Smaller long bone cross-sectional size in people who died of tuberculosis: Insights on frailty factors from a 19th and early 20th century Finnish population

There is little research on how individuals suffering from tuberculosis may differ from those not infected in terms of overall skeletal morphology. Tuberculosis was endemic in 19th and early 20th century Finland making documented skeletal collections of Finns ideal to study effects of the disease on bone. The present study compares long bone cross-sectional total area between individuals who died of tuberculosis and those with another recorded cause of death in a Finnish sample. Adult male individuals (N = 105) were selected for analysis. Complete humeri (N = 56), femora (N = 66) and tibiae (N = 64) were 3D scanned using a laser scanner and total cross-sectional areas calculated with AsciiSection software. Individuals who died of tuberculosis (N = 24, 15 humeri, 14 femora, 13 tibiae) had, when standardized for body size, significantly smaller total cross-sectional femoral and humeral, but not tibial, areas. The mechanisms behind the observed relationship may reflect a combination of biological 'frailty' in terms of susceptibility to infection, reduced childhood activity and/or vitamin D deficiency, which possibly influenced both subperiosteal development during adolescence and, later, susceptibility to contracting and dying of TB. Due to the relatively small sample future studies are needed to further investigate the relationship between TB and bone cross-sectional size.