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Rickets in the Middle East: role of environment and genetic predisposition

Giampiero I Baroncelli1, Abdullah Bereket, Mohamed El Kholy

  • 1Department of Pediatrics, University of Pisa, Via Roma 67, Pisa, Italy. g.baroncelli@med.unipi.it

The Journal of Clinical Endocrinology and Metabolism
|February 21, 2008
PubMed

Insights

Rickets in Middle Eastern children is often caused by low calcium and vitamin D. Genetic factors, like vitamin D receptor (VDR) gene variations, may also increase susceptibility, necessitating tailored preventive strategies.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Nutritional Science

Background:

  • Rickets incidence is high in the Middle East and among Middle Eastern children in Europe.
  • Understanding the specific mechanisms causing rickets in this population is crucial.

Purpose of the Study:

  • To investigate the underlying causes of rickets in children from the Middle East.
  • To identify epidemiological, nutritional, and genetic factors contributing to rickets.

Main Methods:

  • A prospective study involving 98 children with rickets and 50 controls aged 6 months to 4 years in Egypt and Turkey.
  • Data collection included epidemiological, maternal, nutritional, radiographic, and biochemical parameters.
  • Analysis encompassed bone turnover markers and vitamin D receptor (VDR) gene polymorphisms.

Main Results:

  • Lower dietary calcium intake and reduced serum 25-hydroxyvitamin D levels were observed in patients compared to controls.
  • Rickets severity was greater in Egypt, while vitamin D deficiency was more pronounced in Turkey.
  • The F allele of the VDR gene was more frequent in Turkish patients, and the BB VDR genotype correlated with lower vitamin D levels and increased rickets severity.

Conclusions:

  • In Turkey, vitamin D deficiency is the primary cause of rickets, whereas in Egypt, it's a combination of calcium and vitamin D deficiency.
  • Vitamin D receptor (VDR) genotypes, particularly the F allele, may predispose children to rickets in this region.
  • Preventive strategies should consider unique environmental and genetic factors, rather than solely relying on European or American dietary recommendations.
Abstract

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