فهرست مطالب فرهاد حسین پناهگ مهدی هدایتی

Reduction of serum calcium and phosphorus due to nutritional problems has fundamental importance in regard with metabolic bone diseases especially rickets and osteomalacia. As the most abundant serum protein, and the most important calcium binding protein, albumin is necessary for evaluation of total calcium changes. It is also a poor indicator of protein intake. Extracting basic and extensive information in this repect can provide health progrmmers of the country with suitable guides in order to prevent the rising of possible deficiencies. In this descriptive research, a random sample of 1300 children were chosen form the population of rural and urban students aged 8-10y in 23 provinces of the country and blood was taken from them. The levels of calcium, phosphorus and albumin for all samples were checked in the same laboratory and the same manner. Serum calcium was correctd according to the level of albumin. The mean levels for calcium, phosphorus and albumin were 8.6±0.7 mg/dL, 4.9±0.9 mg/dL, and 4.6±0.6 gr/dL respectively. There were not significant differences for the serum calcium and albumin levels in the two sexes, but the serum level of phosphorus was higher in boys than in girls (P<0002). The difference between serum calcium, phosphorus and albumin of rural and urban areas was not significant. Calcium less than 8.8 mg/dL was observed in 61% of the whole sample (58% urban and 62% rural) for both sexes. Calcium was less that 7.5 mg/dL for 6.4%, between 7.5 and 8 mg/dL for 8.4% and between 8 and 8.8 mg/dL for 46%. There were only two cases in Booshehr province with calcium more than 10.8 mg/dL. Average calcium was less than 8.0 mg/dL for East Azerbaijan, Ardebil, and Isfahan provinces. It was less than 8.5 mg/dL for Tehran, Chaharmahal, Zanjan, Semnan, Kerman, Kermanshah, Hamedan and Markazi provinces. Hypocalcemia did not differ significantly for rural and urban areas and for the two sexes. Phosphorus was less than 3.9 mg/dL for 6.2% of the whole population (5.6% boys and 7.1% girls). Hypophosphatemia did not differ significantly for rural and urban areas and for the two sexes. Hyphophosphatemia was observed in Isfahan, Tehran and Khoozestan by 27%, 20% and 18% respectively. Albumin was less than 4.0 g/dL for 12.8%, of the whole population (12.7% boys and 13.7% girls). Hypoalbuminemia was observed in Ardebil, Khoozestan and Tehran by 65%, 42% and 41%, respectively. Hypocalcemia was accompanied by hypophosphatemia in 5% of the cases. The correlation between serum calucium and phosphorus (P<0.001 and r = 0.334) and phosphorus and albumin (P<0.001 and r = 0.153) were significant. This study shows the existence of hypocalcemia in about three fifths of the students aged 8-10y in the country, 5% of which are accompanied by hypophosphatemia. The results of this study demonstrate the need for immediate attention and programming to carry out an etiologic survey and extensive policy making to prevent and remove the nutritional problems of the children and the adolescent, especially in connection with metabolic bone diseases.