RICKETS AND PROTEIN-MALNUTRITION IN NORTHERN NIGERIA

The aim of the study was to explore the relationship between protein n utritional status and the development of rickets in children living in northern Nigeria, The diagnosis of rickets in 16 children between the ages of 10 months and 7 years was confirmed using established, and re cently developed clinical and biochemical parameters. Twenty-seven chi ldren devoid of skeletal stigmata were age and sex-matched to the rach itic patients. A battery of clinical laboratory and anthropometric mea surements designed to assess calcium homeostasis, skeletal growth, the extent of bone remodeling or resorption, and protein nutritional stat us were performed on all subjects. Our central finding was that althou gh the rachitic children were moderately malnourished, their protein n utritional status was significantly better as measured by the serum pr ealbumin concentration (15.4 v. 12.5mg/dl, P = 0.0012) when compared w ith the severely malnourished children who were devoid of any indicati on of rickets. This may be due, in part, to the fact that actively gro wing children are more likely to develop rickets than are children who se linear growth is impeded. Unexpectedly, we found that the mean conc entrations of serum 1,25-dihydroxyvitamin D in both the rachitic and c ontrol group were higher than any values for the active vitamin D meta bolite previously reported in the literature.