7 research outputs found

    Low bone mineral content is common but osteoporotic fractures are rare in elderly rural Gambian women.

    No full text
    Osteoporosis is reported to be rare in Black Africa. The low fracture incidence among North American black women is explained by a high peak bone mass and preservation of bone mineral into old age. To assess whether this is the case among Black African women, we measured bone mineral content (BMC) and bone mineral density (BMD), using single- and dual-photon absorptiometry, in 195 rural Gambian women aged over 44 years and 391 white women of comparable age from three centers in the U.K. Measurements were made at the midshaft of the radius, distal radius, lumbar spine, and femoral neck. The influence of height, weight, and nationality on BMC and BMD was analyzed. BMC and BMD decreased with age at all sites. Age, decreasing weight, but not height were independently associated with lower BMC at all sites. BMC in Gambian women was lower than in British women by 31% at the lumbar spine and 16% at the midshaft of the radius. After adjustment for age, height, and weight, BMC among Gambian women remained 24% lower at the lumbar spine and 10% lower at the radius. In women aged over 64 years, BMC at the lumbar spine was 42% lower and BMD was 31% lower in The Gambia (for all comparisons, p < 0.005). We conclude that bone mineral mass is not preserved in elderly Gambian women. However, minimal trauma fractures are rare in this population. These results challenge the concept of BMC as a primary determinant of fracture risk

    The effect of prepubertal calcium carbonate supplementation on skeletal development in Gambian boys-a 12-year follow-up study

    No full text
    CONTEXT: Calcium intake during growth is essential for future bone health but varies widely between individuals and populations. The impact on bone of increasing calcium intake is unknown in a population where low calcium intake, stunting, and delayed puberty are common.OBJECTIVE: To determine the effect of prepubertal calcium supplementation on mean age at peak velocity for bone growth and mineral accrual.DESIGN AND SETTING: Prospective follow-up of boys in rural Gambia, West Africa, who had participated in a double-blind, randomized, placebo-controlled trial of calcium supplementation.PARTICIPANTS: Eighty boys, initially aged 8.0-11.9 years, were followed up for 12 years.INTERVENTIONS: Subjects received 1 year of calcium carbonate supplementation (1000 mg daily, 5 d/wk).MAIN OUTCOME MEASURES: Dual-energy x-ray absorptiometry measurements were carried out for whole body (WB), lumbar spine, and total hip bone mineral content, bone area (BA), and WB lean mass. Super imposition by translation and rotation models was made to assess bone growth.RESULTS: Age at peak velocity was consistently earlier in the calcium group compared to the placebo group, for WB bone mineral content (mean, -6.2 [SE, 3.1]; P = .05), WB BA (mean, -7.0 [SE, 3.2] mo; P = .03), lumbar spine and total hip BA. By young adulthood, supplementation did not change the amount of bone accrued (mineral or size) or the rate of bone growth.CONCLUSIONS: Twelve months of prepubertal calcium carbonate supplementation in boys with a low calcium diet advanced the adolescent growth spurt but had no lasting effect on bone mineral or bone size. There is a need for caution when applying international recommendations to different populations<br/
    corecore