Rickets in the Middle East: Role of Environment and Genetic Predisposition

Baroncelli, Giampiero I.; Bereket, Abdullah; Kholy, Mohamed El; Audı́, Laura; Cesur, Yaşar; Özkan, Behzat; Rashad, Mona M.; Fernández‐Cancio, Mónica; Weisman, Y; Saggese, Giuseppe; Hochberg, Zèev

doi:10.1210/jc.2007-1413

Cited by 113 publications

(90 citation statements)

References 32 publications

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“…Some studies investigating the genetic factors involved in vitamin D-deficient rickets identified association with VDR ApaI and FokI polymorphisms, whereas others found no association with BsmI, ApaI, and TaqI polymorphisms [40][41][42][43]. Additionally, an almost significant degree of association has been reported between ApaI polymorphism and osteomalacia [44].…”

Section: Discussionmentioning

confidence: 99%

Association of vitamin D-related gene polymorphisms with manifestation of vitamin D deficiency in children

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Association of vitamin D-related gene polymorphisms with manifestation of vitamin D deficiency in children

et al. 2012

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“…Furthermore, the prevalence of vitamin D deficiency is significantly higher in Arab women and children than in the white population (12)(13)(14)(15) . Sedrani et al reported that severe hypovitaminosis D (25-hydroxyvitamin D (25OHD) level #20 nmol/l) was present in 52 % of Saudi females aged 35?4 (SD 11?3) years (16) , but few data exist comparing age-matched boys and girls in Saudi Arabia within the same study design (17) .…”

mentioning

confidence: 99%

Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health

Al-Ghamdi

Lanham-New

Kahn

2012

Public Health Nutr.

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Objective: Few data exist looking at vitamin D status and bone health in schoolaged boys and girls from Saudi Arabia. The present study aimed to determine the extent of poor vitamin D status in school boys and girls aged 6-18 years and to examine if there was any difference in status with age, physical activity and veiling and concomitant effects on bone. Design: Cross-sectional study. Setting: Jeddah, Kingdom of Saudi Arabia. Subjects: A total of 150 boys (7-16 years) and 150 girls (6-18 years) from local schools were divided into age categories: 6-9 years (elementary school); 10-12 years (secondary school); 13-14 years (middle years); 15-18 years (high school). Results: Vitamin D status was significantly lower in girls than boys in all age groups (P , 0?01), with the 15-18-year-old girls having the lowest level (22?0 (SD 9?4) nmol/l) in comparison to the 15-18-year-old boys (39?3 (SD 14?0) nmol/l) and the 6-9-year-old girls (41?2 (SD 9?3) nmol/l). Parathyroid hormone status was highest in the 15-18-year-old girls in comparison to boys of the same age. A total of 64 % of 15-18-year-old girls had 25-hydroxyvitamin D (25OHD) status ,25 nmol/l in comparison to 31 % in the 13-14 years age category, 26 % in the 10-12 years category and 2?5 % in the 6-9 years category. No boys had 25OHD status ,25 nmol/l. Fully veiled girls had lower 25OHD status than partly veiled or unveiled girls (P , 0?05). Low 25OHD and high parathyroid hormone was associated with lower bone mass in the 6-9 years and 13-14 years age groups (P , 0?05). Conclusions: These data suggest significant hypovitaminosis D in older adolescent females, which is a cause for concern given that there is currently no public health policy for vitamin D in the Kingdom of Saudi Arabia.

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“…Poverty, which is associated with rickets 16 , might explain the observed regional variation in rickets prevalence. The percentage of adults living in extreme poverty in the counties with hospitals’ in the CIN ranges from 21% to 65% 10 .…”

Section: Discussionmentioning

confidence: 99%

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

Karuri¹,

Murithi²,

Irimu³

et al. 2017

Wellcome Open Res

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Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences.

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Rickets in the Middle East: Role of Environment and Genetic Predisposition

Cited by 113 publications

References 32 publications

Association of vitamin D-related gene polymorphisms with manifestation of vitamin D deficiency in children

Association of vitamin D-related gene polymorphisms with manifestation of vitamin D deficiency in children

Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

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