Jonnalagadda, Pallavi
(2019)
Cortical Bone Health in African Ancestry Men.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
As the population ages, more non-white men will develop osteoporosis and its associated fractures, yet little is known about skeletal aging in African ancestry men. Studies using quantitative computed tomography (QCT)-measured Bone Mineral Density (BMD) have exposed the incomplete nature of the current understanding of age-related bone loss. Furthermore, studies of the relationship between body fat and BMD have challenged the traditional paradigm that adiposity is beneficial for skeletal health. Moreover, even though cortical bone constitutes 80% of the skeleton, its epidemiology has rarely been described.
To address these knowledge gaps, this dissertation examined the rates of change and correlates for cortical thickness, periosteal and endosteal circumferences, and torsional bone strength (SSI) at the radius and tibia in middle-aged and older African ancestry men from the Tobago Bone Health Study over an average follow-up period of 6.2 years. Secondly, inflammation markers — high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL6) — were examined in relation to rates of change in cortical bone measures in both limbs. Lastly, total calf adipose tissue area (TAT) and its components, percentage subcutaneous (%SAT) and non-subcutaneous fat (%NSAT), were assessed in relation to changes in cortical bone measures at the tibia.
The main findings were: endosteal expansion outpaced periosteal bone formation, such that there was net cortical thinning and reductions in SSI in both limbs. HsCRP was not associated with rates of change in cortical bone measures, while higher baseline serum IL6 was significantly associated with slower rates of loss of cortical BMD and SSI at both limbs. Higher calf TAT was associated with higher rates of cortical BMD loss at the tibia. Higher %SAT and % NSAT were associated with lower and higher rates of cortical BMD loss respectively Higher %SAT was also associated with significantly greater rates of periosteal expansion.
These findings have public health significance due to their focus on an under-studied population, detailed description of changes and correlates of cortical bone structure, particularly periosteal circumference, which is a promising therapeutic target for osteoporosis. Moreover, the relationship between adiposity and skeletal health is especially timely considering the alarming rates of obesity worldwide.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Jonnalagadda, Pallavi | paj23@pitt.edu | paj23 | |
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| ETD Committee: |
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| Date: |
30 January 2019 |
| Date Type: |
Publication |
| Defense Date: |
7 December 2018 |
| Approval Date: |
30 January 2019 |
| Submission Date: |
13 December 2018 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
174 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
DrPH - Doctor of Public Health |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
African ancestry, osteoporosis,cortical bone, aging, computed tomography, strength strain index, inflammation, interleukin, hsCRP |
| Date Deposited: |
30 Jan 2019 19:01 |
| Last Modified: |
13 Feb 2019 16:04 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/35774 |
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