新疆鄯善洋海青铜时代居民眶顶板筛孔样病变的调查

本文对新疆鄯善洋海出土的61例(成年个体45例,未成年个体16例)遗骸进行了眶顶板筛孔样病变的观察。在被调查的成年个体中眶顶板筛孔样病变的患病率为44.4%,未成年个体的患病率为75%,且成年个体眶顶板筛孔样病变的患病率性别差异显著。这种病变的高频率现象,很可能与当时单一的饮食结构、低营养水平及不良卫生状况等因素所诱发的缺铁性贫血有关。为深入研究我国新疆地区古代居民眶顶板筛孔样病变的患病率及其发病原因提供了一组基础数据。     

Cribra orbitalia,a possible sign of anemia in early historic native populations of the British Columbia coast

Excavated and museum skeletons of the postcontact period revealed cribra orbitalia in four native ethnolinguistic divisions of the British Columbia coast, Haida, Kwakiutl, Nootka, and Coast Salish. Affected skulls were distributed among 25 of 35 localities, indicating widespread occurrence in a mainly heterogeneous population. Manifestations were similar to porotic hyperostosis, and additional lesions in the sample tend to support the concept that cribra orbitalia is related to anemia. Both inherited and acquired disorders may have been involved in the etiology. A uniquely high incidence of 52.9% occurred in immature of the Haida, a relatively homogeneous population. However, marked variability in expression by age group and by sex in the total sample is suggestive of iron-deficiency anemia. The data and historical information parallel modern expectations of susceptibility. Among 454 skulls, cribra orbitalia occurred in 32.7% of growing children and adolescents, 19% of infants and toddlers, 13.3% of adult females, and 4.8% of adult males. Postcontact disruptions and disease may have figured in promoting iron-deficiency anemia, but noted precontact occurrences may also have been due to the disorder.     

Cribra orbitalia and trace element content in human teeth from neolithic and early bronze age graves in southern Poland

Determination of element levels in bones and teeth can complement knowledge of the diagnostics and etiology of various diseases in prehistoric populations. Calcium (Ca), cadmium (Cd), copper (Cu), iron (Fe), and lead (Pb) content were analyzed in teeth from human skeletons dated to 3,000–1,400 BC from Malopolska Upland loess. Levels of iron and calcium were determined using atomic absorption spectroscopy (AAS), and lead, cadmium, and copper levels were measured using anodic stripping voltametry (ASV). Molar teeth from specimens with cribra orbitalia were selected for analyses, and teeth from specimens with no pathological changes were used as a control. No significant correlations between the content of particular elements and the tooth class, specimen age, or depth of burial pit were observed. The Fe content in specimens with cribra orbitalia is not the best measure for this disease's etiology. Thus, interelement correlations and proportions might give a better picture of the biological condition of the specimen and of the investigated groups. Am J Phys Anthropol 103:201–207, 1997. © 1997 Wiley-Liss, Inc.     

Paleoepidemiology of cribra orbitalia: Insights from early seventh millennium BP Con Co Ngua,Vietnam

Objectives

We test the hypothesis that the condition(s) leading to the development of cribra orbitalia at Con Co Ngua, an early seventh millennium sedentary foraging community in Vietnam, effectively reduced the resilience of the population to subsequent health/disease impacts. An assessment of both the implications and potential etiology of cribra orbitalia in this specific population is carried out.

Methods

The effective sample included 141 adults aged ≥15 years (53 females, 71 males, and 17 unknown sex) and 15 pre-adults aged ≤14 years. Cribra orbitalia was identified by way of cortical bone porosity of the orbital roof initiated within the diplöic space, rather than initiated subperiosteally. The approach is also robust to the misidentification of various pseudo-lesions. Resultant data was analyzed using Kaplan–Meier survival analysis.

Results

Median survival is higher in adults aged ≥15 years without cribra orbitalia than those with this lesion. For the pre-adult cohort, the opposite pattern is seen where median survival is higher in those with cribra orbitalia than those without.

