Serum Alkaline Phosphatase and Rickets in Urban Schoolchildren

Abstract

Since the decline of the widespread supplementation of the diet with vitamin D, the demands of the physiological growth spurt for extra vitamin D in adolescents already on a borderline intake may be responsible for the great increase in "biochemical" rickets. Once the growth spurt is over the condition subsides but the results ofimpaired growth or permanent pelvic deformity will not necessarily be eradicated.

Plasma Calcium, Magnesium, Phosphorus, and Alkaline Phosphatase Levels in Normal British Schoolchildren

“…It is also clearly important when using alkaline phosphatase as a diagnostic aid to take into account the increase seen normally during the adolescent growth spurt, especially in boys, and the rapid fall which subsequently takes place in the 14-17 age groups. The present survey indicates that "biochemical rickets" measured by phosphatase alone is not a problem among European schoolchildren in London or South Hertfordshire, and these findings must cast some doubt on the validity of the conclusions of Cooke et al (1973).…”

“…has been hampered by the scarcity of such data in later childhood and adolescence. Tanner (1962) drew attention to the "meagre data" available and few additional reports have since appeared (Duinnigan and Gardner, 1965;de Wijn, 1966;Cooke et al, 1973). Data from these have been conflicting.…”

“…Recent work in the Midlands on children aged 14-17 years of both sexes (Cooke et al, 1973) has suggested that "biochemical rickets" indicated by a raised alkaline phosphatase level is becoming more common. The present study has shown that the interpretation of alkaline phosphatase levels should not be based on a normal gaussian distribution as was assumed by these workers.…”

Rickets in a white adolescent

“…The occurrence of vitamin D-deficiency rickets among the Asian population is well recognized (Dunningan et al, 1962;Holmes et al, 1973) and there have also been several recent surveys of white children which have reported biochemical abnormalities suggesting vitamin D deficiency (Dunnigan and Gardner, 1965;Cooke et al, 1973). However, symptomatic nutritional rickets in adolescent Caucasian children must now be rare.…”

Rickets, Growth, and Alkaline Phosphatase in Urban Adolescents

“…is 12-0 ng + 5-4 (range 3-8 32-4 ng/ml). Other laboratory methods, including bone biopsy, have been detailed previously (Swan et al, 1971;Cooke et al, 1973).…”