Nutrition : A comprehensive treatise. Vol. 2: Vitamins, by George H. Beaton

By George H. Beaton

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In adults the epiphyseal line is already closed and endochondrial calcification has ceased; consequently in osteomalacia disturbances in the endochondrial and periostal calcification do not occur. The changes are characterized by diminished mineral content and occurrence of much uncalcified osteoid tissue resulting in softness (malacia). The deformities 28 HENRIK DAM AND EBBE S 0 NDERGAARD of the skeleton can be even more drastic than in infantile rickets (158). In the etiology of senile osteoporosis, other factors than insufficient vitamin D or calcium are involved, including a reduced ability of the osteoblasts to form sufficient bone matrix (158).

With the above-mentioned rachitogenic diet for rats, serum calcium is either normal or slightly elevated. A comprehensive description of the disease is to be found in Chapter 5 (Calcium and Phosphorus) of Volume I, in handbooks of pathology, and elsewhere in the literature (128, pp. 223-248; 157). Rickets is diagnosed by the clinical signs: deformities of the legs, malformation of the chest, enlargement of costosternal junctions, bosses of the temporal bones, etc. Enhanced serum alkaline phosphatase is not a sufficient criterion in itself.

Further, the rachitogenic action of phytic acid can be overcome simply by addition of sufficient amounts of phosphate (and calcium, or both). A heat-labile rachitogenic substance has been reported in liver. About 20 gm of raw pig's liver counteracts the antirachitic activity of about 3 IU of vitamin D (208). Rachitogenic substances have been reported to occur also in hay and other vegetable sources (209, 210). These factors are soluble in fat solvents and rather heat-stable. Their effect can be overcome by increasing the dose of vitamin D, but not by addition of phosphate and calcium.

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