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Vitamin D levels in children with growing pains
Sobia Qamar1, Shaheena Akbani, Samina Shamim
1Department of Paediatrics, Liaquat National Medical College and Hospital, Karachi.
Insights
Low vitamin D levels are common in children with growing pains, suggesting a potential role in its development. Testing and treating vitamin D deficiency is recommended for children with unexplained limb pain.
Area of Science:
- Pediatrics
- Endocrinology
- Nutritional Science
Background:
- Growing pains are a common cause of limb pain in children.
- The etiology of growing pains is not fully understood.
- Vitamin D deficiency is prevalent globally and linked to various musculoskeletal issues.
Purpose of the Study:
- To determine serum vitamin D levels in children experiencing growing pains.
- To investigate the relationship between vitamin D, parathormone, and routine biochemical markers in this population.
Main Methods:
- A cross-sectional study involving 100 children aged 5-12 years with growing pains.
- Exclusion of children with systemic illness, rickets, or other organic causes of pain.
- Measurement of serum vitamin D3 (25-hydroxocholecalciferol), parathormone, calcium, inorganic phosphorus, and alkaline phosphatase.
Main Results:
- Only 6% of children had normal vitamin D levels; over 94% exhibited insufficiency or deficiency.
- The majority of participants (59%) were female.
- Most children with vitamin D insufficiency (over 95%) had normal alkaline phosphatase and parathormone levels.
Conclusions:
- Hypovitaminosis D (vitamin D deficiency or insufficiency) may contribute to the pathogenesis of growing pains.
- Routine biochemical markers are insufficient for detecting all cases of hypovitaminosis D.
- Children with unexplained limb pains should be assessed for vitamin D status and treated if deficient.
Objective:
To estimate the serum levels of vitamin D in children with growing pains and determine the relationship between serum vitamin D levels, parathormone and routine biochemical markers.
Study Design:
Cross-sectional study.
Place And Duration Of Study:
Department of Paediatrics, Liaquat National Hospital, Karachi, from October 2008 to September 2009.
Methodology:
Hundred children, aged 5-12 years presenting in Paediatric Outpatient Department of Liaquat National Hospital, Karachi, with limb pains, fulfilling the diagnostic criteria of growing pains, were included. Children with any systemic illness, organic cause of pain, rheumatologic disorders and signs of rickets were excluded from the study. Children were investigated for serum total calcium, inorganic phosphorus, alkaline phosphatase, vitamin D3 (25-hydroxecholecalciferol) and parathormone levels. On the basis of serum vitamin D3 level, patients were divided into 3 groups; group 1 with normal level of vitamin D3 (> 75 nmol/L), group 2 with vitamin D insufficiency (level between 50-75 nmol/L), and group 3 with vitamin D deficiency (level < 50 nmol/L). Significance of group proportions was determined using chi-square test with significance at p < 0.05.
Results:
The mean age of the participants was 8.05 years with the majority (59%) being females. Only 6% had normal vitamin D levels. Over 95% of the children with vitamin D insufficiency had normal alkaline phosphatase and parathormone levels.
Conclusion:
Hypovitaminosis D may have a role in pathogenesis of growing pains. All children with unexplained limb pains without identifiable organic pathology should be tested for vitamin D status, and treated, if necessary. Routine biochemical markers alone are not sufficient to detect all cases of hypovitaminosis D.
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