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Cortical Bone Histomorphometry of the Iliac Crest in Normal Black and White South African Adults

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Abstract

Fragility fracture rates in South African blacks (B) are lower than in whites (W). Since bone strength in many parts of the skeleton depends mainly on cortical bone, we examined iliac crest cortical bone from 97 B (49 male, 48 female) aged 22–80 and 111 W (60 male, 51 female) aged 21–84 histomorphometrically for differences between B and W and effects of age. B had thicker (P = 0.02) and less porous (P = 0.0007) cortices, fewer haversian (H) osteons (P < 0.0001), and greater endocortical (Ec) wall thickness (P < 0.0001). B also had thicker H (P = 0.0005) and Ec osteoid seams (P < 0.0001); greater Ec osteoid surface (P = 0.0005), Ec mineral apposition rate (P < 0.0001), and Ec bone formation rate (P = 0.038); and lower H (P = 0.0002) and Ec eroded surfaces (P = 0.029). Some of the differences were already present in subjects aged 21–30 years. Although cortical structure deteriorated with age in B and W, after age 40 Ec wall thickness declined only in W. Greater Ec mineral apposition and bone formation rates, i.e., greater osteoblast efficiency at the cellular and tissue levels, suggest better Ec bone preservation that may contribute to lower fragility fracture rates in B.

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Acknowledgement

This study was funded by the Medical Research Council of South Africa and the University of the Witwatersrand. We thank Dr. P. Becker from the MRC Biostatistics Unit for statistical advice. We acknowledge the inclusion of bone biopsies from Drs. S. L. Biddulph and E. Schnaid.

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Authors and Affiliations

  1. MRC Mineral Metabolism Research Unit, University of the Witwatersrand, Chris Hani Baragwanath Hospital, Soweto, Johannesburg, 2013, South Africa

    C. M. Schnitzler & J. M. Mesquita

  2. Department of Orthopaedic Surgery, University of the Witwatersrand, Medical School, 7 York Road, Parktown, Johannesburg, 2193, South Africa

    J. M. Mesquita

  3. 608 Helderberg Village, Private Bag X19, 7129, Somerset West, South Africa

    C. M. Schnitzler

Authors
  1. C. M. Schnitzler
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  2. J. M. Mesquita
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Correspondence to C. M. Schnitzler.

Appendix

Appendix

Formulae for the calculation of derived dynamic variables:

  • H mineralizing surface: H.MS/BS (%) = H.dLS/BS + ½H.sLS/BS

  • H bone formation rate: H.BFR/BS (μm3/μm2/year) = H.MAR * (H.dLS/BS + ½H.sLS/BS) * 3.65

  • H adjusted apposition rate: H.Aj.AR (μm/day) = H.MAR * (H.dLS/BS + ½H.sLS/BS)/(H.OS/BS)

  • H mineralization lag time: Mlt (days) = H.O.Th/H.Aj.AR

  • H activation frequency: H.Ac.f (n/year) = (H.BFR/BS)/H.W.Th

  • Ec mineralizing surface: Ec.MS/BS (%) = Ec.dLS/BS + ½Ec.sLS/BS

  • Ec bone formation rate: Ec.BFR/BS (μm3/μm2/year) = Ec.MAR * (Ec.dLS/BS + ½Ec.sLS/BS) * 3.65

  • Ec adjusted apposition rate: Ec.Aj.AR (μm/day) = Ec.MAR * (Ec.dLS/BS + ½Ec.sLS/BS)/(Ec.OS/BS)

  • Ec mineralization lag time: Ec.Mlt (days) = Ec.O.Th/Ec.Aj.AR

  • Ec activation frequency: Ec.Ac.f (n/year) = (Ec.BFR/BS)/Ec.W.Th

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Schnitzler, C.M., Mesquita, J.M. Cortical Bone Histomorphometry of the Iliac Crest in Normal Black and White South African Adults. Calcif Tissue Int 79, 373–382 (2006). https://doi.org/10.1007/s00223-006-0053-z

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  • DOI: https://doi.org/10.1007/s00223-006-0053-z

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