Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis

Background. Nutritional rickets (NR) is still a major problem and is exacerbated by an increasing influx of immigrants. In this study, Turkish and immigrant cases followed with the diagnosis of NR in our pediatric endocrinology clinic were retrospectively evaluated. Methods. Detailed d...

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Main Authors: İsmail Dündar, Mehmet Akif Büyükavcı
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2023-06-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/47
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author İsmail Dündar
Mehmet Akif Büyükavcı
author_facet İsmail Dündar
Mehmet Akif Büyükavcı
author_sort İsmail Dündar
collection DOAJ
description Background. Nutritional rickets (NR) is still a major problem and is exacerbated by an increasing influx of immigrants. In this study, Turkish and immigrant cases followed with the diagnosis of NR in our pediatric endocrinology clinic were retrospectively evaluated. Methods. Detailed data of cases diagnosed with NR between 2013 and 2020 and followed for at least six months were reviewed. Results. In the study period, 77 cases of NR were identified. Turkish children constituted 76.6% (n=59) while 18 (23.4%) were immigrant children. The mean age at diagnosis was 8.1±7.8 months, 32.5% (n=25) were female, and 67.5% (n=52) were male. The 25-hydroxyvitamin D3 was below normal in all patients, with a mean value of 4.3±2.6 ng/mL. Parathyroid hormone (PTH) was above normal in all and the mean value was 301.7±139.3 pg/ mL. While there were 3.9 cases of NR in 10,000 endocrine clinic patients in 2013, this rate increased more than four-fold to 15.7 patients in 2019. Conclusions. Despite the vitamin D prophylaxis program in Türkiye, NR is seen significantly more frequently in recent years, which may be associated with an increasing number of refugees. High PTH levels indicate the severity of NR cases admitted to our clinic. However, clinically significant NR is only the tip of the iceberg and the true burden of subclinical rickets is unknown. Increasing compliance with the vitamin D supplementation program in refugee and Turkish children is important for the prevention of nutritional rickets.
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spelling doaj-art-01de0329b13e44729a827f9ac5f8f7cc2025-08-20T02:17:53ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212023-06-0165310.24953/turkjped.2022.860Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxisİsmail Dündar0Mehmet Akif Büyükavcı1Department of Pediatric Endocrinology, Faculty of Medicine, Inonu University, Malatya.Department of Developmental Pediatrics, Faculty of Medicine, Inonu University, Malatya, Türkiye. Background. Nutritional rickets (NR) is still a major problem and is exacerbated by an increasing influx of immigrants. In this study, Turkish and immigrant cases followed with the diagnosis of NR in our pediatric endocrinology clinic were retrospectively evaluated. Methods. Detailed data of cases diagnosed with NR between 2013 and 2020 and followed for at least six months were reviewed. Results. In the study period, 77 cases of NR were identified. Turkish children constituted 76.6% (n=59) while 18 (23.4%) were immigrant children. The mean age at diagnosis was 8.1±7.8 months, 32.5% (n=25) were female, and 67.5% (n=52) were male. The 25-hydroxyvitamin D3 was below normal in all patients, with a mean value of 4.3±2.6 ng/mL. Parathyroid hormone (PTH) was above normal in all and the mean value was 301.7±139.3 pg/ mL. While there were 3.9 cases of NR in 10,000 endocrine clinic patients in 2013, this rate increased more than four-fold to 15.7 patients in 2019. Conclusions. Despite the vitamin D prophylaxis program in Türkiye, NR is seen significantly more frequently in recent years, which may be associated with an increasing number of refugees. High PTH levels indicate the severity of NR cases admitted to our clinic. However, clinically significant NR is only the tip of the iceberg and the true burden of subclinical rickets is unknown. Increasing compliance with the vitamin D supplementation program in refugee and Turkish children is important for the prevention of nutritional rickets. https://turkjpediatr.org/article/view/47childrenimmigrantnutritional ricketsvitamin D deficiency
spellingShingle İsmail Dündar
Mehmet Akif Büyükavcı
Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
The Turkish Journal of Pediatrics
children
immigrant
nutritional rickets
vitamin D deficiency
title Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
title_full Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
title_fullStr Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
title_full_unstemmed Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
title_short Nutritional rickets in Turkish and refugee children aged 0-2: an increasing problem despite vitamin D prophylaxis
title_sort nutritional rickets in turkish and refugee children aged 0 2 an increasing problem despite vitamin d prophylaxis
topic children
immigrant
nutritional rickets
vitamin D deficiency
url https://turkjpediatr.org/article/view/47
work_keys_str_mv AT ismaildundar nutritionalricketsinturkishandrefugeechildrenaged02anincreasingproblemdespitevitamindprophylaxis
AT mehmetakifbuyukavcı nutritionalricketsinturkishandrefugeechildrenaged02anincreasingproblemdespitevitamindprophylaxis