Zuckerman Molly K, Garofalo Evan M, Frohlich Bruno, Ortner Donald J
Department of Anthropology and Middle Eastern Cultures, Cobb Institute of Archaeology, Mississippi State University, P.O. Box AR, Mississippi State, MS 39762-5542, USA.
Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Int J Paleopathol. 2014 Jun;5:27-33. doi: 10.1016/j.ijpp.2014.02.001. Epub 2014 Mar 14.
Metabolic disorders, such as scurvy, manifested in human skeletal remains provide insight into health, nutrition, and environmental quality in past populations. Porous cranial vault lesions are often used to diagnose metabolic conditions in subadult remains, but overlapping gross lesion expressions have led to over-diagnosis of anemia and under-diagnosis of scurvy. Studies by Ortner and colleagues have suggested that specific porous cranial lesions are pathognomonic of scurvy, but additional diagnostic tools are necessary. In this technical report, we offer a preliminary assessment of cranial vault thickness (CVT) at the site of porous lesions (sensu lato porotic hyperostosis, cribra orbitalia) as a method for distinguishing between scurvy and anemia in subadult crania. Computed Tomography (CT) was used to measure CVT at various landmarks associated with porotic hyperostosis and cribra orbitalia, complemented by lesion scores, from scorbutic (N=11), anemic (N=3), and non-pathological (N=28) subadult crania used as a control group. Results indicate that CVT consistently distinguishes scorbutic from non-pathological individuals, while anemic individuals overlap with both - likely a function of small sample size in this study. Despite current limitations, CVT has the potential to be an objective diagnostic tool for distinguishing scurvy and expanding reconstructions of nutritional adequacy over the life course in past populations.
人类骨骼遗骸中表现出的代谢紊乱，如坏血病，能让我们了解过去人群的健康、营养和环境质量。多孔性颅顶病变常被用于诊断亚成人遗骸的代谢状况，但明显的病变表现相互重叠，导致贫血被过度诊断，而坏血病则诊断不足。奥尔特纳及其同事的研究表明，特定的多孔性颅骨病变是坏血病的特征性表现，但还需要其他诊断工具。在本技术报告中，我们对多孔性病变部位（广义的多孔性骨质增生、眶筛板）的颅顶厚度（CVT）进行了初步评估，以此作为区分亚成人颅骨中坏血病和贫血的一种方法。我们使用计算机断层扫描（CT）测量了与多孔性骨质增生和眶筛板相关的各个标志点的CVT，并辅以病变评分，对照组采用了坏血病组（N = 11）、贫血组（N = 3）和非病理性组（N = 28）的亚成人颅骨。结果表明，CVT能够持续区分坏血病患者和非病理性个体，而贫血个体则与两者都有重叠——这可能是本研究样本量较小所致。尽管存在当前的局限性，但CVT有潜力成为一种客观的诊断工具，用于区分坏血病，并扩展对过去人群一生中营养充足情况的重建。