Conclusion

Adults displayed increased frailty and pre-adults increased resilience with respect to cribra orbitalia. The differential diagnosis for a survival analysis of adults and pre-adults with and without cribra orbitalia included iron deficiency anemia and B12/folate deficiency, parasitism (including hydatid disease and malaria) in addition to thalassemia. The most parsimonious explanation for observed results is for both thalassemia and malaria being the chief etiological agents, while appreciating these conditions interact with, and can cause, other forms such as hematinic deficiency anemias.

     

Porotic hyperostosis in a marine-dependent California Indian population

A maize-based iron- and protein-deficient diet is commonly cited as the most important cause of porotic hyperostosis among American Indian agriculturalists. An alternative to this maize dependence hypothesis is suggested by the analysis of 432 crania from the nonagricultural, fish-dependent population of the Channel Island area of southern California. Cribra orbitalia, a form of porotic hyperostosis associated with iron deficiency anemia, is just as common among these fisherpeople, whose diet was rich in iron and essential amino acids, as it is among maize-dependent agriculturalists. Northern Channel Island crania have much more cribra orbitalia than those from the California mainland. The highest incidence is on San Miguel, a small geographically isolated island with a shortage of fresh water and terrestrial resources. The Indians who lived on Santa Cruz, the largest of the northern Channel Islands with the greatest diversity of terrestrial plants and animals, have less cribra orbitalia than those who lived on Santa Rosa or San Miguel Island. This geographical distribution appears to be explained by island-mainland and interisland differences in water contamination, exposure to fish-borne parasites, and nutritional adequacy of the diet. The prevalence of porotic hyperostosis in a population with a heavy dietary dependence on marine resources shows that among prehistoric American Indians, this condition is not always associated with an iron- and protein-deficient diet of cultigens. It seems likely that high nutrient losses associated with diarrheal disease are often more significant in the etiology of porotic hyperostosis than a low dietary intake of essential nutrients.     

The character of parietal and orbital alterations in the superfamily Hominoidea (families Hominidae [exclusive of Homo] and Hylobotidae)

Parietal external surface disruption routinely referred to as porotic hyperostosis, and orbital alterations (cribra orbitalia), have been attributed to anemia‐related bone marrow hyperplasia in humans. A recent study in humans identified that they were actually vascular in nature. Skeletons were examined and epi‐illumination surface microscopy was performed on the parietal region and orbit of 156 Hominidae and 123 Hylobotidae to assess if these phenomena were trans‐phylogenetic. Trans‐cortical channels were recognized on the basis of visualized ectocranial surface defects penetrating the parietal; cribra orbitalia, by alteration of the normally smooth orbital roof appearance. Trans‐cortical parietal channels, ranging in size from 20 to 100 µm, are rare in Gorilla and Pan troglodytes and absent in Pan paniscus. They are universally present in adult Pongo abeli and in Hylobatidae, independent of species. Cribra orbitalia was common in Hylobotidae, Pongo pygmaeus and P. abelii, less prevalent in adult P. troglodytes, and not recognized in any Gorilla gorilla or P. paniscus examined. The proliferative form predominated, with the exception of Hylobates concolor and muelleri, in which uncalcified vascular grooves predominated. No correlation was observed between the presence of either trans‐cortical channels or cribra orbitalia and fractures, osteoarthritis, or inflammatory arthritis. Parietal alterations observed in apes are trans‐cortical channels, analogous to those observed in humans, and do not represent porosity. Similarly, cribra orbitalia in apes is confirmed as vascular in nature. The proliferative form apparently represents calcification of blood vessel walls, indistinguishable from observations in humans. Predominant presence in adults rather than in juveniles suggests that both forms are acquired rather than developmental in derivation. Sex and bone alteration/disease‐independence suggests that mechanical, endocrine, and inflammatory phenomena do not contribute to the development of either. Further, independent occurrence of trans‐cortical channels and cribra orbitalia suggests that they do not have a shared etiology.     

