Cortical bone development in black and white South African children: iliac crest histomorphometry.

Abstract

Fragility fracture rates in South Africa are lower in blacks (B) than in whites (W) both in adults and in children. In adults this difference may in part be explained by histomorphometric findings in iliac crest cortical bone of B of thicker, less porous cortices, greater endocortical (Ec) wall thickness, fewer canals and greater osteoid thickness accompanied by greater mineral apposition rate and bone formation rate compared to W. Since no comparative data for B and W children are available we examined iliac crest cortical bone of 57 B and 56 W aged 0-23 yrs by routine histomorphometry. The effects of growth as expressed in differences between external and internal cortex were similar in B and W children. Cortical thickness increased with age similarly in B and W until about age 15 whereafter it continued to increase only in B. Ec wall thickness rose with age in B but did not change in W. After age 11 canal number was lower in B. Cortical porosity was highest between ages 6 and 15 with a tendency to lower values in the external cortex in B. Thus structural differences reported in adults were evident in children. Bone turnover as reflected in osteoid surface and eroded surface declined with age similarly in B and W but osteoid thickness did not change with age. Greater osteoid thickness in B children could reflect greater vigor of osteoblasts and greater osteoblast team performance as it did in B adults and may have contributed to the structural advantage in B children. B children showed greater values for osteoid thickness, endocortical wall thickness and cortical thickness, and a tendency to lower porosity compared to W children. These features may contribute to lower fragility fracture rates in B children. Differing environmental influences and possibly genetic effects may play a role.