Osteoporosis is reported to be rare in Black Africa. The low fracture incidence among North American black women is explained by a high peak bone mass and preservation of bone mineral into old age. To assess whether this is the case among Black African women, we measured bone mineral content (BMC) and bone mineral density (BMD), using single- and dual-photon absorptiometry, in 195 rural Gambian women aged over 44 years and 391 white women of comparable age from three centers in the U.K. Measurements were made at the midshaft of the radius, distal radius, lumbar spine, and femoral neck. The influence of height, weight, and nationality on BMC and BMD was analyzed. BMC and BMD decreased with age at all sites. Age, decreasing weight, but not height were independently associated with lower BMC at all sites. BMC in Gambian women was lower than in British women by 31% at the lumbar spine and 16% at the midshaft of the radius. After adjustment for age, height, and weight, BMC among Gambian women remained 24% lower at the lumbar spine and 10% lower at the radius. In women aged over 64 years, BMC at the lumbar spine was 42% lower and BMD was 31% lower in The Gambia (for all comparisons, p < 0.005). We conclude that bone mineral mass is not preserved in elderly Gambian women. However, minimal trauma fractures are rare in this population. These results challenge the concept of BMC as a primary determinant of fracture risk.

Twenty male patients with primary hypertriglyceridemia were treated for 4 weeks with daily supplements (15 g) of oil, which provided approximately 6 g of polyunsaturated fatty acid (PUFA) either of fish or of vegetable origin. Total plasma cholesterol concentrations were unaffected, but both types of supplement increased high density lipoprotein-3 (HDL 3 ) cholesterol concentrations. The fish, but not the vegetable, oil supplement led to a decrease in plasma triglyceride concentrations. Very low density lipoprotein (VLDL), fatty acid composition, and VLDL triglyceride kinetics were subsequently studied in five patients (four male, one female) before and after 4 weeks of therapy with 15 g of the same fish oil. The fish oil led to increases in the proportion of eicosapentaenoic acid in both the VLDL triglyceride and phospholipid fractions, but the increase was greater in the latter. In contrast, the proportion of docosahexanoic acid was increased only in the VLDL triglycerides. The decrease in plasma triglyceride concentrations that occurred with fish-oil therapy was accompanied by a reduction in the absolute catabolic rate of VLDL triglyceride, implying a concomitant change in synthetic rate; the fractional catabolic rate of VLDL triglyceride was unaltered. It is suggested that polyunsaturated fatty acids of marine origin may be therapeutically useful for hypertriglyceridemia. (Arteriosclerosis 5:459-465, September/October 1985)

If gamma-carboxylation, by the vitamin K1 - cycle, of glutamate residues of bone-matrix peptides is essential for the formation of bone, the circulating levels of this vitamin might indicate the potential efficiency of this process. Methods involving HPLC with electrochemical detection have very recently been developed for assaying the low levels of vitamin K1 that occur in normal plasma. Using such methods, we found that the circulating levels of vitamin K1 in osteoporotic patients (who had sustained either spinal crush-fractures or fractures of the neck of the femur) were significantly lower than those of age-matched control subjects.