Secular trend and age distribution of cribra orbitalia in Japanese

Cribra orbitalia is currently regarded as an indicator of environmental conditions. The prevalence and severity of this lesion in Japanese populations from prehistoric Jomon to modern times were recorded and discussed. Since the lesion was low in both frequency and grade in the late and final Jomon people from Chiba Prefecture, they presumably lived in relatively favorable environmental conditions. The increased prevalence of the lesion in the medieval Muromachi citizens of Kamakura may be attributed to the poor hygiene and social conditions. The high prevalence and marked severity of the lesion in the citizens of Edo (the old name of Tokyo) in the 17th century suggested that they lived under extremely unfavorable situations of nutrition, sanitation and medical care. Cribra orbitalia was most prevalent in adolescence (81.3%) among the Edo citizens. The incidence of the most severe type of lesion rose gradually during childhood, reached a peak in adolescence, and then gradually decreased with age. These findings would reflect intense marrow hyperplasia in the orbital roof associated with both iron deficiency anemia of long standing during the immature period and increased iron requirement in adolescence. The results obtained support the hypothesis that iron deficiency anemia is the primary factor in the etiology of cribra orbitalia. It was concluded that the incidence and severity of cribra orbitalia due to various anemic reactions reflected the dietary, hygienic, social and environmental circumstances of the populations investigated.     

Is cribra orbitalia synonymous with anemia? Analysis and interpretation of cranial pathology in Sudan

Cribra orbitalia is a porotic or sieve-like lesion in the bony orbital roof. Its cause has been the object of research and discussion since the end of the 19th century. Since about 1960, most scientists have started to agree on the hypothesis that the lesion is a result of hypertrophy of the red bone marrow, and therefore is proof of anemia. However, recent investigations showed that in some cases, the histologic bone structure does not support the diagnosis of anemia. The status of cribra orbitalia as an indicator then becomes uncertain. We carried out a histologic examination of thin-ground sections in polarized light to clarify the possible sources of orbital roof lesions in a Nubian population from Missiminia, northern Sudan (n = 333). In at least 56.5% of cribra orbitalia cases, there were no histologic features indicating changes due to anemia. Signs of other pathological conditions, such as inflammation or osteoporosis, as well as pseudopathological cases, were found.     

Factors influencing the etiology of cribra orbitalia in prehistoric Nubia

The present research represents an attempt to explain the occurrence of cribra orbitalia in Nubian skeletal remains associated with Meroitic, X-Group and Christian cultural horizons. The distribution of cribra orbitalia among 285 crania examined revealed a concentration of lesions among infants and aged individuals. While earlier studies have suggested cribra orbitalia may reflect the occurrence of abnormal hemoglobins such as sickle cell anemia or thalassemia, a consideration of the environmental context in which the lesions occurred makes an alternative hypothesis more likely. Particularly in Nubia (past and present), where parasitic infection is high, the diet is poor in iron, weanling diarrhea is frequent and multiparity is the norm, chronic iron deficiency anemia is a more likely causal factor. This interpretation is also compatable with clinical observations of cribra orbitalia among modern individuals suffering from chronic iron deficiency anemia.     

Morbidity in the marshes: using spatial epidemiology to investigate skeletal evidence for Malaria in Anglo-Saxon England (AD 410-1050)

Concerns over climate change and its potential impact on infectious disease prevalence have contributed to a resurging interest in malaria in the past. A wealth of historical evidence indicates that malaria, specifically Plasmodium vivax, was endemic in the wetlands of England from the 16th century onwards. While it is thought that malaria was introduced to Britain during the Roman occupation (AD first to fifth centuries), the lack of written mortality records prior to the post-medieval period makes it difficult to evaluate either the presence or impact of the disease. The analysis of human skeletal remains from archaeological contexts is the only potential means of examining P. vivax in the past. Malaria does not result in unequivocal pathological lesions in the human skeleton; however, it results in hemolytic anemia, which can contribute to the skeletal condition cribra orbitalia. Using geographical information systems (GIS), we conducted a spatial analysis of the prevalence of cribra orbitalia from 46 sites (5,802 individuals) in relation to geographical variables, historically recorded distribution patterns of indigenous malaria and the habitat of its mosquito vector Anopheles atroparvus. Overall, those individuals living in low-lying and Fenland regions exhibited higher levels of cribra orbitalia than those in nonmarshy locales. No corresponding relationship existed with enamel hypoplasia. We conclude that P. vivax malaria, in conjunction with other comorbidities, is likely to be responsible for the pattern observed. Studies of climate and infectious disease in the past are important for modeling future health in relation to climate change predictions.     

