Rickets, resorption and revolution: An investigation into the relationship between vitamin D deficiency in childhood and osteoporosis in adulthood in an 18th-19th century population

Abstract

Objective
This study employs a Developmental Origins of Health and Disease (DOHaD) approach to assess the effect of vitamin D deficiency (VDD) in childhood on the risk of osteoporosis in adulthood in an archaeological sample of skeletons dating from the 18th to 19th centuries.

Materials
Femora and lumbar vertebrae of 65 adults aged 18+ years (26 diagnosed with residual rickets and 39 without) from an 18th-19th century Quaker burial ground at Coach Lane, North Shields, England.

Methods
Bone mineral density (BMD) was measured for the femoral neck and first four lumbar vertebrae of each individual using a dual energy X-ray absorptiometry (DXA) scanner as a proxy for assessing osteoporotic fracture risk.

Results
3-way ANOVA revealed no statistically significant differences in BMD between individuals with and without residual rickets across age and sex.

Conclusions
A combination of lifestyle and environmental factors likely influenced the BMD of people buried at Coach Lane across the life course. The impact of childhood VDD on BMD later in life can be mitigated through other factors such as physical activity and diet.

Significance
This is one of the first bioarchaeological studies to take a DOHaD approach to understand osteoporosis risk in 18th-19th century England. It highlights the complexity of aetiological factors for osteoporosis and that VDD in early life does not necessarily predispose a person to osteoporosis in adulthood.

Limitations
BMD is not the only indicator of osteoporosis. Microscopic methods for the assessment of childhood vitamin D deficiency, such as inter-globular dentine analysis, were not applied.