INVESTIGATING SUBCLINICAL RICKETS IN URBAN PEDIATRIC POPULATIONS

Abstract

Subclinical rickets, characterized by biochemical disturbances in bone metabolism without overt skeletal deformities, represents a growing but underappreciated public health issue in urban pediatric populations. This study aimed to investigate the prevalence, risk factors, and biochemical markers associated with subclinical rickets among children aged 5–15 years in urban environments. A cross-sectional analysis involving dietary assessments, biochemical profiling, and imaging diagnostics was conducted on a stratified sample of 500 children. Results revealed that 42.5% of children aged 5–7 years were vitamin D deficient, with overall serum 25-hydroxyvitamin D levels remaining below optimal thresholds across all age groups. Children with darker skin pigmentation exhibited higher deficiency rates (65.5%) despite similar sun exposure, underscoring the role of melanin in limiting dermal vitamin D synthesis. Socioeconomic disparities were significant; children from low-income families had the lowest dietary vitamin D intake (150 IU/day), least physical activity, and the highest deficiency rate (70%). Biochemical evaluations showed elevated alkaline phosphatase (185 IU/L) and parathyroid hormone (88 pg/mL) in deficient children, indicative of increased bone turnover and secondary hyperparathyroidism. Processed and fast foods were the predominant dietary components among deficient groups, contributing minimally to micronutrient requirements. These findings demonstrate that subclinical rickets in urban children is multifactorial—rooted in biological, nutritional, and socioeconomic domains. The study highlights the necessity for early detection, public health education, and targeted interventions such as supplementation and policy-driven nutritional programs to prevent disease progression and support optimal skeletal health in childhood.