Oral and physiological paleohealth in cold adapted peoples: Northeast Asia, Hokkaido

This paper examines variables useful in reconstructing oral (caries, antemortem tooth loss, alveolar defects) and physiological (cribra orbitalia, linear enamel hypoplasia) well-being in two bioarchaeological assemblages from Hokkaido, Japan: Okhotsk (n = 37 individuals) and Jomon (n = 60). Findings are compared and contrasted with each other, with published series from Honshu Japan, and samples from climatically near-equivalent Alaska. It was found that more meaningful comparisons of Hokkaido paleohealth could be made with Alaskan material, rather than the more southerly Jomon. Results were ambiguous with respect to physiological well-being. Low levels of LEH in the cold-adapted samples suggest operating in arctic and subarctic environments with marine-based subsistence regimes is not physiologically expensive. However, the relatively high levels of cribra orbitalia in Hokkaido, relative to Alaska, suggest the picture is not straightforward: the reasons for elevated cribra orbitalia in Hokkaido are unclear. The subarctic and arctic samples formed three broadly similar groupings in terms of oral health profiles: (1) Aleuts and Eskimo; (2) Ipiutak and Tigara; (3) Hokkaido Jomon, Okhotsk, and Kodiak Island. Differences between these groupings could be explained with a combination of sample demographics and subsistence orientations. The extremely high frequency of caries in one sample, caribou hunting Ipiutak, may have been influenced by factors such as low levels of dietary magnesium and potentially cariogenic foodstuffs, such as preparations of caribou stomach contents. It was concluded that oral health profiles are potentially sensitive to differences in subsistence strategies among cold-adapted hunter-gatherers, although they lack predictive value.     

Cribra orbitalia in the aborigines of Hawaii and Australia

Cranii of 53 Hawaiian aboriginal infants and children, and 45 from Australian aboriginal children were inspected. Cribra orbitalia was present in 22.8% of the former and 26.6% of the latter; osteoporotic pitting (symmetrical osteoporosis; porotic hyperostosis) was also present in the latter. The frequency compares favorably with that found in pre-Columbian North American Pueblo Indians, 24.7%. It is associated with a widespread skeletal involvement suggestive of an active bone marrow. The findings support the concept that cribra orbitalia is related to symmetrical osteoporosis and that it may be associated with a blood disorder.     

Continuity or discontinuity of the life-style in central Italy during the Roman Imperial Age-Early Middle Ages transition: diet, health, and behavior

Dento-alveolar pathologies and alterations (dental wear, caries, abscesses, ante mortem tooth loss (AMTL), calculus, hypoplastic defects, and chipping) and skeletal markers of health (cribra orbitalia and periostitis) were analyzed in two skeletal samples from the necropolises of Quadrella (I-IV c. AD) and Vicenne-Campochiaro (VII c. AD) in the Molise region of central Italy. The aim was to determine if the Roman Imperial Age-Early Middle Ages transition characterized by political, socioeconomic, and cultural transformations affected the biology of these populations, particularly their alimentation and health status. The frequencies of caries and AMTL, similar in the two samples, suggest a high consumption of carbohydrates. The higher levels of heavy wear, calculus, and interproximal chipping in the Vicenne population indicate a greater use of fibrous foods (both meat and others), in line with the dietary model of Germanic peoples. Health conditions do not appear to have been good in either period, as shown by the high frequencies of linear hypoplasia and the presence of cribra orbitalia and periostitis. The diet of the individuals buried with horses of the Vicenne population did not differ from that of the rest of the population, whereas there were evident differences in the use of the teeth for nonmasticatory activities among these individuals. Therefore, from the point of view of alimentation and health status, the profound socioeconomic and cultural transformations during the Late Antiquity-Early Middle Ages transition do not seem to have been translated into a true discontinuity of the two Molisan populations.     

