{"title":"Sex Estimation Using Patellar Morphometry: Evidence from a Late Roman Population in Anatolia.","authors":"Yarenkur Alkan, Adem Tokpinar","doi":"10.4274/MMJ.galenos.2025.38839","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Accurate sex estimation is a cornerstone in forensic and bioarchaeological investigations. While the pelvis and skull are traditionally used for this purpose, their absence due to taphonomic damage necessitates the use of alternative skeletal elements such as the patellar. This study evaluates the diagnostic potential of patellar morphometry for sex estimation in a Late Roman population.</p><p><strong>Methods: </strong>The study analyzed 146 adult patellar (70 males, 76 females) recovered from the Karlığın Tepesi Necropolis 3<sup>rd</sup>-6<sup>th</sup> centuries AD in Malatya, Türkiye. Standard osteological methods were used to determine sex. Three patellar dimensions/length (PL), patellar width (PW), and patellar thickness (PT)-were measured. Intraobserver reliability was assessed via technical error of measurement (TEM), relative TEM (rTEM), and the reliability coefficient (R). Stepwise logistic regression and receiver operating characteristic analyses were conducted to identify the best predictors of sex. Area under the receiver operating characteristic (AUROC) values, cut-off thresholds, and effect sizes were reported.</p><p><strong>Results: </strong>Statistically significant differences were found between males and females in PL (p=0.001), PW (p<0.001), and PT (p=0.003). The stepwise logistic regression model using PL and PT produced AUROC values of 0.906 in Step 1 and 0.920 in Step 2, with sensitivity and specificity ranging from 82.85% to 94.73%. All intraobserver reliability metrics (TEM, rTEM, R) indicated excellent measurement precision (R=1.000).</p><p><strong>Conclusions: </strong>Patellar morphometry demonstrates high diagnostic accuracy for sex estimation, particularly when multivariate models are applied. Despite the moderate discriminative power of patella thickness alone, its combination with other parameters enhances overall performance. The study provides the first population-specific discriminant model for sex estimation using the patella in an Anatolian archaeological sample. However, the skewed sex distribution and the possibility of post-depositional changes in ancient skeletal remains should be considered when interpreting results. Additionally, the population-specific nature of the archaeological sample and the lack of external validation on independent datasets limit the generalizability of the model to other contexts.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":"40 3","pages":"166-172"},"PeriodicalIF":1.1000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478640/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medeniyet medical journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4274/MMJ.galenos.2025.38839","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Accurate sex estimation is a cornerstone in forensic and bioarchaeological investigations. While the pelvis and skull are traditionally used for this purpose, their absence due to taphonomic damage necessitates the use of alternative skeletal elements such as the patellar. This study evaluates the diagnostic potential of patellar morphometry for sex estimation in a Late Roman population.
Methods: The study analyzed 146 adult patellar (70 males, 76 females) recovered from the Karlığın Tepesi Necropolis 3rd-6th centuries AD in Malatya, Türkiye. Standard osteological methods were used to determine sex. Three patellar dimensions/length (PL), patellar width (PW), and patellar thickness (PT)-were measured. Intraobserver reliability was assessed via technical error of measurement (TEM), relative TEM (rTEM), and the reliability coefficient (R). Stepwise logistic regression and receiver operating characteristic analyses were conducted to identify the best predictors of sex. Area under the receiver operating characteristic (AUROC) values, cut-off thresholds, and effect sizes were reported.
Results: Statistically significant differences were found between males and females in PL (p=0.001), PW (p<0.001), and PT (p=0.003). The stepwise logistic regression model using PL and PT produced AUROC values of 0.906 in Step 1 and 0.920 in Step 2, with sensitivity and specificity ranging from 82.85% to 94.73%. All intraobserver reliability metrics (TEM, rTEM, R) indicated excellent measurement precision (R=1.000).
Conclusions: Patellar morphometry demonstrates high diagnostic accuracy for sex estimation, particularly when multivariate models are applied. Despite the moderate discriminative power of patella thickness alone, its combination with other parameters enhances overall performance. The study provides the first population-specific discriminant model for sex estimation using the patella in an Anatolian archaeological sample. However, the skewed sex distribution and the possibility of post-depositional changes in ancient skeletal remains should be considered when interpreting results. Additionally, the population-specific nature of the archaeological sample and the lack of external validation on independent datasets limit the generalizability of the model to other contexts.
期刊介绍:
The Medeniyet Medical Journal (Medeniyet Med J) is an open access, peer-reviewed, and scientific journal of Istanbul Medeniyet University Faculty of Medicine on various academic disciplines in medicine, which is published in English four times a year, in March, June, September, and December by a group of academics. Medeniyet Medical Journal is the continuation of Göztepe Medical Journal (ISSN: 1300-526X) which was started publishing in 1985. It changed the name as Medeniyet Medical Journal in 2015. Submission and publication are free of charge. No fees are asked from the authors for evaluation or publication process. All published articles are available online in the journal website (www.medeniyetmedicaljournal.org) without any fee. The journal publishes intradisciplinary or interdisciplinary clinical, experimental, and basic researches as well as original case reports, reviews, invited reviews, or letters to the editor, Being published since 1985, the Medeniyet Med J recognizes that the best science should lead to better lives based on the fact that the medicine should serve to the needs of society, and knowledge should transform society. The journal aims to address current issues at both national and international levels, start debates, and exert an influence on decision-makers all over the world by integrating science in everyday life. Medeniyet Med J is committed to serve the public and influence people’s lives in a positive way by making science widely accessible. Believing that the only goal is improving lives, and research has an impact on people’s lives, we select the best research papers in line with this goal.