Perhaps half of Russian children have rickets, 500 IU vitamin D was not enough

ROLE OF EXOGENOUS VITAMIN D DEFICIENCY IN PATHOGENESIS OF RICKETS

Presented at 6th Europaediatrics Conference, June 2013, Scotland

Irina Zakharova ; Yulia Dmitrieva

Russian Medical Academy of Postgraduate Education, Russia

Introduction: The prevalence of rickets in Russia continues to be high with the rate up to 50-60% in spite of its active prophylaxis with oral supplementation of vitamin D. That makes reasonable the determination of the role of hypovitaminosis D in pathogenesis of rickets with the aim to develop modern guideline for management of such patients.

Objective: to evaluate the level of vitamin D in children with rickets depending on the type of feeding and additional supplementation of vitamin D.

Materials and methods: 54 infants with rickets aged 2-9 months were included in the study. The content of vitamin D in organism was evaluated based on the level of 25-hydroxy-vitamin D measured with high-performance liquid chromatography.

Results: we found that just 46.3% of patients with rickets had the level of 25(OH)D lower than 30 ng/ml, while the majority of patients developed rickets with normal serum content of vitamin D . Among patients with low level of 25-hydroxyvitamin D the mean level of metabolite fell down with the increase in severity of rickets. Analysis of the type of feeding and additional use of vitamin D showed that 16.7% infants were exclusively breastfed, 38.9% of patients received additional supplementation of 500 IU vitamin D while breast feeding . 31.5% children got just standard milk formula, 12.9% of all patients were supplemented with vitamin D being formula fed.

Conclusion: ineffective prophylaxis of rickets with oral vitamin D supplementation in children and the development of the disease in patients with normal serum level of 25-hydroxyvitamin D indicates the role of additional factors involved in the pathogenesis of rickets that can negatively influence the metabolism of vitamin D and lead to the development of endogenous hypovitaminosis D even in cases with its normal nutritional supplementation.

See also Vitamin D Life

• Overview of Rickets and Vitamin D

• Rickets can be suspected below 36 ng of vitamin D – Oct 2012

• Russian children need 2,000-4,000 IU of Vitamin D to get most above 40 ng - Dec 2017

See also web

• THE WORLD; In the New Russia, Children Are Born Fighting the Odds NYT 1992
  • "By definitions used by the Health Ministry, only 14 percent can be said to be in good health. Between 15 and 20 percent of preschool children suffer from chronic diseases; up to 60 percent have rickets, are underweight or have allergies . More than 10 percent are anemic. "