Osteological and dental markers of health in the transition from the Late Antique to the Early Medieval period in Croatia

The purpose of this study is to analyze health at the transition from the Late Antique (LA) to the Early Medieval (EM) period in Croatia. Results of the analyses of skeletal remains are compared with historical and archaeological data to test the hypothesis that the transition was catastrophic. An additional objective is to determine whether the transition was a uniform process, or differentially affected the past inhabitants of Croatia because of various local considerations. To accomplish this, four markers of health: cribra orbitalia, linear enamel hypoplasia, nonspecific periostitis, and trauma were compared in 981 skeletons: 477 from nine urban LA sites, and 504 from six rural EM sites. Data were collected by sex and age for individual, and for co-occurrences of various features. Because continental and Adriatic Croatia has different ecological features, data were specifically tabulated for the two regions. Comparisons between the continental and Adriatic regions of the LA series showed no significant differences in the frequencies of the analyzed markers of stress. Comparisons between the LA and EM series showed similar frequencies in continental Croatia--suggesting no significant discontinuity of living conditions, and a significant increase of cribra orbitalia, periostitis, and trauma frequencies during the EM period in Adriatic Croatia. The deterioration of living conditions primarily affected subadults and males. These data suggest that the transition from the LA to the EM period in Croatia was not a uniform process, but differentially affected population biology most likely because of local cultural, socio-economical or political considerations.     

Probable evidence of scurvy in subadults from archeological sites in Peru

Subadult scurvy is not well documented in archeological human remains despite the existence of many biomedical references indicating that bone changes do occur in some cases and, because of this, should be observable in human burials. There are several potential reasons for this gap in our knowledge of scurvy. Not all children who suffered from scurvy died of the disease or from other causes when they had scurvy. Scurvy may not leave characteristic bone changes in every case of the disease. Some of the pathological conditions associated with scurvy have been known for many years, but these features may be rare or difficult to differentiate from other pathological conditions. Recently a lesion of the skull has been described that is probably pathognomonic for scurvy, specifically porous and sometimes hypertrophic lesions of the greater wing of the sphenoid. This lesion is bilateral and highly associated with evidence of inflammation at other anatomical sites in the skull. A survey of subadult skulls (N = 363) in the human skeletal collection from Peru at the National Museum of Natural History, Smithsonian Institution, reveals a prevalence of 10% of skulls that exhibit plausible evidence of scurvy. Some cases of scurvy also have cribra orbitalia that has been attributed to anemia. In most of the Peruvian scurvy cases, anemia is an unlikely possibility because there is no evidence of marrow hyperplasia. This highlights the need for caution in using lesions of the orbit as an indicator of anemia when there is no other evidence of this disease elsewhere in the skeleton. Anatomical evidence of scurvy offers the potential of providing new and important evidence of diet in archeological human populations.     

河南渑池笃忠遗址仰韶晚期出土的人骨骨病研究

本文对河南省渑池笃忠遗址仰韶晚期灰坑出土人骨的骨病做了详细的观察.在牙病方面.对龋病、牙周病、牙釉质发育不全等情况做了记录和分析,应用两样本率差异的x2检验,比较了龋病在性别、年龄的差异.研究结果表明,笃忠组龋病的患齿率性别差异不显著,与年龄变化也没有明显的关系.此外,笃忠组人骨标本中还观察到错(牙合)畸形、骨瘤、退行...     

Female biological resiliency: Differential stress response by sex in human remains from ancient Nubia

