Fluoride Action Network


The aim of this comparative study was to investigate the bone mineral density (BMD) and bone mineral content (BMC) in a group of subjects who have been living in a village endemic for fluorosis since their birth. The fluoride in drinking water was around 4.5 ppm in the village. The control group comprised of subjects ingesting normal level of fluoride. Twelve apparently healthy (men and women) subjects were randomly selected from the fluorotic village of Nalgonda district. Fourteen, age and sex matched control individuals from urban slum were selected for comparison. Bone mineral density of L2–L4 vertebrae, femur neck, hip, whole body and left fore arm were measured using dual X-ray absorptiometry (DXA). Bone related biochemical parameters like serum calcium (Ca), phosphorus (P), zinc (Zn), total alkaline phosphatase and bone specific alkaline phosphatase were analyzed in both the groups. The BMD of L2–L4 vertebrae, femoral neck, hip and whole body were significantly higher in fluorotic than non-fluorotic subjects (P < 0.01). However, there was decrease in forearm BMD in fluorotic subjects although not significant when compared to nonfluorotic subjects. Levels of total and bone specific alkaline phosphatases in serum were significantly elevated (P < 0.01) in fluorotic group than non fluorotic group, whereas serum Ca, protein and phosphrous was significantly lower (P < 0.01) in fluorotic group than nonfluorotic group. However, there was no significant difference in serum zinc levels in both the groups. Higher BMD levels were seen in fluorotic subjects, indicating that BMD measurement along with bone related biochemical parameters can be used as diagnostic markers which in turn can help in prevention and management of this crippling disease.