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

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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.