This research presents male-female differences in stress response evidenced in human remains from the Medieval site of Kulubnarti in Sudanese Nubia. This analysis is unique in that a direct comparison of subadult males and females is rarely possible using archaeological remains. Rather, such analyses invariably rely on evidence of subadult differences retained in adult (sexable) skeletons. In the case of Kulubnarti, natural mummification has made it possible to measure sex-specific differences among subadults as well as adults following five avenues of investigation: 1) mortality, 2) growth and development, 3) enamel hypoplasia, 4) cribra orbitalia, and 5) cortical bone maintenance. A comparison of mean life expectancy (eox) values for males and females aged 10–55+ years revealed a consistent pattern of greater female survivorship, particularly in childhood (age 10 category) where female life expectancy exceeds that of males by 19%. Measures of growth and development, enamel hypoplasia, cribra orbitalia, and cortical bone loss were subsequently used to test a hypothesis of greater female resiliency based on the mortality data. Male-female differences in skeletal maturation are pronounced with male skeletal ages averaging a significant 2.9 years below their dental age. Females show no significant differences with an average skeletal age 0.75 years ahead of dental age. Males begin hypoplasia formation one year earlier than females and, prior to age four, average 18% more hypoplasias (p<0.05). Also, by age 8, males have on average more than twice the frequency of cribra orbitalia (p<0.05). In contrast to their consistent pattern of reduced childhood stress, adult females lose significantly more cortical bone than their male counterparts and have less cortical bone across the adult age range. Nevertheless, females outnumber males of all ages with a sex-ratio below but parallel to that observed in modern populations. The rapid age-related reduction in males relative to females, even in old age, suggests a continuing female resiliency in spite of their greater rate of osteopenia and may reflect a reproductive advantage to the population through heightened female survival and adaptability.     

The Alto Salaverry child: a case of anemia from the Peruvian preceramic.

Excavations during 1974 at the Peruvian Preceramic site of Alto Salaverry led to the discovery of a child's skeleton. The fragmentary skeleton exhibits cribra orbitalia, a pitting of the orbital roof associated with anemia. This specimen provides the first evidence of anemia in a population of the predominantly non-agricultural Peruvian Preceramic and extends the antiquity of the pathology among Precolumbian Peruvians.     

Cribra orbitalia in two temporally disjunct population samples from the Dakhleh Oasis, Egypt

Cribra orbitalia (CO), an osseous sign of anemic stress, occurs in 67% (n = 296) of the pre-Roman (n = 153) and Roman (n = 143) period crania from the Dakhleh Oasis, Egypt. CO is primarily a childhood condition in these samples, and its prevalence is significantly higher in virtually all cohorts in the pre-Roman group, including among females, who display higher rates of active lesions. This temporal trend suggests that the underlying causative factors (i.e., synergism between disease and nutrition) were less pervasive in the Roman period. In both population samples, anemic stress develops in some perinates prior to the expected minimum age for the development of iron deficiency anemia. This suggests additional causes of anemic stress in the Dakhleh population. A strong candidate is folic acid deficiency and its concomitant, megaloblastic anemia, which results from weaning of infants on goat's milk, a known practice in ancient Egypt. The putative incorporation of other food items in the weanling diet, particularly honey, a confirmed source of C. botulinum, represents yet another retrospective data source to help understand the epidemiological profile of cribra orbitalia in this population. Comparative data from other Egyptian populations, though limited, show similar patterns, however, they display a lower prevalence than the data from Dakhleh.     

The people of Jabuticabeira II: reconstruction of the way of life in a Brazilian shellmound

Sambaquis are huge shellmounds built along almost the entire Brazilian coast between 8000 and 600 years ago. In the present article, 14 osteological markers from 89 individuals excavated at the Sambaqui Jabuticabeira II (2890±55/2186±60 BP) are analyzed in order to reconstruct the population′s health status and way of life. The present palaeopathological findings (such as lower frequency of degenerative joint diseases in legs, as compared to arms, and the rarity of traumas) together with archaeological findings support the idea of nearby resource abundance and infrequent interpersonal competition. The presence of auditory exostoses mainly in males corroborates previous findings indicating the importance of marine resources. The low caries frequency and the high degrees of dental wear point to a diet poor in cariogenic food, and rich in abrasives such as sand, shell fragments and phytoliths. This suggests a broader diet, based on marine protein as well as plants, than previously thought. The etiology of cribra orbitalia could be explained by gastrointestinal parasites or other sources of physiological stress. These parasites, in turn, could have led to higher frequencies of infectious diseases, either by the debilitation of the immune system or by the direct contact with infectious agents. Despite the periods of illness various individuals experienced, the daily life among the builders of the Sambaqui Jabuticabeira II seems to have been relatively easy due to the abundance and predictability of resources and the paucity of violent traumas.