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Perhaps half of Russian children have rickets, 500 IU vitamin D was not enough – June 2013

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.


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  • 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. "
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