Abstract
The sternal foramen, usually an asymptomatic osteological defect, can lead to catastrophic consequences if not recognized prior to certain medical procedures. This study reports the prevalence of a sternal foramen in two South Amerindian populations compared with other published populations. We evaluated the presence of sternal foramina using thoracic computed tomography scans of 1334 (48% female) participants from two indigenous populations of Bolivia (n = 900 Tsimane, 434 Moseten). The prevalence of sternal foramina was compared to two U.S. populations of similar sex/age distribution (n = 572 Midwest Americans, 131 self-identified Native North Americans) via similar CT scans. A sternal foramen was significantly more common in the two Bolivian populations (prevalence ranging from 12.8 to 13.4%), compared to 4.4–5.1% in the two U.S. groups, consistent with prior estimates in studies from industrialized populations. Males had higher frequency of a sternal foramen compared to females in each of the four groups (OR = 1.904, 95% CI: 1.418–2.568, p < 0.001). Age was not associated with sternal foramen presence. These data show both a higher rate of sternal foramina in the South Amerindian populations versus comparator populations in North America and the highest rate of any studied living population. Although it is not possible to determine from our data the relative contribution of genetics versus early life or environmental causes to the higher rates of sternal foramen, we note that small prior studies have likewise demonstrated a higher prevalence in lower income countries. Further determination of the contributing factors warrants greater investigation and research.
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Acknowledgements
The authors thank the Tsimane and US participants, and the THLHP team for their relentless efforts. We also thank the HORUS Study Team for assistance in conducting the study.
Funding
The Tsimane Health and Life History Project (THLHP) is funded by the National Institute on Aging within the National Institute of Health (RF1AG054442 and 3RF1AG054442-02S2) and by National Science Foundation (1748282). RCT acknowledges funding from St. Luke’s Hospital Foundation of Kansas City. BCS1440212). JS acknowledges the Institute for Advanced Study in Toulouse (IAST) funding from the French National Research Agency (ANR) under grant ANR-17-EURE-0010 (Investissements d’Avenir program).
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BDG: Data collection, data analysis, manuscript writing and editing; ADN: Data collection and data analysis; LJU: Manuscript writing and editing; BCT: Subject recruitment, data analysis, manuscript writing and editing; DKC: Data analysis, manuscript writing and editing; LSW: Data collection, data analysis, manuscript framing writing and editing; KRL: Data collection and manuscript editing; AM: Data collection and manuscript editing; DER: Data collection and manuscript editing; DEM: Data analysis and manuscript editing; CJR: Data collection and manuscript editing; CEF: Data gathering and critical manuscript editing; MLS: Data gathering and manuscript editing; JDS: Data gathering and manuscript editing; AHA: Data gathering and manuscript editing. JS: Subject recruitment, obtaining funding, data collection, and manuscript editing; MG: Protocol/project development, obtaining funding, data collection, and manuscript editing; HK: Protocol/project development, obtaining funding, data analysis, and manuscript editing; GST: Study concept, data analysis, and manuscript editing; RCT: Protocol/project development, data collection, data analysis, and manuscript writing and editing.
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This study was approved by the University of New Mexico and University of California, Santa Barbara human subject review committees and by the Institutional Review Board of St. Luke’s Hospital of Kansas City.
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Written informed consent was obtained from all Tsimane and Moseten participants after the procedure and risks were explained to them in their respective native language, as well as from each village, and by the tribal governments (Gran Consejo Tsimane; Gran Consejo Regional Moseten). Radiation dose was low (≈ 2 mSv), and all participants were mature adults (≥ 40 years). Informed consent for the US patients was waived by the St. Luke’s Hospital IRB as the study was conducted by a retrospective chart review of existing medical records.
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Gans, B.D., Neunuebel, A.D., Umbarger, L.J. et al. High prevalence of sternal foramina in indigenous Bolivians compared to Midwest Americans and indigenous North Americans (sternal foramina in indigenous Bolivians). Anat Sci Int 96, 517–523 (2021). https://doi.org/10.1007/s12565-021-00618-7
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DOI: https://doi.org/10.1007/s12565-021-00618-7
Keywords
- Comparator
- Computed tomography
- Indigenous
- Moseten
- Sternal foramen
- Tsimane