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

@article{Baroncelli2008RicketsIT,
  title={Rickets in the Middle East: role of environment and genetic predisposition.},
  author={Giampiero I. Baroncelli and Abdullah Bereket and Mohamed El Kholy and Laura Aud{\'i} and Yaşar Cesur and Behzat Ozkan and Mona Mohamed Rashad and M{\'o}nica Fern{\'a}ndez-Cancio and Yoseph Weisman and Giuseppe Saggese and Ze’ev Hochberg},
  journal={The Journal of clinical endocrinology and metabolism},
  year={2008},
  volume={93 5},
  pages={
          1743-50
        }
}
CONTEXT The Middle East has a high incidence of rickets, and it is also common in Europe-dwelling children of Middle Eastern origin. OBJECTIVE The objective of the study was to explore the mechanisms leading to rickets in children of the Middle East. DESIGN AND SETTING We conducted a prospective study in 98 rachitic and 50 controls (aged 6 months to 4 yr) from university and community outpatient hospitals in Egypt and Turkey. MAIN OUTCOME MEASURES We collected epidemiological, maternal… 
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The lack of populations based studies, gaps in studies in infants, pre-pubertal children and pregnant women, hinder the development of region specific guidelines and constitute a major obstacle to impact this chronic and most often subclinical disease.
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Exclusive breastfeeding for >4 months, sunlight exposure <30 minutes/day, dark skin color, number of siblings, urban slum residence, deficit monthly income, and parent’s education are the risk factors for NR in Bangladeshi child.
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The most important risk factors were low vitamin D and calcium intakes, lack of exposure to sunlight, prolonged breast feeding without supplementation of vitamin D, and diabetes mellitus.
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Being under the care of caregivers, dressing fully and no oil massage during sun exposure, and being sick one month prior to the study were significantly associated with rickets.
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TLDR
Vitamin D deficiency rachitic genu varus is a multifactorial condition in Egypt, and raising the standard of living, level of education, housings, and dietary supplementation of vitamin D to the pregnant women and infants are the solution.
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Nutritional rickets around the world
  • A. Prentice
  • Medicine
    The Journal of Steroid Biochemistry and Molecular Biology
  • 2013
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