TY - JOUR
T1 - Longitudinal Change in Bone Density, Geometry, and Estimated Bone Strength in Older Men and Women From The Gambia
T2 - Findings From the Gambian Bone and Muscle Aging Study (GamBAS)
AU - Ó Breasail, Mícheál
AU - Pearse, Camille
AU - Zengin, Ayse
AU - Jarjou, Landing
AU - Cooper, Cyrus
AU - Ebeling, Peter R.
AU - Prentice, Ann
AU - Ward, Kate A.
N1 - Funding Information:
The authors acknowledge the contribution of the participants who took part in this study. We thank the men and women of West Kiang who patiently participated in the study. We acknowledge the enthusiastic work of the GamBAS study team, especially the research and bone imaging staff and laboratory technicians who tirelessly collected the data and samples. We also acknowledge the support of Mr Bai Lamin Dondeh, Dr Tony Fulford, and Mr Musa Jarjou and colleagues at MR Gambia Unit at the London School of Hygiene and Tropical Medicine. This research was jointly funded by the MRC (program codes U105960371, U123261351, MCA760‐5QX00) and the Department for International Development (DFID) under the MRC/DFID Concordat agreement. For the purposes of Open Access, the authors (KAW, AP) have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arisisng.
Publisher Copyright:
© 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
PY - 2023/1
Y1 - 2023/1
N2 - Musculoskeletal aging in the most resource-limited countries has not been quantified, and longitudinal data are urgently needed to inform policy. The aim of this prospective study was to describe musculoskeletal aging in Gambian adults. A total of 488 participants were recruited stratified by sex and 5-year age band (aged 40 years and older); 386 attended follow-up 1.7 years later. Outcomes were dual-energy X-ray absorptiometry (DXA) (n = 383) total hip areal bone mineral density (aBMD), bone mineral content (BMC), bone area (BA); peripheral quantitative computed tomography (pQCT) diaphyseal and epiphyseal radius and tibia (n = 313) total volumetric BMD (vBMD), trabecular vBMD, estimated bone strength indices (BSIc), cross-sectional area (CSA), BMC, and cortical vBMD. Mean annualized percentage change in bone outcomes was assessed in 10-year age bands and linear trends for age assessed. Bone turnover markers, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25(OH)D) were explored as predictors of change in bone. Bone loss was observed at all sites, with an annual loss of total hip aBMD of 1.2% in women after age 50 years and in men at age 70 years plus. Greater loss in vBMD and BSIc was found at the radius in both men and women; strength was reduced by 4% per year in women and 3% per year in men (p trend 0.02, 0.03, respectively). At cortical sites, reductions in BMC, CSA, and vBMD were observed, being greatest in BMC in women, between 1.4% and 2.0% per annum. Higher CTX and PINP predicted greater loss of trabecular vBMD in women and BMC in men at the radius, and higher 25(OH)D with less loss of tibial trabecular vBMD and CSA in women. The magnitude of bone loss was like those reported in countries where fragility fracture rates are much higher. Given the predicted rise in fracture rates in resource-poor countries such as The Gambia, these data provide important insights into musculoskeletal health in this population.
AB - Musculoskeletal aging in the most resource-limited countries has not been quantified, and longitudinal data are urgently needed to inform policy. The aim of this prospective study was to describe musculoskeletal aging in Gambian adults. A total of 488 participants were recruited stratified by sex and 5-year age band (aged 40 years and older); 386 attended follow-up 1.7 years later. Outcomes were dual-energy X-ray absorptiometry (DXA) (n = 383) total hip areal bone mineral density (aBMD), bone mineral content (BMC), bone area (BA); peripheral quantitative computed tomography (pQCT) diaphyseal and epiphyseal radius and tibia (n = 313) total volumetric BMD (vBMD), trabecular vBMD, estimated bone strength indices (BSIc), cross-sectional area (CSA), BMC, and cortical vBMD. Mean annualized percentage change in bone outcomes was assessed in 10-year age bands and linear trends for age assessed. Bone turnover markers, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25(OH)D) were explored as predictors of change in bone. Bone loss was observed at all sites, with an annual loss of total hip aBMD of 1.2% in women after age 50 years and in men at age 70 years plus. Greater loss in vBMD and BSIc was found at the radius in both men and women; strength was reduced by 4% per year in women and 3% per year in men (p trend 0.02, 0.03, respectively). At cortical sites, reductions in BMC, CSA, and vBMD were observed, being greatest in BMC in women, between 1.4% and 2.0% per annum. Higher CTX and PINP predicted greater loss of trabecular vBMD in women and BMC in men at the radius, and higher 25(OH)D with less loss of tibial trabecular vBMD and CSA in women. The magnitude of bone loss was like those reported in countries where fragility fracture rates are much higher. Given the predicted rise in fracture rates in resource-poor countries such as The Gambia, these data provide important insights into musculoskeletal health in this population.
KW - AGING
KW - ANALYSIS/QUANTITATION OF BONE
KW - BIOCHEMICAL MARKERS OF BONE TURNOVER
KW - BONE MODELING AND REMODELING
KW - BONE QCT/μCT
KW - DXA
UR - http://www.scopus.com/inward/record.url?scp=85141947708&partnerID=8YFLogxK
U2 - 10.1002/jbmr.4727
DO - 10.1002/jbmr.4727
M3 - Article
C2 - 36270918
AN - SCOPUS:85141947708
VL - 38
SP - 48
EP - 58
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
SN - 0884-0431
IS - 1
ER -
