scholarly journals Rickets in Children: An Update

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 738
Author(s):  
Cristina Gentile ◽  
Francesco Chiarelli
Keyword(s):  
Vitamin D ◽  
Physical Examination ◽  
Vitamin D Deficiency ◽  
Preventive Measures ◽  
Rapid Diagnosis ◽  
Common Disease ◽  
Biochemical Tests ◽  
Nutritional Rickets ◽  
Laboratory Features ◽  
Radiologic Features

Rickets refers to a deficient mineralization of the growth plate cartilage, predominantly affecting longer bones. Despite the fact that preventive measures are available, it is still a common disease worldwide; nutritional rickets, due to vitamin D deficiency or dietary calcium inadequate intake, remains the most common form. Medical history, physical examination, radiologic features and biochemical tests are essential for diagnosis. Although recent studies suggest hypophosphatemia as the leading alteration, rickets is classically divided into two categories: calcipenic rickets and phosphopenic rickets. Knowledge of this categorization and of respective clinical and laboratory features is essential for rapid diagnosis and correct management. The aim of this review is to analyze the epidemiological, pathogenetic, clinical, and therapeutic aspects of the different forms of rickets, describing the novelties on this “long-lived” disease.

scholarly journals VITAMIN D DEFICIENCY AND PARATOHOMMONIUM INCREASE IN LATE POSTOPERATIVE GASTRIC BYPASS IN ROUX-EN-Y

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Daniela Vicinansa MÔNACO-FERREIRA ◽  
Vânia Aparecida LEANDRO-MERHI ◽  
Nilton César ARANHA ◽  
Andre BRANDALISE ◽  
Nelson Ary BRANDALISE
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Calcium Metabolism ◽  
Calcium Deficiency ◽  
Ionized Calcium ◽  
Nutritional Deficiencies ◽  
Biochemical Tests

ABSTRACT Background : Roux-en-Y gastric bypass patients can experience changes in calcium metabolism and hyperparathyroidism secondary to vitamin D deficiency. Aim : To evaluate nutritional deficiencies related to the calcium metabolism of patients undergoing gastric bypass with a 10-year follow-up. Method : This is a longitudinal retrospective study of patients submitted to Roux-en-Y gastric bypass at a multidisciplinary clinic located in the Brazilian southeast region. The study investigated the results of the following biochemical tests: serum calcium, ionized calcium, vitamin D, and parathormone (PTH). The generalized estimating equations (GEE) determined the nutritional deficiencies using a significance level of 5%. Results : Among the patients who finished the study (120 months), 82.86% (n=29) had vitamin D deficiency, and 41.94% (n=13) had high PTH. Postoperative time had a significant effect on PTH (p=0.0059). The percentages of patients with vitamin D, serum calcium, and ionized calcium deficiencies did not change significantly over time. Conclusion : One of the outcomes was vitamin D deficiency associated with secondary hyperparathyroidism. These findings reaffirm the importance of monitoring the bone metabolism of patients submitted to Roux-en-Y gastric bypass. HEADINGS: Calcium deficiency. Vitamin D deficiency. Secondary hyperparathyroidism.

The Effects of Vitamin D Deficiency and Insufficiency on the Endocrine and Paracrine Systems

2007 ◽  
Vol 9 (2) ◽  
pp. 117-129 ◽  
Author(s):  
Patricia T. Alpert ◽  
Ulfat Shaikh
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Paracrine Effects ◽  
Breastfed Infants ◽  
Nutritional Rickets ◽  
Disease States

Individuals are capable of producing vitamin D with proper exposure to sunlight. However, several factors can interfere with the effectiveness of this process. Most sunscreens filter out UVB light, thus inhibiting vitamin D production. Individuals with more darkly pigmented skin have greater difficulty producing vitamin D because melanin acts as an effective natural sunscreen, requiring longer sun exposure to produce an adequate daily allotment of vitamin D. Additionally, solely breastfed infants whose mothers suffered from vitamin D deficiency or insufficiency when pregnant have smaller reserves of the nutrient and are at greater risk of developing nutritional rickets. Vitamin D deficiency leads to rickets, osteomalacia, and osteoporosis. Long-term vitamin D insufficiency can lead to paracrine effects such as type 1 diabetes, cancer, and multiple sclerosis. This article reviews the current literature on vitamin D deficiency and insufficiency and their relation to different disease states. Potential areas for research are discussed.

The Spectrum of Vitamin D Deficiency: Description of a Family

2017 ◽  
Vol 125 (07) ◽  
pp. 478-484 ◽  
Author(s):  
Francesco Vierucci ◽  
Marta Del Pistoia ◽  
Emioli Randazzo ◽  
Francesco Massart ◽  
Giovanni Federico
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
High Risk ◽  
Global Health ◽  
Vitamin D Deficiency ◽  
Family Members ◽  
Vitamin D Supplementation ◽  
Nutritional Rickets ◽  
Clinical Pictures ◽  
Global Health Problem

Abstract Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide. Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures. Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities. Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation. Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency.

scholarly journals Prevalence of vitamin D is not associated with the COVID-19 epidemic in Europe. A critical update of the existing evidence

2021 ◽  
Author(s):  
Dimitra Rafailia Bakaloudi ◽  
Michail Chourdakis
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Preventive Measures ◽  
Methodological Approach ◽  
Adult Population ◽  
Correlation Coefficients ◽  
European Countries ◽  
Global Pandemic ◽  
The Mean ◽  
The Relationship

