the single, large pads with high elevation, typically found on the distal phalanges, those on the middle phalanges are multiple, small, and only slightly elevated. This observation provides further support to the concept of the relationship between the fetal digital pads and the development of the epidermal ridge patterns.

Bone mass in Guamanian patients with amyotrophic lateral sclerosis and parkinsonism-dementia

Bone mass, as assessed by measurements of total subperiosteal diameter and medullary width of the second metacarpal bone on hand-wrist radiographs, was evaluated for 31 Guamanian patients (15 males, 16 females) with amyotrophic lateral sclerosis (ALS), 67 patients (39 males, 28 females) with parkinsonism-dementia (PD), and 66 (34 males, 32 females) nonaffected Guamanian controls. Comparisons between the two disease groups and between each disease group and the nonaffected controls were made taking into account the sex, age, and disability status of each participant. At all ages, ALS patients of both sexes had significantly lower percent cortical areas (PCA) than did nonaffected controls. The ALS males also had significantly lower PCA than PD males, although no significant differences were observed between female ALS and PD patients. The PD patients of either sex had a lower PCA when compared to controls, but the differences were not statistically significant. The observed differences in PCA were due solely to increased medullary width, suggesting that the diminished cortical bone thickness resulted from greater bone resorption rather than differential bone growth. Longitudinal studies support the cross-sectional findings of accelerated bone loss among ALS patients. It is not possible to determine from the present data whether the observed differences in PCA of the second metacarpal of the ALS patients are due to atrophy of the first interosseous muscle, to a generalized resorption process inherently associated with the development and progression of ALS, or to factors not accounted for by the present analysis.

The effect of a pattern in palmar interdigital II on a-b ridge count in black and white Down syndrome cases and controls

An unconfirmed study by Fang (Ph.D. thesis, Univ. of London, 1950) in Britain showed that individuals with Down syndrome had lower total a-b ridge counts in palmar Interdigital area II (ID II) than a group of controls. This study compares 603 white Down syndrome cases and 93 black Down syndrome cases with 668 white and 402 black controls. Our results confirm those of Fang in that the Down syndrome cases in both racial groups had lower total a-b ridge counts than their respective controls. In addition, the black controls and Down syndrome cases had lower a-b ridge counts than their white counterparts. The mean a-b ridge count was significantly lower in individuals with a pattern in ID II compared to individuals without a pattern in ID II in both the Down syndrome and control groups. Some of the lower a-b ridge counts in the Down syndrome samples can be accounted for by the fact that there is an increased frequency of a pattern in ID II in Down syndrome cases. Both Down syndrome and normal individuals who had a pattern unilaterally had a lower than expected a-b ridge count on the contralateral hand that did not have a pattern. There was a tendency also for increased asymmetry in Down syndrome cases with a pattern in ID II.

Digital and palmar dermatoglyphics in dementia of the Alzheimer type

Digital and palmar dermatoglyphics were examined in 29 men and 27 women with dementia of the Alzheimer type (DAT) and 112 age-, sex-, and racial group-matched controls. Female patients had significantly (p less than 0.05) more accessory triradii and complete Sydney creases than controls; no dermatoglyphic differences were detected in the males. Separating the patients by age of onset prior to or after age 65 years did not help differentiate patients from controls by dermatoglyphic profile. This study failed to confirm either the previously reported dermatoglyphic differences between DAT patients and controls or the reported similarity of the dermatoglyphic pattern of DAT to that of Down syndrome patients.

Toe and plantar dermatoglyphics in adult American Caucasians

The scarcity of information on control data of toe and plantar dermatoglyphics led us to undertake this study of adult American Caucasians. Toe and sole prints of 168 male and 83 female participants of the Baltimore Longitudinal Study of Aging were analyzed. Toe pattern frequencies demonstrate that fibular loops are the most prevalent pattern on the toes in both males and females. Pattern distribution by digit shows that arches are most often located on the fifth toe while whorls are found with greatest frequency on the third toe. Plantar pattern frequencies indicate that the most common pattern found in the hallucal area is the distal loop. Open fields are frequently found in the II and IV interdigital areas while distal loops are prevalent in the III area. These results are compared to the finger and palmar patterns of the same individuals. The distribution of patterns on the toes and fingers of the same individuals appear to be quite different. Population comparisons did not demonstrate a clear racial difference in the toe pattern frequencies or in the plantar areas.

