Vitamin D deficiency and rickets in the Eastern Province of Saudi Arabia.

Abstract

BACKGROUND:

Nutritional rickets remains prevalent in many developing countries, despite the availability of ample sunlight. The aim of this study was to investigate the clinical features and chemical pathology in a group of children with rickets and to compare them with a control group.

SUBJECTS AND METHODS:

In a case-control study over a 1-year period (March 2004 to February 2005), children clinically diagnosed with rickets (n=61) were age- and sex-matched with controls (n=58). In addition to routine chemical pathology, 25 (OH) vitamin D3 and parathormone (PTH) were determined. Controls were children without clinical rickets attending hospital for other blood investigations.

RESULTS:

The mean age of children with rickets was 14.8 mths and of controls was 16.5 mths. Mean (SD) body mass index of the children with rickets [16.8 (1.86)] was not significantly different from that of the controls [17.02 (3.16)]. Mean (SD) head circumference of rachitic children [45.41 (3.64) cm] was greater than that of controls [44.39 (5.07) cm, p=0.03]. Eighty per cent of the children with rickets were breastfed compared with 67% of controls. Thirty per cent of children with rickets were hypocalcaemic vs <7% of controls, 89% had phosphorus values <1.5 mmol/L vs 34.5% of controls and 75% had alkaline phosphatise levels >500 IU/L vs 28% of controls. Seventy-five per cent of children with rickets had serum 25 (OH) D3 <20 nmol/L vs 25% of controls. Mean (SD) PTH level was 23.59 (19.03) pmol/L in the rachitic group and 1.9 (1.05) pmol/L in controls (p<0.05). Lack of exposure to sunlight was recorded in 90% of the children with rickets and in 37% of the controls.

CONCLUSION:

Apparently healthy children living in areas where rickets is prevalent have risk factors for rickets and a small proportion will have evidence of biochemical rickets.

• Authors: Zaki H Al-Mustafa, Mohammed Al-Madan, Hussain J Al-Majid, Sami Al-Muslem, Suad Al-Ateeq, Amein K Al-Ali
• Journal: Annals of tropical paediatrics (Ann Trop Paediatr) Vol. 27 Issue 1 Pg. 63-7 (Mar 2007) ISSN: 0272-4936 [Print] England
• PMID: 17469734 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Parathyroid Hormone
• Phosphorus
• Alkaline Phosphatase
• Calcifediol
• Calcium

Topics

• Alkaline Phosphatase (blood)
• Breast Feeding (adverse effects)
• Calcifediol (blood)
• Calcium (blood)
• Case-Control Studies
• Female
• Humans
• Infant
• Male
• Parathyroid Hormone (blood)
• Phosphorus (blood)
• Rickets (blood, etiology)
• Risk Factors
• Saudi Arabia
• Sunlight
• Vitamin D Deficiency (blood, etiology)