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Dual Energy X-Ray Absorptiometry (DXA) study of endemic skeletal fluorosis in a village of Nalgonda District, Andhra Pradesh, IndiaAbstract
A comparative study of bone mineral density (BMD) and bone fracture was conducted in a fluorotic and a nonfluorotic area of the Nalgonda District, Andhra Pradesh, India. BMD measured by dual X- ray absorptiometry (DXA) of L2–L4 vertebrae, femoral neck, hip, and whole body was significantly higher by 112%, 43%, 57%, and 50%, respectively, in 12 fluorotic subjects than in 14 nonfluorotic subjects (p<0.01). However, there was an 11% decrease, although not statistically significant, in forearm BMD in the fluorotic subjects compared to the nonfluorotic subjects. Serum levels of total and bone specific alkaline phosphatase in the fluorotic subjects were significantly elevated by 219 and 313% , respectively (p<0.01), whereas serum Ca, protein, and phosphorus were 10, 12, and 32% lower, respectively (p<0.01). On the other hand, serum creatinine, urea, and zinc levels in the two groups of subjects were not significantly different. In the fluorotic village, with a 34% lower average consumption unit intake of calcium, the overall bone fracture rate of 6.3% was significantly higher than the 2.1% rate in the nonfluorotic village (p<0.05).