Association between linear enamel hypoplasia, cribra orbitalia and porotic hyperostosis in a South African skeletal sample

Abstract

Background: Linear enamel hypoplasia (LEH) and porous cranial lesions such as cribra orbitalia (CO) and porotic hyperostosis (PH) are considered nonspecific indicators of early childhood metabolic stress. Objectives: The study aims to describe the association of LEH with CO and PH in a sample of the Kirsten Skeletal Collection (KSC) rep- resenting a cohort in the Western Cape, South Africa. This will be used to determine if one or more of these lesions can be used as an indicator of adult mortality. Sample and Methods: Skulls (n = 412) of both sexes with known demo- graphics from the KSC were macroscopically scored for LEH, CO and PH lesions using a ring light. This study was ethically approved by the Health Research and Ethics Committee of Stellenbosch Uni- versity (S13/05/100).Statistical chi-square tests were used to deter- mine the association between lesions and student’s t-tests to deter- mine if there was a significant difference in mean age-of-death be- tween groups. Results: There was no association when comparing LEH with CO and PH in the cohort, although an association was found between CO and PH. Individuals who exhibited the pathological lesions for LEH, CO or PH (or a combination thereof) were observed to have a younger mean age-at-death than the individuals without any of the three disease lesions. Conclusions: The lesions may potentially be used as an indicator of adult mortality. However, the results of this study might represent a biased population of low socio-economic status in the Western Cape as represented in the KSC, rather than the general population of the region.