ABSTRACTBackgroundCOVID-19 has emerged as a global pandemic, affecting nearly 104 million people worldwide as of February 4th 2021. In previous published studies, the association between the mean Vit D status of each country and COVID-19 infection rate, and mortality among the adult population in European countries was examined. The aim of this study was to re-examine the relationship between the Vit D status of each country and COVID-19 infection, recovery, and mortality using updated data and a different methodological approach.MethodsInformation only form the last decade on Vit D concentration/deficiency for each country was retrieved through literature search on PubMed® database. As of February, 4th 2021, COVID-19 infections and mortalities per one million population as well as total recoveries were extracted from the Worldometer website. The association between vitamin D deficiency and COVID-19 infection, recovery, and mortality were explored using correlation coefficients and scatterplots.FindingsThe prevalence of vitamin D deficiency among European countries ranged from 6.0 (Finland) to 75.5% (Turkey), with several countries facing more than 50% of vitamin D deficiency among their population. Non-significant correlations were observed between the number of COVID-19 infections (r=0.190; p=0.374), recoveries (rs=0.317, p=0.131), and mortalities (r=0.129; p=0.549) per one million population, with the prevalence of vitamin D deficiency.InterpretationPrevalence of vitamin D deficiency was not significantly associated with either number of infections, recoveries or mortality rate of COVID-19 among European countries. Thus, it is an important parameter to be considered when implementing preventive measures to face COVID-19.FundingNone

scholarly journals Social dilemma and vitamin D deficiency: a cross-sectional study of nutritional rickets in children ages 6 months to 24 months

2019 ◽  
Vol 6 (3) ◽  
pp. 1367
Author(s):  
Sajid S. ◽  
Irfan Khan ◽  
Khalid K. ◽  
Khalil A. ◽  
Zahid I. Marwat ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Breast Feeding ◽  
Social Dilemma ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutritional Rickets ◽  
Per Capita ◽  
Sun Light

Background: In developing countries, malnutrition's is one of the challenges that still need to be addressed. Undernutrition is usually a result of the unavailability of food and/or repeated infections in children. Countries with comparatively lower per-capita incomes as well as those with middle per-capita income have its increased prevalence in younger age. Social dilemma of mothers, like exclusively breastfeeding, heavy clothing’s and practice of keeping babies inside the doors, lead vitamin D deficiency and ultimately into nutritional rickets. The objective of this study was to determine the frequency of factors leading to nutritional rickets in children ages 6 months to 24 months.Methods: This cross-sectional study was conducted at Department of Pediatrics, Ayub Teaching Hospital, Abbottabad, Pakistan from March to December 2017. After inclusion/exclusion criteria, total 160 patients of rickets were observed. Detailed history followed by vitamin D level (<15 ng/ml) was measure. Data was analyzed by SPSS-22 and all documents were locked with principal author.Results: Present study showed that 62% children were in age ranged 6-12 months and 38% children were in age range 13-24 months. Mean age was 12 months with SD±2.16. Seventy nine percent children were male, and 21% children were females. More over 52% children had exclusive breast feeding, and 48% children did not have exclusive breast feeding. Similarly, 15% children had limited sun-light exposure and 85% children did not have limited sun-light exposure.Conclusions: Present study concluded that a lack of health education and sunlight exposure and exclusive breastfeeding were the significant risk factors contributed to nutritional rickets among children of Abbottabad, Pakistan.

scholarly journals Meat consumption reduces the risk of nutritional rickets and osteomalacia

2005 ◽  
Vol 94 (6) ◽  
pp. 983-991 ◽  
Author(s):  
Matthew G. Dunnigan ◽  
Janet B. Henderson ◽  
David J. Hole ◽  
E. Barbara Mawer ◽  
Jacqueline L. Berry
Keyword(s):  
Vitamin D ◽  
Relative Risk ◽  
Vitamin D Deficiency ◽  
Religious Affiliation ◽  
Outdoor Exposure ◽  
Negative Association ◽  
Dietary Factors ◽  
Degree Of Protection ◽  
Nutritional Rickets ◽  
Meat Content

Endogenous vitamin D deficiency (low serum 25(OH)D3) is a necessary but insufficient requirement for the genesis of vitamin D-deficiency rickets and osteomalacia. The magnitude of the independent contributions of dietary factors to rachitic and osteomalacic risk remains uncertain. We reanalysed two weighed dietary surveys of sixty-two cases of rickets and osteomalacia and 113 normal women and children. The independent associations of four dietary variables (vitamin D, Ca, fibre and meat intakes) and daylight outdoor exposure with rachitic and osteomalacic relative risk were estimated by multivariate logistic regression. Meat and fibre intakes showed significant negative and positive associations respectively with rachitic and osteomalacic relative risk (RR; zero meat intake: RR 29·8 (95 % CI 4·96, 181), P<0·001; fibre intake: RR 1·53 (95 % CI 1·01, 2·32), P+0·043). The negative association of meat intakes with rachitic and osteomalacic relative risk was curvilinear; relative risk did not fall further at meat intakes above 60 g daily. Daylight outdoor exposure showed a significant negative association with combined relative risk (RR 0·33 (95 % CI 0·17, 0·66), P<0·001). Operation of the meat and fibre risk factors was related to sex, age and dietary pattern (omnivore/lactovegetarian), mainly determined by religious affiliation. The mechanism by which meat reduces rachitic and osteomalacic risk is uncertain and appears independent of revised estimates of meat vitamin D content. The meat content of the omnivore Western diet may explain its high degree of protection against nutritional rickets and osteomalacia from infancy to old age in the presence of endogenous vitamin D deficiency.

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