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Case-control study of factors associated with nutritional rickets in Nigerian children.
J Pediatr. 2000 Sep; 137(3):367-73.JPed

Abstract

OBJECTIVE

Because the causes of nutritional rickets in tropical countries are poorly understood, we conducted a case-control study to determine factors associated with rickets in Nigerian children.

STUDY DESIGN

We compared 123 Nigerian children who had rickets with matched control subjects. Dietary, demographic, anthropometric, and biochemical data were collected to assess factors related to calcium and vitamin D status, which might predispose children to rickets.

RESULTS

Mean (+/- SD) daily dietary calcium intake was low in both children with rickets and control children (217 +/- 88 mg and 214 +/- 77 mg, respectively; P =.64). Children with rickets had a greater proportion of first-degree relatives with a history of rickets (14.6% vs 3.1%; P <.001), a shorter mean duration of breast-feeding (16.0 vs 17.3 months; P =.041), and a delayed age of walking (14 vs 12 months; P <.001). Among children with rickets, biochemical features suggestive of calcium deficiency included hypocalcemia, extremely low calcium excretion, and elevated 1, 25-dihydroxyvitamin D and parathyroid hormone values. Median 25-hydroxyvitamin D concentrations were 32 and 50 nmol/L (13 and 20 ng/mL) in children with rickets and control children, respectively (P <.0001). Only 46 subjects with rickets (37%) had 25-hydroxyvitamin D values <30 nmol/L (12 ng/mL).

CONCLUSIONS

Vitamin D deficiency appears unlikely to be the primary etiologic factor of rickets in African children. Moreover, low dietary calcium intake alone does not account for rickets. Insufficient dietary calcium probably interacts with genetic, hormonal, and other nutritional factors to cause rickets in susceptible children.

Authors+Show Affiliations

Department of Family Medicine, Jos University Teaching Hospital, Jos, Nigeria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10969262

Citation

Thacher, T D., et al. "Case-control Study of Factors Associated With Nutritional Rickets in Nigerian Children." The Journal of Pediatrics, vol. 137, no. 3, 2000, pp. 367-73.
Thacher TD, Fischer PR, Pettifor JM, et al. Case-control study of factors associated with nutritional rickets in Nigerian children. J Pediatr. 2000;137(3):367-73.
Thacher, T. D., Fischer, P. R., Pettifor, J. M., Lawson, J. O., Isichei, C. O., & Chan, G. M. (2000). Case-control study of factors associated with nutritional rickets in Nigerian children. The Journal of Pediatrics, 137(3), 367-73.
Thacher TD, et al. Case-control Study of Factors Associated With Nutritional Rickets in Nigerian Children. J Pediatr. 2000;137(3):367-73. PubMed PMID: 10969262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case-control study of factors associated with nutritional rickets in Nigerian children. AU - Thacher,T D, AU - Fischer,P R, AU - Pettifor,J M, AU - Lawson,J O, AU - Isichei,C O, AU - Chan,G M, PY - 2000/9/2/pubmed PY - 2000/10/7/medline PY - 2000/9/2/entrez SP - 367 EP - 73 JF - The Journal of pediatrics JO - J. Pediatr. VL - 137 IS - 3 N2 - OBJECTIVE: Because the causes of nutritional rickets in tropical countries are poorly understood, we conducted a case-control study to determine factors associated with rickets in Nigerian children. STUDY DESIGN: We compared 123 Nigerian children who had rickets with matched control subjects. Dietary, demographic, anthropometric, and biochemical data were collected to assess factors related to calcium and vitamin D status, which might predispose children to rickets. RESULTS: Mean (+/- SD) daily dietary calcium intake was low in both children with rickets and control children (217 +/- 88 mg and 214 +/- 77 mg, respectively; P =.64). Children with rickets had a greater proportion of first-degree relatives with a history of rickets (14.6% vs 3.1%; P <.001), a shorter mean duration of breast-feeding (16.0 vs 17.3 months; P =.041), and a delayed age of walking (14 vs 12 months; P <.001). Among children with rickets, biochemical features suggestive of calcium deficiency included hypocalcemia, extremely low calcium excretion, and elevated 1, 25-dihydroxyvitamin D and parathyroid hormone values. Median 25-hydroxyvitamin D concentrations were 32 and 50 nmol/L (13 and 20 ng/mL) in children with rickets and control children, respectively (P <.0001). Only 46 subjects with rickets (37%) had 25-hydroxyvitamin D values <30 nmol/L (12 ng/mL). CONCLUSIONS: Vitamin D deficiency appears unlikely to be the primary etiologic factor of rickets in African children. Moreover, low dietary calcium intake alone does not account for rickets. Insufficient dietary calcium probably interacts with genetic, hormonal, and other nutritional factors to cause rickets in susceptible children. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/10969262/Case_control_study_of_factors_associated_with_nutritional_rickets_in_Nigerian_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(00)43487-6 DB - PRIME DP - Unbound Medicine ER -