Nutritional rickets around the world: causes and future directions

Thacher, Tom D.; Fischer, Philip R.; Strand, Mark; Pettifor, John M.

doi:10.1179/146532806x90556

Cited by 249 publications

(164 citation statements)

References 121 publications

(117 reference statements)

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…Rickets is the most common bone disease in children worldwide, but data on prevalence are few [56,57]. The disease often afflicts immigrants, including children with dark pigmentation living in low-UVB environments and those living in poverty in cities with little access to recreational sunshine.…”

Section: Diseases Related To Uvb Exposure Insufficient To Maintain Admentioning

confidence: 99%

Human skin pigmentation, migration and disease susceptibility

Jablonski

Chaplin

2012

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

Human skin pigmentation evolved as a compromise between the conflicting physiological demands of protection against the deleterious effects of ultraviolet radiation (UVR) and photosynthesis of UVB-dependent vitamin D 3 . Living under high UVR near the equator, ancestral Homo sapiens had skin rich in protective eumelanin. Dispersals outside of the tropics were associated with positive selection for depigmentation to maximize cutaneous biosynthesis of pre-vitamin D 3 under low and highly seasonal UVB conditions. In recent centuries, migrations and high-speed transportation have brought many people into UVR regimes different from those experienced by their ancestors and, accordingly, exposed them to new disease risks. These have been increased by urbanization and changes in diet and lifestyle. Three examples-nutritional rickets, multiple sclerosis (MS) and cutaneous malignant melanoma (CMM)-are chosen to illustrate the serious health effects of mismatches between skin pigmentation and UVR. The aetiology of MS in particular provides insight into complex and contingent interactions of genetic and environmental factors necessary to trigger lethal disease states. Low UVB levels and vitamin D deficiencies produced by changes in location and lifestyle pose some of the most serious disease risks of the twenty-first century.

show abstract

Section: Diseases Related To Uvb Exposure Insufficient To Maintain Admentioning

confidence: 99%

Human skin pigmentation, migration and disease susceptibility

Jablonski

Chaplin

2012

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

show abstract

“…Although the pathophysiology of nutritional rickets and preventive measures are well recognized, the disease is not eradicated in industrialized countries (2). In a study conducted in Copenhagen between 1990 and 1999, only 40 cases of rickets were found, all among immigrant children (3).…”

Section: Introductionmentioning

confidence: 99%

Incidence and prevalence of nutritional and hereditary rickets in southern Denmark

Beck-Nielsen

Brock-Jacobsen²,

Gram

et al. 2009

European Journal of Endocrinology

249

158

View full text Add to dashboard Cite

Objective: To estimate the incidence of nutritional rickets and the incidence and prevalence of hereditary rickets. Design: Population-based retrospective cohort study based on a review of medical records. Methods: Patients aged 0-14.9 years referred to or discharged from hospitals in southern Denmark from 1985 to 2005 with a diagnosis of rickets were identified by register search, and their medical records were retrieved. Patients fulfilling the diagnostic criteria of primary rickets were included. Results: We identified 112 patients with nutritional rickets of whom 74% were immigrants. From 1995 to 2005, the average incidence of nutritional rickets in children aged 0-14.9 and 0-2.9 years was 2.9 and 5.8 per 100 000 per year respectively. Among immigrant children born in Denmark, the average incidence was 60 (0-14.9 years) per 100 000 per year. Ethnic Danish children were only diagnosed in early childhood and the average incidence in the age group 0-2.9 years declined from 5.0 to 2.0 per 100 000 per year during 1985-1994 to 1995-2005. Sixteen cases of hereditary rickets were diagnosed during the study period giving an average incidence of 4.3 per 100 000 (0-0.9 years) per year. The prevalence of hypophosphatemic rickets and vitamin D-dependent rickets type 1 was 4.8 and 0.4 per 100 000 (0-14.9 years) respectively. Conclusions: Nutritional rickets is rare in southern Denmark and largely restricted to immigrants, but the incidence among ethnic Danish children was unexpectedly high. Hereditary rickets is the most common cause of rickets in ethnic Danish children, but nutritional rickets is most frequent among all young children.

show abstract

“…Vitamin D deficiency (VDD) is observed in up to 90% of Asian Indians (Goswami et al, 2000;Vupputuri et al, 2006) and is equally prevalent in several other countries (Holick, 2006;Thacher et al, 2006). Though the rise in serum PTH is a well-characterized bio-adaptive response in VDD (Fraser et al, 1967), a majority of volunteers with chronic VDD have normal PTH values (Goswami et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Presence of 25(OH)D deficiency and its effect on vitamin D receptor mRNA expression

et al. 2008

View full text Add to dashboard Cite

Background and objectives: Vitamin D and its metabolites act through vitamin D receptor (VDR). We hypothesized that subjects with low serum 25(OH)D levels but normal PTH might have increased VDR expression. Design and Methods: VDRmRNA expression was assessed by real time PCR in duodenal mucosa and PBMC (peripheral blood mononuclear cells) in 45 subjects with normal duodenoscopy and in PBMC alone in 48 healthy volunteers with hypovitaminosis D. 25(OH)D, PTH and VDRmRNA expression in PBMC was reassessed after 8 weeks of oral cholecalciferol (60 000 IU per week) in a subset (n ¼ 23) of healthy volunteers. Results and Conclusions: The VDRmRNA expressions in the duodenum and PBMC were significantly correlated (r ¼ 0.42), but the expression was 13 times higher in the former than the latter. The mean VDRmRNA expression was similar in 25(OH)Ddeficient subjects with or without PTH elevation, both in the duodenum and PBMC. The PBMC VDRmRNA expression showed no significant change after cholecalciferol supplementation. A weak correlation coefficient between duodenal mucosa and PBMC VDRmRNA suggests that caution needs to be exercised while using the latter as a surrogate for other sites.

show abstract

Nutritional rickets around the world: causes and future directions

Cited by 249 publications

References 121 publications

Human skin pigmentation, migration and disease susceptibility

Human skin pigmentation, migration and disease susceptibility

Incidence and prevalence of nutritional and hereditary rickets in southern Denmark

Presence of 25(OH)D deficiency and its effect on vitamin D receptor mRNA expression

Contact Info

Product

Resources

About