Rickets and vitamin D deficiency in Alaska native children

Abstract

Background: Rickets and vitamin D deficiency appeared to increase in Alaskan children starting in the 1990s. We evaluated the epidemiology of rickets and vitamin D deficiency in Alaska native (AN) children in 2001-2010.

Methods: We analyzed 2001-2010 visits with rickets or vitamin D deficiency diagnosis for AN and American Indian children and the general US population aged <10 years. We conducted a case-control study of AN rickets/vitamin D deficient cases and age- and region-matched controls.

Results: In AN children, annual rickets-associated hospitalization rate (2.23/100,000 children/year) was higher than the general US rate (1.23; 95% CI 1.08-1.39). Rickets incidence increased with latitude. Rickets/vitamin D deficiency cases were more likely to have malnutrition (OR 38.1; 95% CI 4.9-294), had similar breast-feeding prevalence, and were less likely to have received vitamin D supplementation (OR 0.23; 95% CI 0.1-0.87) than controls.

Conclusions: Our findings highlight the importance of latitude, malnutrition, and lack of vitamin D supplementation as risk factors for rickets.

Figure 1

Alaska Native confirmed rickets and vitamin D deficiency cases < 10 years of age, by year of diagnosis, 1999-2013. * Other rickets: Children with rickets/vitamin D deficiency associated with hepatic disease or malabsorption.

Figure 2

Age at diagnosis of Alaska Native children < 10 years of age with confirmed rickets or vitamin D deficiency 1999-2013. * Other rickets: Children with rickets/vitamin D deficiency associated with hepatic disease or malabsorption