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Long-term epidemiological insights into rickets: a nationwide population-based retrospective study
Chun-Hao Chu1,2,3, Ying-Chuan Chen4, Pei-Yao Liu4
1Department of Pediatrics, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Clinical and Experimental Pediatrics
|August 22, 2025
Summary
This study found that while rickets incidence is rising, mortality rates are falling. Key factors influencing mortality risk include low income, anemia, chronic kidney disease, and prolonged hospital stays.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Clinical Epidemiology
Background:
- Rickets is a significant global growth disorder causing childhood disability.
- Large-scale studies on nutritional vs. hereditary rickets epidemiology and mortality are limited, especially in Asia.
Purpose of the Study:
- To investigate the nationwide incidence and demographics of pediatric rickets in Taiwan.
- To identify mortality risk factors stratified by nutritional and hereditary rickets subtypes.
Main Methods:
- Utilized Taiwan's National Health Insurance Research Database (2008-2018) covering over 31 million individuals.
- Analyzed 1,551 pediatric rickets cases, comparing nutritional and hereditary subtypes.
- Examined risk of mortality (ROM) based on etiology and clinical factors.
Main Results:
- Nutritional rickets occurred twice as often as hereditary rickets, primarily affecting preschoolers.
- Hereditary rickets showed male predominance and later diagnosis.
- Mortality risk was linked to low income, anemia, chronic kidney disease (CKD), hyperparathyroidism, and prolonged hospital stay (LOS).
- Rickets incidence increased, while mortality rates decreased between 2012-2018.
Conclusions:
- Rising rickets incidence and falling mortality suggest improved clinical awareness and management.
- Factors like income, anemia, CKD, and LOS are crucial for managing rickets mortality risk.
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