Abstract

The purpose of this prospective study was to investigate the quantity and quality of bone by quantitative ultrasound (QUS) measurements and to assess bone resorption by urinary excretion measurement of C-terminal telopeptide of type I collagen (CTX) in an adult Turkish population living in an endemic fluorosis area and consuming drinking water with a high fluoride (F) concentration (mean 3.57 ppm F). Excretion of urinary CTX, heel broadband ultrasound attenuation (HBUA; dB/MHz), and speed of sound (SOS; m/s) were examined in 122 Turkish adults (37 pre-menopausal, 40 post-menopausal women, and 45 men) living in the endemic fluorosis area. For comparison, the same measurements were made on 117 controls (48 pre-menopausal women, 34 post-menopausal women, and 35 men) living in a nonendemic low F water area (mean 0.4 ppm F). In the F endemic area urinary excretion of CTX was higher in all subjects, whereas calcaneal BUA was lower in post-menopausal women. In the F endemic area SOS was significantly greater among pre-menopausal women but was not significantly different in the other two groups. Although non-trauma bone fracture rates were not significantly different among any of the groups, some of the bone marker differences indicate that exposure to prolonged high concentration of F may increase the risk of bone fracture, especially in post-menopausal women.

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