Bener Abdulbari, Hoffmann Georg F
Department of Medical Statistics & Epidemiology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Int J Pediatr Endocrinol. 2010;2010:410502. doi: 10.1155/2010/410502. Epub 2010 Oct 27.
Objective. This study describes the magnitude and characteristics of nutritional rickets and associated risk factors among children in Qatar. Subjects. A consecutive sample of 730 healthy subjects who visited the primay health care clinics were approached and 540 (73.9%) subjects gave consent. Mehods. Nutritional rickets diagnosis was based on clinical radiologic and biochemical parameters and normalization of alkaline phosphatase level after 6 weeks course of daily vitamin D therapy. Results. The study revealed that 23.9% of the studied children had nutritional rickets. The mean ± SD age of those with rickets (3.76 years ± 1.51) was slightly higher than those without rickets (3.57 years ± 1.45). Family history of vitamin D deficiency (44.2%; P = .001) and diabetes mellitus (53.5%; P = .002) were significantly higher in rachitic children than in nonrachitic children. The children with rickets spent a significantly shorter average duration (26.86 minutes ± 19.94) under the sun than those without rickets (30.59 minutes ± 15.72; P < .001). A significantly larger proportion of rachitic children was afflicted with vitamin D deficiency (75.2% versus 62.2%; P < .001), secondary hypothyroidism (100% versus 7.5%; P = .009) and muscular weakness (56.6% versus 26.3%; P < .001). Conclusion. The most important risk factors were low vitamin D and calcium intakes, lack of exposure to sunlight, prolonged breast feeding without supplementation of vitamin D.
目的。本研究描述了卡塔尔儿童营养性佝偻病的严重程度、特征及相关危险因素。
对象。连续选取730名到初级保健诊所就诊的健康受试者,其中540名(73.9%)受试者同意参与研究。
方法。营养性佝偻病的诊断基于临床、放射学和生化参数,以及每日维生素D治疗6周后碱性磷酸酶水平恢复正常。
结果。研究显示,23.9%的受试儿童患有营养性佝偻病。患佝偻病儿童的平均年龄±标准差为(3.76岁±1.51),略高于未患佝偻病的儿童(3.57岁±1.45)。佝偻病患儿维生素D缺乏家族史(44.2%;P = 0.001)和糖尿病家族史(53.5%;P = 0.002)显著高于非佝偻病患儿。患佝偻病的儿童在阳光下平均暴露时间(26.86分钟±19.94)明显短于未患佝偻病的儿童(30.59分钟±15.72;P < 0.001)。佝偻病患儿中维生素D缺乏(75.2%对62.2%;P < 0.001)、继发性甲状腺功能减退(100%对7.5%;P = 0.009)和肌肉无力(56.6%对26.3%;P < 0.001)的比例显著更高。
结论。最重要的危险因素是维生素D和钙摄入不足、缺乏阳光照射、长期母乳喂养且未补充维生素D。