47 - Cribra Orbitalia Is Associated with Increased Visceral Fat and Reduction of the Vertebral Neural Canal in a Pediatric Autopsy Sample

Poster Board Number: 47
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Abstract Body : Cribra orbitalia (CO) and porotic hyperostosis (PH) are porous lesions that develop on the orbital roof and cranial vault, respectively. They can form in children from 0.5 up to 8 years of age. In anthropological settings, the presence of CO and PH is interpreted as signs of iron deficiency, anemia, and nutrient deficiency, but their etiology is debated. Recent research indicates that individuals with respiratory diseases have increased odds of developing CO and PH and that CO is associated with increased mortality hazards and worse long-term health outcomes than PH. Other biomarkers of stress or pathology, such as accumulation of visceral adipose tissue (VAT), low subcutaneous adipose tissue (SAT), low bone mineral density (BMD), and small vertebral neural canal (VNC) size, have independently shown some degree of association with increased mortality risk, early mortality, low socioeconomic status, or adverse health outcomes. However, little is known about their concomitant levels of expression or association with CO or PH. We hypothesize that the presence of CO, but not PH, is associated with increased VAT and decreased VNC.

We examine the association of CO and PH with respiratory diseases, sex, VAT, SAT, BMD of the fourth lumbar vertebra (L4), and VNC size of the twelfth thoracic (T12) and fifth lumbar (L5) vertebrae in a contemporary pediatric autopsy sample of 270 individuals aged 05 to 20.9 years from New Mexico. The anterior-posterior (AP) and transverse (TR) diameters of the VNC for the 5th lumbar (L5) and 12th thoracic vertebra (T12) were measured on the virtually reconstructed surfaces of the bones from post-mortem computed tomography (PMCT) scans using the Amira medical imaging software. VAT, SAT, BMD (Hounsfield Units), and CO /PH were recorded using Horos, a freeware DICOM viewer. Stepwise logistic regression (p>0.2) in the Stata 15 software was used for model selection.

Individuals with PH have increased odds of having respiratory diseases and reduced L5-AP diameters. CO shows associations with other markers of early stress or higher disease susceptibility: reduction of T12-AP and L5-TR diameters, higher VAT, lower SAT, and reduction of BMD in L4 (10% levels). Because of its association with not only illness but also visceral adiposity and reduction of the VNC, it can be assumed that CO is representative of severe health issues, perhaps more so than PH. CO may be more likely to occur in individuals who were stressed in early life (as inferred through reduction of VNC) compared to those with PH.