Introduction: Rickets is usually attributed to vitamin D deficiency. However, recent studies have implicated dietary calcium deficiency in its etiology. Information on relative efficacy of calcium, vitamin D or both together in healing of rickets is limited.
Objective: To study effect of treatment with calcium, vitamin D or a combination of these two on healing of nutritional rickets in young children.
Design: Randomized controlled trial.
Methods: Sixty-seven cases of nutritional rickets in the age group of 6 months to 5 years were randomly allocated to receive vitamin D (600 000 IU single intramuscular dose), calcium (75 mg/kg/day elemental calcium orally) or a combination of the above two for a period of 12 weeks. The demographic parameters, nutritional status, dietary calcium and phytate intake were assessed for all. Radiographs (wrist and knee) and biochemical parameters (serum calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxycholecalciferol and parathyroid hormone) were evaluated at baseline, 6 and 12 weeks for evidence of healing.
Results: Mean dietary intake of calcium in all cases was low (204 ± 129 mg/day). Mean serum 25-hydroxycholecalciferol D level was 15.9 ± 12.4 ng/ml, and 82.1% of patients had serum vitamin D levels <20 ng/ml, indicative of vitamin D deficiency. After 6 and 12 weeks of treatment, radiological and biochemical evidence of healing rickets was observed in all treatment groups, albeit to a variable extent. The combined end point of normal serum alkaline phosphatase and complete radiological healing at 12 weeks was observed in 50% subjects on combination therapy as compared with 15.7% subjects on vitamin D alone and 11.7% on calcium alone.
Conclusions: Children with rickets had a low serum vitamin D level and a low dietary calcium intake. The best therapeutic response was seen with a combination of vitamin D and calcium than either of them given alone.
Trial Registration Number: CTRI/2010/091/000448.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/tropej/fms058 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Oral Versus Injectable Vitamin D Therapy for Treating Nutritional Rickets in Indian Children: A Comparative Study.
Indian J Orthop
February 2025
Department of Orthopaedics, JSS Medical College, Mysore, 570004 India.
Background: Rickets is a common metabolic bone disease in children, primarily caused by vitamin D deficiency. This study aimed to compare the efficacy of oral weekly vitamin D supplementation and injectable stoss therapy in treating nutritional rickets in Indian children.
Methods: This prospective, randomized, controlled trial was conducted over 18 months at a tertiary care center.
Etiology, clinical characteristics, genetic profile, and outcomes of children with refractory rickets at a referral center in India: a cohort study.
Pediatr Nephrol
January 2025
Pediatric Nephrology Services, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.
Background: Limited research exists regarding the genetic profile, clinical characteristics, and outcomes of refractory rickets in children from India.
Methods: Patients with refractory rickets aged ≤ 18 years were enrolled. Data regarding clinical features, etiology, genotype-phenotype correlation, and estimated glomerular filtration rate (eGFR) were recorded.
Segmental analysis of human hair reveals intra-annual variation in 25(OH)D concentrations in modern and archaeological individuals.
Sci Rep
January 2025
The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, UK.
Vitamin D is essential for healthy skeletal growth and is increasingly recognised for its role in chronic disease development, inflammation and immunity. 25-hydroxyvitamin D (25(OH)D) concentrations are an indicator of vitamin D status and are normally analysed in plasma or serum samples in clinical settings, while archaeological studies rely on the identification of skeletal markers of vitamin D deficiency, such as rickets. Here, we determined 25(OH)D concentrations in hair specimens ('locks') that had been sampled close to the root, aligned by cut end, and sliced into sequential segments from participants (n = 16), from Aberdeen, Scotland, using a modified protocol designed to minimise sample size.
View Article and Find Full Text PDFPractice and factors associated with sunlight exposure of infants among mothers in Ethiopia: a systematic review and meta-analysis.
Reprod Health
January 2025
Department of Public Health Nutrition, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Background: Exposure to sunlight aids in the body's production of vitamin D, guards against rickets, and treats newborn jaundice. In Ethiopia, the magnitude of sunlight exposure practice varies across studies. Thus, this study aimed to estimate the pooled practices and factors associated with sunlight exposure of infants among mothers in Ethiopia.
View Article and Find Full Text PDFMetabolic Bone Disease: An Overview.
Mo Med
November 2024
Department of Pediatrics, Division of Endocrinology and Diabetes and the Division of Bone and Mineral Diseases; Washington University School of Medicine, St. Louis, Missouri.
Metabolic bone diseases are a heterogenous group of conditions that all result in aberrant bone mineral homeostasis with resulting skeletal disease. The underlying causes are variable, ranging from nutritional deficiencies to pathogenic variants in skeletal genes. To properly diagnose and treat these conditions, a clinician needs to understand bone metabolism as well as recognize the signs of disease in a patient.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!