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Varying role of vitamin D deficiency in the etiology of rickets in young children vs. adolescents in northern India.
J Trop Pediatr. 2003 08; 49(4):201-6.JT

Abstract

The relative importance of calcium vs. vitamin D deficiency in the etiology of nutritional rickets in the tropics may be different in children compared with adolescents. We studied calcium intake, sun exposure, serum alkaline phosphatase, and 25 hydroxyvitamin D in 24 children and 16 adolescents with rickets/osteomalacia. The values were compared with those obtained in control subjects (34 children and 19 adolescents). We found that young children with rickets had lower calcium intake compared with controls (285 +/- 113 vs. 404 +/- 149 mg/day, p < 0.01), but similar sun exposure (55 +/- 28 vs. 56 +/- 23 min x m2/day) and 25 hydroxyvitamin D (49 +/- 38 vs. 61 +/- 36 nmol/l). Sixteen of 24 children with rickets had 25 hydroxyvitamin D above the rachitic range (> 25 nmol/l), in contrast to one of 16 adolescents. Adolescent patients had low calcium intake vs. controls (305 +/- 196 vs. 762 +/- 183 mg, p < 0.001), and lower sunshine exposure (16 +/- 15 vs. 27 +/- 17 min x m2/day, p < 0.01) and serum 25 hydroxyvitamin D (12.6 +/- 7.1 vs. 46 +/- 45.4 nmol/l, p < 0.001). The odds ratio for developing rickets with a daily calcium intake below 300 mg was 4.8 (95 per cent CI, 1.9 - 12.4, p = 0.001). Subjects with rickets were randomized to receive 1 g calcium daily, with or without vitamin D. Children showed complete healing in 3 months, whether they received calcium alone or with vitamin D. Adolescents showed no response to calcium alone, but had complete healing with calcium and vitamin D in 3-9 months (mean 5.3 months). Thus deficient calcium intake is universal among children and adolescents with rickets/osteomalacia. Inadequate sun exposure and vitamin D deficiency are important in the etiology of adolescent osteomalacia.

Authors+Show Affiliations

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12929879

Citation

Balasubramanian, K, et al. "Varying Role of Vitamin D Deficiency in the Etiology of Rickets in Young Children Vs. Adolescents in Northern India." Journal of Tropical Pediatrics, vol. 49, no. 4, 2003, pp. 201-6.
Balasubramanian K, Rajeswari J, Gulab , et al. Varying role of vitamin D deficiency in the etiology of rickets in young children vs. adolescents in northern India. J Trop Pediatr. 2003;49(4):201-6.
Balasubramanian, K., Rajeswari, J., Gulab, ., Govil, Y. C., Agarwal, A. K., Kumar, A., & Bhatia, V. (2003). Varying role of vitamin D deficiency in the etiology of rickets in young children vs. adolescents in northern India. Journal of Tropical Pediatrics, 49(4), 201-6. https://doi.org/10.1093/tropej/49.4.201
Balasubramanian K, et al. Varying Role of Vitamin D Deficiency in the Etiology of Rickets in Young Children Vs. Adolescents in Northern India. J Trop Pediatr. 2003;49(4):201-6. PubMed PMID: 12929879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Varying role of vitamin D deficiency in the etiology of rickets in young children vs. adolescents in northern India. AU - Balasubramanian,K, AU - Rajeswari,J, AU - Gulab,, AU - Govil,Y C, AU - Agarwal,A K, AU - Kumar,A, AU - Bhatia,V, PY - 2003/8/22/pubmed PY - 2003/10/16/medline PY - 2003/8/22/entrez SP - 201 EP - 6 JF - Journal of tropical pediatrics JO - J. Trop. Pediatr. VL - 49 IS - 4 N2 - The relative importance of calcium vs. vitamin D deficiency in the etiology of nutritional rickets in the tropics may be different in children compared with adolescents. We studied calcium intake, sun exposure, serum alkaline phosphatase, and 25 hydroxyvitamin D in 24 children and 16 adolescents with rickets/osteomalacia. The values were compared with those obtained in control subjects (34 children and 19 adolescents). We found that young children with rickets had lower calcium intake compared with controls (285 +/- 113 vs. 404 +/- 149 mg/day, p < 0.01), but similar sun exposure (55 +/- 28 vs. 56 +/- 23 min x m2/day) and 25 hydroxyvitamin D (49 +/- 38 vs. 61 +/- 36 nmol/l). Sixteen of 24 children with rickets had 25 hydroxyvitamin D above the rachitic range (> 25 nmol/l), in contrast to one of 16 adolescents. Adolescent patients had low calcium intake vs. controls (305 +/- 196 vs. 762 +/- 183 mg, p < 0.001), and lower sunshine exposure (16 +/- 15 vs. 27 +/- 17 min x m2/day, p < 0.01) and serum 25 hydroxyvitamin D (12.6 +/- 7.1 vs. 46 +/- 45.4 nmol/l, p < 0.001). The odds ratio for developing rickets with a daily calcium intake below 300 mg was 4.8 (95 per cent CI, 1.9 - 12.4, p = 0.001). Subjects with rickets were randomized to receive 1 g calcium daily, with or without vitamin D. Children showed complete healing in 3 months, whether they received calcium alone or with vitamin D. Adolescents showed no response to calcium alone, but had complete healing with calcium and vitamin D in 3-9 months (mean 5.3 months). Thus deficient calcium intake is universal among children and adolescents with rickets/osteomalacia. Inadequate sun exposure and vitamin D deficiency are important in the etiology of adolescent osteomalacia. SN - 0142-6338 UR - https://www.unboundmedicine.com/medline/citation/12929879/Varying_role_of_vitamin_D_deficiency_in_the_etiology_of_rickets_in_young_children_vs__adolescents_in_northern_India_ L2 - https://academic.oup.com/tropej/article-lookup/doi/10.1093/tropej/49.4.201 DB - PRIME DP - Unbound Medicine ER -