Interaction of lifestyle, geographic and environmental conditions, and genetics factors concerned in Rickets

佝偻病从古代就已经被注意到，人类已经通过食用富含维生素D的食物和乳制品，控制暴露于阳光和其他适应机制来避免这种不良健康状况。内陆地区最近的快速城市化可能破坏了这种适应机制。蒙古儿童佝偻病的患病率仍然很高，超过30%，其次是骨骼畸形的患病率很高。生活方式，地理，环境和遗传因素的相互作用被认为是解释蒙古佝偻病高患病率的一个原因，我们进行了一项病例对照研究，以检查佝偻病的症状，胫骨皮质骨声速（TCSOS），文化为基础的生活方式，地理特征，环境条件，社会经济地位，遗传因素-维生素D受体（VDR）多态性。本研究分析了（1）蒙古族儿童佝偻病发病的环境和遗传因素，（2）传统生活习惯与佝偻病发病的关系，以及（3）亚洲内陆地区佝偻病患病率的基线数据。研究表明，VDR多态性在蒙古国佝偻病的发生中不起主要作用，童年.在乌兰巴托，传统的襁褓做法本身既不影响佝偻病的发作，也不影响学龄儿童的骨骼特性。生活方式、地理、环境等因素的交互作用对佝偻病发病的影响应进一步研究，综合防治。

Rickets has been noted from ancient times and human being has adapted to avoid such ill-health status by consuming Vitamin D rich food and dairy products, controlling exposure to sunlight, and other adaptation mechanisms. Recent rapid urbanization in inner land may have disrupted this adaptation mechanism. Children in Mongolia still show a high prevalence of rickets, more than 30%, followed by a high prevalence of skeletal deformities. Interaction of lifestyle, geographic, environmental, and genetic factors has been suggested as a reason to explain this high prevalence of rickets in Mongolia.We have conducted a case-control study to examine symptoms of rickets, tibial cortical bone speed of sound (TCSOS), culturally based lifestyles, geographic characteristics, environmental conditions, socioeconomic status, and genetic factors-vitamin D receptor (VDR) polymorphism. Analyses were performed to identify (1) environmental and genetic factors associated to the onset of rickets among Mongolian children, (2) relationship between traditional life practices and onset of rickets, and (3) baseline data of rickets prevalence in inner land area in Asia.The study revealed that the VDR polymorphism does not play a major role in the development of rickets in Mongolia and has no effect on TCSOS in childhood. A traditional practice, swaddling, itself neither influences rickets onset nor bone properties in school-aged children in Ulaanbaatar. Influence of interaction of lifestyle, geographic, environmental factors on rickets onset should be further investigated with a comprehensive viewpoint in prevention of this disease.