Amyotrophic lateral sclerosis and parkinsonism-dementia on Guam: a 25-year prospective case-control study

Familial and genetic studies of high-incidence amyotrophic lateral sclerosis and parkinsonism-dementia among the Chamorro people of Guam were initiated in 1958 with the establishment of a prospective case-control registry. The major objective of this registry was to determine if first-degree relatives and spouses of patients with amyotrophic lateral sclerosis or parkinsonism-dementia had an increased risk of developing disease compared with relatives of nonaffected controls individually matched for age, sex, and village. At the time of its closing in 1963, the registry included 126 patients (77 with amyotrophic lateral sclerosis, 42 with parkinsonism-dementia, and seven with both amyotrophic lateral sclerosis and parkinsonism-dementia) and an equal number of controls; 994 living first-degree relatives (parents, siblings, and offspring) of patients and 1,218 of controls; and 88 living spouses of patients and 101 of controls. The present analysis of the 25-year follow-up study (1958-1983) demonstrated a significantly increased risk of developing amyotrophic lateral sclerosis or parkinsonism-dementia among parents, siblings, and spouses of patients, but not among relatives of controls. Offspring of both patients and controls showed no significantly increased risk of developing disease. The increased risk among spouses of patients and the lack of increase among their offspring, together with recent histochemical findings, support the contention that exogenous factors are strong contributors to the etiology of amyotrophic lateral sclerosis and parkinsonism-dementia. The present results also demonstrate a declining incidence of both diseases.

Longitudinal study of bone loss in the second metacarpal

This longitudinal study was undertaken to ascertain the rate of bone loss and to identify aging, cohort and/or time effects on bone loss in male participants of the Baltimore Longitudinal Study of Aging. Hand-wrist radiographs were obtained from 1958-1981 and were evaluated for total width, medullary width, and length of the second metacarpal. Data were analyzed using an age-time matrix with 8-year intervals for three epochs and nine age groups. The bone measurements were analyzed in three perspectives (cross-sectional, longitudinal and time-series). The results demonstrate that there is both a cross-sectional and longitudinal loss of cortical bone with age in the second metacarpal. Furthermore, the results show that males lose approximately 14% of their cortical bone, at a rate of about 2% per decade, over the adult lifespan. The majority of this loss occurs between the ages of 45 and 69 and is due primarily to aging and is not an artifact of cohort differences or secular change.

Markers of genetic variation among the Waorani Indians of the Ecuadorian Amazon headwaters

Until recently, the Waorani Indians of Ecuador's Amazon headwaters maintained a fierce resistance to all intruders into their territory, and as a result of their actions and reputations a population of 600 people controlled a very large territory (about 8,000 square miles). The isolation of the Waorani has resulted in a large linguistic and genetic distance from their neighbors. Our survey of red cell enzymes, immunoglobulin allotypes, and dermatoglyphics demonstrates that the Waorani are a highly inbred and homogeneous population. Of 18 red cell enzymes studied, the Waorani have a limited polymorphism for only 6. Only two Gm haplotypes (Gm1,2,17,21, Gm1,17,21) were found and 60% of those tested were homozygous for the Gm1,17,21 haplotype. All individuals were A2m (1) and 95% of these were homozygous. The Waorani's dermatoglyphic traits fell within the wide range found among other South American Indians with close affinity to the Ecuadorian Jivaro group. Despite the limitations of these genetic systems, they demonstrate that the Waorani share limited genetic traits with the neighboring Jivaro Indians and are isolated from other tribal populations in South America.

Cortical bone loss and measurements of the second metacarpal bone: II. Hypodense bone in postwar Guamanian children

Hand-wrist radiographs from 326 Guamanian children (180 boys and 146 girls) were evaluated for total width, medullary width, length, and combined cortical thickness of the second metacarpal. Bone measurements as well as standing height and weight were compared to similar published data from U.S. mainland black, white, and Mexican-American children. The results demonstrated that the second metacarpal bones of Guamanian boys and girls of all age groups (5-17 years) have narrower width and shorter length with less combined cortical thickness than any of the other groups. Guamanian children also weighed less and were of shorter stature than their black, white, or Mexican-American counterparts. These results agree closely with those comparisons between Guamanian and U.S. mainland white adults published earlier. It is not possible from the present data to ascertain whether these differences were due to genetic variability or nutritional deficiency.

Calcium and vitamin D metabolism in Guamanian Chamorros with amyotrophic lateral sclerosis and parkinsonism-dementia

We evaluated 16 Guamanian Chamorros with amyotrophic lateral sclerosis and 33 patients with parkinsonism-dementia for disturbances of calcium and vitamin D metabolism. The serum immunoreactive parathyroid hormone level was mildly elevated in 6 patients with amyotrophic lateral sclerosis and in 5 patients with parkinsonism-dementia. There were significant positive correlations between serum immunoreactive parathyroid levels and duration of illness in male patients with motor neuron disease, but not in female patients or in patients with parkinsonism-dementia. Intestinal absorption of calcium, as assessed by serum and urinary activity of calcium 47 following oral administration, was decreased in 2 patients with amyotrophic lateral sclerosis and in 4 patients with parkinsonism-dementia, all of whom had low levels of serum 1,25-dihydroxyvitamin D. Reductions in cortical bone mass were striking in patients with motor neuron disease. A significant negative correlation was found between the percentage of cortical area of the second metacarpal bone and muscle atrophy and weakness, and significant positive correlations were found between degree of immobility and ratio of urinary hydroxyproline to creatinine in patients with amyotrophic lateral sclerosis and parkinsonism-dementia. In general, abnormalities in calcium metabolism were subtle. Thus, if the demonstrated deposition of metals, particularly calcium and aluminum, in central nervous system tissues of Guamanians with these two conditions is a cause of the diseases and of the early appearance of neurofibrillary tangles in neurons, the accumulation has apparently occurred long before onset of symptoms, and detectable abnormalities of calcium and vitamin D metabolism may already have been corrected.

