Osteoporosis in Johannesburg Bantu Males

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Abstract
An unusual variety of osteoporosis has previously been shown to occur in middleaged male Bantu subjects in Johannesburg, and associations with severe iron overload and with scurvy have been established. In the present investigation 110 asymptomatic manual laborers whose diets contained large amounts of iron and little ascorbic acid were studied. The mean leukocyte ascorbic acid concentration of this group was significantly lower than that of control groups. Seventeen (15%) of these subjects exhibited radiological evidence of vertebral osteoporosis, and the mean leukocyte ascorbic acid concentration of the osteoporotic individuals was significantly lower than that of the group as a whole. These results are consistent with the hypothesis that this unusual form of osteoporosis is the consequence of chronic ascorbic acid deficiency. A study of 71 Bantu male subjects dying of acute trauma and exhibiting no evidence of disease at necropsy was also carried out. A highly significant inverse correlation was established between the mineral density of the iliac crest bone and the hepatic iron concentration. This association may be due to the part played by severe iron overload in the pathogenesis of ascorbic acid deficiency in this population.

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