Tags

Type your tag names separated by a space and hit enter

Physiologic Leg Bowing is not a Physiologic Condition but Instead is Associated with Vitamin D Disorders in Toddlers.

Abstract

When children around 2-year-old show leg bowing without lower-limb radiographic abnormalities for rickets, the leg bowing is classified as "physiologic" genu varum without conducting a blood test. However, it has recently been suggested that toddlers who are diagnosed with physiologic genu varum may in fact have some form of bone metabolic disorder. In this 1:2 case-control study, blood samples were obtained from 33 toddlers with genu varum without radiographic abnormalities for rickets and 66 age- and gender-matched healthy children. Serum alkaline phosphatase (sALP), intact parathyroid hormone (siPTH), 25-hydroxy vitamin D [s25(OH)D], calcium (sCa), and inorganic phosphate (sP) were measured. s25(OH)D of the subjects with genu varum (24.8 ng/ml) were significantly lower than those of the control (33.6 ng/ml) (p < 0.001). The frequency of vitamin D insufficiency/deficiency (< 20 ng/ml) of the subjects with genu varum (39%) was significantly higher than that in the control (14%) (p = 0.004) (odds ratio by vitamin D insufficiency/deficiency: 4.1 [1.5-11.1, p = 0.004]). sCa in subjects with genu varum (10.2 ng/ml) were significantly higher than in control (9.8 ng/ml) (p < 0.001), as were sALP (1057 IU/l) and siPTH (28.4 pg/ml) (740 IU/l and 8.8 pg/ml in control, respectively; p < 0.001). siPTH levels were associated with s25(OH)D levels in subjects with genu varum (r = - 0.57, p < 0.001), while no association was observed in the control (r = 0.11, p = 0.36). Genu varum without radiographic abnormalities of rickets was associated with both vitamin D and bone-metabolic disorders in toddlers, indicating that physiologic genu varum is not a physiologic condition in toddlers.

Authors+Show Affiliations

Department of Orthopaedics, Juntendo University Nerima Hospital, Tokyo, Japan.Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. ishijima@juntendo.ac.jp. Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan. ishijima@juntendo.ac.jp.Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan.Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan.Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.Clinic Bambini, Tokyo, Japan.Department of Orthopaedics, Juntendo University Nerima Hospital, Tokyo, Japan.Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan.Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan.Department of Orthopaedics, Juntendo University Nerima Hospital, Tokyo, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31595325

Citation

Sakamoto, Yuko, et al. "Physiologic Leg Bowing Is Not a Physiologic Condition but Instead Is Associated With Vitamin D Disorders in Toddlers." Calcified Tissue International, 2019.
Sakamoto Y, Ishijima M, Nakano S, et al. Physiologic Leg Bowing is not a Physiologic Condition but Instead is Associated with Vitamin D Disorders in Toddlers. Calcif Tissue Int. 2019.
Sakamoto, Y., Ishijima, M., Nakano, S., Suzuki, M., Liu, L., Tokita, A., ... Nozawa, M. (2019). Physiologic Leg Bowing is not a Physiologic Condition but Instead is Associated with Vitamin D Disorders in Toddlers. Calcified Tissue International, doi:10.1007/s00223-019-00619-9.
Sakamoto Y, et al. Physiologic Leg Bowing Is Not a Physiologic Condition but Instead Is Associated With Vitamin D Disorders in Toddlers. Calcif Tissue Int. 2019 Oct 8; PubMed PMID: 31595325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physiologic Leg Bowing is not a Physiologic Condition but Instead is Associated with Vitamin D Disorders in Toddlers. AU - Sakamoto,Yuko, AU - Ishijima,Muneaki, AU - Nakano,Satoshi, AU - Suzuki,Mitsuyoshi, AU - Liu,Lizu, AU - Tokita,Akifumi, AU - Kim,Sung-Gon, AU - Shimizu,Toshiaki, AU - Kaneko,Kazuo, AU - Nozawa,Masahiko, Y1 - 2019/10/08/ PY - 2019/05/10/received PY - 2019/09/21/accepted PY - 2019/10/10/entrez PY - 2019/10/9/pubmed PY - 2019/10/9/medline KW - Alkaline phosphatase KW - Genu varum KW - Parathyroid hormone KW - Physiologic leg bowing KW - Vitamin D JF - Calcified tissue international JO - Calcif. Tissue Int. N2 - When children around 2-year-old show leg bowing without lower-limb radiographic abnormalities for rickets, the leg bowing is classified as "physiologic" genu varum without conducting a blood test. However, it has recently been suggested that toddlers who are diagnosed with physiologic genu varum may in fact have some form of bone metabolic disorder. In this 1:2 case-control study, blood samples were obtained from 33 toddlers with genu varum without radiographic abnormalities for rickets and 66 age- and gender-matched healthy children. Serum alkaline phosphatase (sALP), intact parathyroid hormone (siPTH), 25-hydroxy vitamin D [s25(OH)D], calcium (sCa), and inorganic phosphate (sP) were measured. s25(OH)D of the subjects with genu varum (24.8 ng/ml) were significantly lower than those of the control (33.6 ng/ml) (p < 0.001). The frequency of vitamin D insufficiency/deficiency (< 20 ng/ml) of the subjects with genu varum (39%) was significantly higher than that in the control (14%) (p = 0.004) (odds ratio by vitamin D insufficiency/deficiency: 4.1 [1.5-11.1, p = 0.004]). sCa in subjects with genu varum (10.2 ng/ml) were significantly higher than in control (9.8 ng/ml) (p < 0.001), as were sALP (1057 IU/l) and siPTH (28.4 pg/ml) (740 IU/l and 8.8 pg/ml in control, respectively; p < 0.001). siPTH levels were associated with s25(OH)D levels in subjects with genu varum (r = - 0.57, p < 0.001), while no association was observed in the control (r = 0.11, p = 0.36). Genu varum without radiographic abnormalities of rickets was associated with both vitamin D and bone-metabolic disorders in toddlers, indicating that physiologic genu varum is not a physiologic condition in toddlers. SN - 1432-0827 UR - https://www.unboundmedicine.com/medline/citation/31595325/Physiologic_Leg_Bowing_is_not_a_Physiologic_Condition_but_Instead_is_Associated_with_Vitamin_D_Disorders_in_Toddlers L2 - https://dx.doi.org/10.1007/s00223-019-00619-9 DB - PRIME DP - Unbound Medicine ER -