Nutritional rickets in Norway: a nationwide register-based cohort study
BMJ Open Nutrition and metabolism Vol 7, Issue 5 http://dx.doi.org/10.1136/bmjopen-2016-015289
Haakon E Meyer1,2, Kristina Skram3, Ingvill Almås Berge3, Ahmed A Madar1, Hilde Johanne Bjørndalen3
- Vitamin D deficiency diseases in dark skinned people living far from equator – Meta-analysis Oct 2013
- Overview of Rickets and Vitamin D
- Rickets – 26 percent had autism: no rickets, no autism (both associated with low vitamin D) – June 2015
- Rickets prevented by single injection of vitamin D or weekly supplementation – RCT Jan 2014
- Rickets reduced 60X - lessons learned by Turkey 2011
Gave Vitamin D to EVERY child in the country - Perhaps half of Russian children have rickets, 500 IU vitamin D was not enough – June 2013
- Rickets: Less costly to prevent than to treat SE Asians in UK – 2006
However, UK, Norway, Russia, etc. have not made any changes - Dark Skinned babies probably need vitamin D to prevent nutritional rickets - 2001
Associated with Dark skin and breastfed
- Ricket was known to be associated with dark skin and breast feeding a century ago - 2005
- Black Sudanese children 350X more likely to have rickets than other Australians – April 2012
- Dark Skinned babies probably need vitamin D to prevent nutritional rickets - 2001
- Nutritional Rickets in Denmark especially among immigrant children- Feb 2012
- 16% of exclusively breastfed infants so low on vitamin D that they had rickets – June 2010
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Objectives Poor vitamin D status has been reported to be highly prevalent in many non-western immigrant groups living in Norway and other western countries. However, data on rickets are scarce, and the aim of the current study was to identify new cases of nutritional rickets in Norway in the period 2008–2012 among children under the age of 5 years.
Design Register-based cohort study.
Setting The Norwegian population from 2008 to 2012.
Participants Children with nutritional rickets under the age of 5 years.
Main outcome measure Nutritional rickets. Patients with ICD10 (International Statistical Classification of Diseases and Related Health Problems, 10th revision) diagnosis code E55.0 (active rickets) treated at all Norwegian hospitals were identified in the Norwegian Patient Registry. We were able to review 85% of the medical records for diagnosis confirmation. In addition, we identified patients with the diagnoses E55.9, E64.3 and E83.3 to identify individuals with rickets who had been given other diagnoses.
Results Nutritional rickets was confirmed in 39 children aged 0–4 years with the diagnosis of E55.0. In addition, three patients with the diagnosis of unspecified vitamin D deficiency (E55.9) were classified as having nutritional rickets, giving a total of 42 patients. Mean age at diagnosis was 1.40 years (range 0.1–3.5 years), and 93% had a non-western immigrant background. The incidence rate of rickets was estimated to be 0.3 per 10 000 person-years in the total Norwegian child population under the age of 5 years and 3.1 per 10 000 person-years in those with an immigrant background from Asia or Africa.
Conclusion The number of children with nutritional rickets in Norway remained low in the period 2008–2012. Nearly all children had a non-western immigrant background.