Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Sydney, NSW.
Med J Aust. 2012 Apr 16;196(7):466-8. doi: 10.5694/mja11.10662.
To determine the incidence of and factors associated with vitamin D deficiency rickets in Australian children.
18-month questionnaire-based prospective observational study, using Australian Paediatric Surveillance Unit (APSU) data.
Australian paediatricians and child health workers, January 2006 - July 2007.
Children aged ≤ 15 years with vitamin D deficiency rickets (25-hydroxyvitamin D [25OHD] ≤ 50 nmol/L, and elevated alkaline phosphatase levels [> 229 IU/L] and/or radiological rickets).
Incidence of vitamin D deficiency rickets. Description of demographics, clinical presentation, identification and further analysis of overrepresented groups, and treatment regimens compared with best-practice guidelines.
We identified 398 children with vitamin D deficiency (55% male; median age, 6.3 years [range, 0.2-15 years]). The overall incidence in children ≤ 15 years of age in Australia was 4.9/100 000/year. All had a low 25OHD level (median, 28 nmol/L [range, 5-50 nmol]) and an elevated alkaline phosphatase level (median, 407 IU/L [range, 229-5443 IU/L]), and 48 (12%) were hypocalcaemic. Ninety-five children had wrist x-rays, of whom 67 (71%) had rachitic changes. Most (98%) had dark or intermediate skin colour and 18% of girls were partially or completely veiled. Most children were born in Africa (252; 63%) and 75% of children were refugees. Duration of exclusive breastfeeding was inversely related to serum vitamin D levels in children < 3 years of age. Empirical vitamin D treatment was given to 4% of children before diagnosis.
Vitamin D deficiency rickets is a significant problem in Australia among known high-risk groups. Public health campaigns to prevent, identify and tre@vitamin D deficiency, especially in high-risk groups, are essential.
确定澳大利亚儿童维生素 D 缺乏性佝偻病的发病率及相关因素。
18 个月的基于问卷调查的前瞻性观察性研究，使用澳大利亚儿科监测单位（APSU）的数据。
澳大利亚儿科医生和儿童保健工作者，2006 年 1 月至 2007 年 7 月。
年龄≤15 岁、维生素 D 缺乏性佝偻病（25-羟维生素 D[25OHD]≤50nmol/L，碱性磷酸酶水平升高[>229IU/L]和/或影像学佝偻病）的儿童。
维生素 D 缺乏性佝偻病的发病率。描述人口统计学、临床表现、高发病率组的识别和进一步分析，以及与最佳实践指南相比的治疗方案。
我们共发现 398 例维生素 D 缺乏儿童（55%为男性；中位年龄 6.3 岁[范围 0.2-15 岁]）。澳大利亚≤15 岁儿童的总发病率为 4.9/100000/年。所有儿童的 25OHD 水平均较低（中位数 28nmol/L[范围 5-50nmol]），碱性磷酸酶水平升高（中位数 407IU/L[范围 229-5443IU/L]），48 例（12%）血钙降低。95 例儿童进行了腕骨 X 线检查，其中 67 例（71%）有佝偻病改变。大多数（98%）儿童肤色较深或中等，18%的女孩戴头巾或面纱。大多数儿童（252 例，63%）出生于非洲，75%的儿童为难民。＜3 岁儿童的纯母乳喂养时间与血清维生素 D 水平呈负相关。在诊断前，4%的儿童接受了经验性维生素 D 治疗。
在澳大利亚，维生素 D 缺乏性佝偻病是一个严重的问题，尤其是在已知的高危人群中。预防、识别和治疗维生素 D 缺乏症，特别是在高危人群中，开展公共卫生运动是非常重要的。