Studies of endemic cretinism in Papua New Guinea: digital and palmar dermatoglyphic patterns

We have tested the hypothesis that the abnormal development of the central nervous system seen in endemic cretinism might be accompanied by concurrent abnormal dermatoglyphic patterns. We compared digital and palmar dermatoglyphics of normal individuals and endemic cretins inhabiting the Huon Peninsula of Papua New Guinea. The population sampled from the Irumu River Valley included 118 males and 114 females with 22 male cretins and 23 female cretins. The population sampled from the Wantoat River Valley included 72 males and 38 females with 12 male cretins. No pathognomonic patterns were found that could identify the endemic cretin subpopulation. However, the occurrence of a number of differences between controls and cretins suggests that subtle changes in dermatoglyphic patterns accompany the anomalous development of the CNS secondary to maternal iodine deficiency. We discuss the significance of these findings and compare the dermatoglyphic patterns of normal Irumu and Wantoat natives and 21 other populations of Papua New Guinea.

Blood groups, immunoglobulin allotypes and dermatoglyphic features of patients with amyotrophic lateral sclerosis and parkinsonism-dementia of Guam

Blood group frequencies, immunoglobulin allotypes, and dermatoglyphic patterns were determined on patients with amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD), two chronic, degenerative, neurologic disorders of unknown cause found commonly among the Chamorros of the Mariana Islands, in an attempt to identify a specific genetic or phenetic marker associated with either disorder. With the exception of the Kidd system, no significant differences were found in blood group frequencies nor in immunoglobulin allotypes between ALS patients, PD patients, and unaffected controls. The dermatoglyphic analysis demonstrated that ALS patients had higher frequencies of palmar patterns and accessory triradii in the IV interdigital area, and PD patients had significantly higher frequencies of complete simian creases and of palmar patterns in the thenar/I interdigital area than unaffected controls. The frequencies of the remaining dermatoglyphic traits showed no significant differences. We conclude that none of the marker systems tested show a particular pattern of association in patients and controls or a genetic predisposition to either disorder, and that early identification of at-risk individuals remains elusive.

Digital and palmar dermatoglyphic patterns among natives of extreme northwest Nepal

A dermatoglyphic study was made of two high-altitude populations inhabiting the same ecozone in extreme northwest Nepal. Despite cultural and linguistic differences there appears to be a significant amount of dermatoglyphic homology between the Buddhist-Tibetan villages and their Hindu-Caucasian neighbors.

Further studies on the genetics of the Chamorros of Guam: dermatoglyphics

The present study represents a continuation of our efforts to further define the genetic structure of the Chamorro population of Guam. The dermatoglyphic features of Guamanian Chamorros differ significantly from those of Western Carolinians from the Outer Islands of Yap in fingerprint patterns, model types of C line, frequency of patterns in the thenar/I area and in the presence of Sydney creases. The results of this analysis confirm earlier data from serological and other genetic markers that Guamanian Chamorros are genetically more closely related to the people of southeastern Asia than to their Micronesian neighbors to the south.

Cortical bone loss and measurements of the second metacarpal bone. I. Comparisons between adult Guamanian Chamorros and American Caucasians

The amount of radiographically detectable cortical bone, as determined by measurements of the second metacarpal, was evaluated in 42 male and 45 female Guamanian Chamorros and compared with the degree of bony demineralization in U.S. Caucasians participating in the Baltimore Longitudinal Study on Aging of the Gerontology Research Center. All Chamorros were individually matched to the Caucasian participants for age, sex, and menopause status. Chamorros of both sexes showed bilateral asymmetry in bone measurements and in the amount of cortical bone. Both Chamorro and Caucasian males had longer second metacarpals and more cortical bone than females. Caucasian males, however, had longer and larger second metacarpals than Chamorro males. Despite differences in the length and total width, Chamorro and Caucasian participants generally showed no significant differences in the amount of cortical bone or percent cortical area in the second metacarpal, suggesting that larger bones may not always indicate greater cortical mass. Although cross-sectional data suggested apparent age differences in the onset and rate of bone loss between Chamorros and Caucasians, the numbers of participants were too small to allow meaningful age-by-age statistical comparisons.

Digital dermatoglyphics and breast cancer

Fingerprints of one hundred nineteen Caucasian females were obtained. Of these females, thirty-four had histologically proven breast cancer, fifty-three were at high risk for development of breast cancer, and thirty-two comprised a control group. The digital pattern frequencies and the pattern intensity index were significantly different between the three groups. The presence of six or more whorls appears significant as noted by 32.4% of breast cancer patients possessing this number of whorls as compared to 3.1% controls. Also of note is that 95% of subjects with six or more whorls either had cancer or were at high risk.