Objective

This paper will review how different methods employed to study bone loss in the past were used to explore different questions and aspects of bone loss, how methodology has changed over time, and how these different approaches have informed our understanding of bone loss in the past.

Materials and methods

A review and discussion is conducted on research protocols and results of 84 paleopathology publications on bone loss in archaeological skeletal collections published between 1969 and 2021.

Conclusions

The variety in research protocols confounds accurate meta-analysis of previously published research; however, more recent publications incorporate a combination of bone mass and bone quality based methods. Biased sample selection has resulted in a predominance of European and Medieval publications, limiting more general observations on bone loss in the past. Collection of dietary or paleopathological covariables is underemployed in the effort to interpret bone loss patterns.

Significance

Paleopathology publications have demonstrated differences in bone loss between distinct archaeological populations, between sex and age groups, and have suggested factors underlying observed differences. However, a lack of a gold standard has encouraged the use of a wide range of methods. Understanding how this array of methods effects results is crucial in contextualizing our knowledge of bone loss in the past.

Limitations

The development of a research protocol is also influenced by available expertise, available equipment, restrictions imposed by the curator, and site-specific taphonomic aspects. These factors will likely continue to cause (minor) biases even if a best practice can be established.

Suggestions for future research

Greater effort to develop uniform terminology and operational definitions of osteoporosis in skeletal remains, as well as the expansion of time scale and geographical areas studied. The Next-Generation Sequencing revolution has also opened up the possibility of ancient DNA analyses to study genetic predisposition to bone loss in the past.

中文翻译：

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古病理学中的骨质疏松症方法：方法论是如何塑造骨质流失研究的？

客观的

本文将回顾过去研究骨质流失所采用的不同方法是如何用于探索骨质流失的不同问题和方面的，方法如何随着时间的推移而发生变化，以及这些不同的方法如何帮助我们了解过去对骨质流失的理解。

材料和方法

回顾和讨论了 1969 年至 2021 年间出版的 84 篇关于考古骨骼收藏中骨质流失的古病理学出版物的研究方案和结果。

结论

研究方案的多样性混淆了对先前发表的研究的准确荟萃分析；然而，最近的出版物结合了基于骨量和骨质量的方法。有偏见的样本选择导致欧洲和中世纪出版物占主导地位，限制了过去对骨质流失的更一般性观察。在解释骨质流失模式的努力中，饮食或古病理学协变量的收集未得到充分利用。

意义

古病理学出版物已经证明了不同考古人群之间、性别和年龄组之间骨质流失的差异，并提出了观察到差异的潜在因素。然而，由于缺乏金标准，鼓励使用多种方法。了解这一系列方法如何影响结果对于了解我们过去对骨质流失的了解至关重要。

限制

研究方案的制定还受到可用专业知识、可用设备、馆长施加的限制以及特定地点的埋藏方面的影响。即使可以建立最佳实践，这些因素也可能会继续导致（轻微）偏差。

对未来研究的建议

更加努力地制定骨骼遗骸中骨质疏松症的统一术语和操作定义，以及扩大研究的时间尺度和地理区域。下一代测序革命也开启了通过古代 DNA 分析研究过去骨质流失遗传易感性的可能性。