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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Foods and Nutrition, University of Utah, Salt Lake City (MG); the Department of Family Medicine, Jos University Teaching Hospital, Jos, Nigeria (TDT); the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN (PRF); the Division of Endocrinology, Diabetes, and Clinical Nutrition, Department of Medicine, Oregon Health Sciences University School of Medicine, Portland (DS); the Departments of Paediatrics (SDP) and Chemical Pathology (COI), University of Jos, Jos, Nigeria; the MRC Mineral Metabolism Research Unit, Department of Paediatrics, University of the Witwatersrand and Chris Hani Baragwanath Hospital, Bertsham, South Africa (JMP); and the US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston (SAA)
Background: Nutritional rickets is common in Nigerian children and responds to calcium supplementation. Low dietary calcium intakes are also common in Nigerian children with and without rickets.
Objective: The objective was to assess intestinal calcium absorption in Nigerian children with rickets.
Design: Calcium absorption was assessed in 15 children with active rickets (2–8 y of age) and in 15 age- and sex-matched children without rickets by using a dual-tracer stable-isotope method. The children with rickets were supplemented with calcium for 6 mo; calcium absorption was reevaluated 12 mo after the baseline study. Fractional calcium absorption could be determined in 10 children with rickets and in 10 children without rickets.
Results: The children with and without rickets had dietary calcium intakes of 
200 mg/d. Compared with the control children, the children with rickets had lower serum 25-hydroxyvitamin D and calcium concentrations and greater 1,25-dihydroxyvitamin D and parathyroid hormone concentrations. In fact, there were 15 rachitic and 15 control children in the study. Mean (±SD) fractional calcium absorption did not differ between those with (61 ± 20%) and without (63 ± 13%) rickets (P = 0.47). Calcium absorption was not associated with serum concentrations of calcium, alkaline phosphatase, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, or parathyroid hormone. Mean fractional calcium absorption was significantly greater after (81 ± 10%) than before (61 ± 20%) calcium supplementation for the treatment of rickets (P = 0.035).
Conclusions: In Nigerian children with rickets, the capacity to absorb calcium is not impaired; however, fractional calcium absorption increases after the resolution of active disease. Calcium absorption may be inadequate to meet the skeletal demands of children with rickets during the active phase of the disease, despite being similar to that of control children.
Key Words: Stable isotopes • diet • vitamin D • calcium excretion • Nigeria • nutritional rickets • dietary calcium deficiency • intestinal calcium absorption
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