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Longitudinal change in bone density, geometry and estimated bone strength in older men and women from The Gambia: Findings from The Gambian Bone and Muscle Aging Study (GamBAS)

Longitudinal change in bone density, geometry and estimated bone strength in older men and women from The Gambia: Findings from The Gambian Bone and Muscle Aging Study (GamBAS)
Longitudinal change in bone density, geometry and estimated bone strength in older men and women from The Gambia: Findings from The Gambian Bone and Muscle Aging Study (GamBAS)

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. © 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).

AGING, ANALYSIS/QUANTITATION OF BONE, BIOCHEMICAL MARKERS OF BONE TURNOVER, BONE MODELING AND REMODELING, BONE QCT/μCT, DXA
0884-0431
48-58
Breasail, Mícheál Ó
d9d3bc19-e3ca-4e67-90fc-0eec72004164
Parsons, Camille
43244c4b-0e18-4657-816d-9f5710cc7b07
Zengin, Ayse
b2023a08-983d-45bc-ba35-02b5e08aaaa3
Jarjou, Landing
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ebeling, Peter R
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Prentice, Ann
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Ward, Kate A
39bd4db1-c948-4e32-930e-7bec8deb54c7
Breasail, Mícheál Ó
d9d3bc19-e3ca-4e67-90fc-0eec72004164
Parsons, Camille
43244c4b-0e18-4657-816d-9f5710cc7b07
Zengin, Ayse
b2023a08-983d-45bc-ba35-02b5e08aaaa3
Jarjou, Landing
4d70b448-7870-4532-9a8d-cff803f6be39
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ebeling, Peter R
71a1d109-c0fe-438d-9d01-660012eb7049
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Ward, Kate A
39bd4db1-c948-4e32-930e-7bec8deb54c7

Breasail, Mícheál Ó, Parsons, Camille, Zengin, Ayse, Jarjou, Landing, Cooper, Cyrus, Ebeling, Peter R, Prentice, Ann and Ward, Kate A (2022) Longitudinal change in bone density, geometry and estimated bone strength in older men and women from The Gambia: Findings from The Gambian Bone and Muscle Aging Study (GamBAS). Journal of Bone and Mineral Research, 38 (1), 48-58. (doi:10.1002/jbmr.4727).

Record type: Article

Abstract

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. © 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).

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Accepted/In Press date: 21 October 2022
e-pub ahead of print date: 21 October 2022
Additional Information: © 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).
Keywords: AGING, ANALYSIS/QUANTITATION OF BONE, BIOCHEMICAL MARKERS OF BONE TURNOVER, BONE MODELING AND REMODELING, BONE QCT/μCT, DXA

Identifiers

Local EPrints ID: 471826
URI: http://eprints.soton.ac.uk/id/eprint/471826
ISSN: 0884-0431
PURE UUID: 772bb2c1-849c-41cf-b4a6-e311dfa684d9
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Kate A Ward: ORCID iD orcid.org/0000-0001-7034-6750

Catalogue record

Date deposited: 21 Nov 2022 17:46
Last modified: 14 Jan 2023 02:48

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Contributors

Author: Mícheál Ó Breasail
Author: Camille Parsons
Author: Ayse Zengin
Author: Landing Jarjou
Author: Cyrus Cooper ORCID iD
Author: Peter R Ebeling
Author: Ann Prentice
Author: Kate A Ward ORCID iD

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