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Our aim was to study the concentration of betaxolol in plasma after its topical ocular use during the normal 12 hr dosing interval. Twenty microliters of betaxolol 0.5% solution were applied into both eyes of nine glaucoma patients, and the plasma concentrations of the drug were measured 12 hr thereafter using a radioreceptor assay. The same amount of betaxolol was then applied ocularly, and its concentration in plasma was measured at 5, 10, 15, 30 min and 1, 2, 4 and 8 hr thereafter. The mean (SD) concentration of betaxolol in plasma twelve hr after the first dose was 0.4 (0.2) ng/ml. After the second dose, the patients showed a biphasic concentration vs. time curve, the first peak occurring at 8 (4) min, and the second peak at 210 (132) min; the mean (SD) peak concentrations being 1.1 (0.3) and 2.0 (1.1) ng/ml, respectively. The area under the concentration vs. time curve showed a 4-fold variation among our patients. Topically applied betaxolol was rapidly absorbed into systemic circulation, and concentrations were detectable even at 12 hr. The interindividual variation in the systemic absorption of betaxolol was large.

Aims: Hydroxychloroquine (HCQ) is used widely in the treatment of chronic inflammatory diseases such as rheumatoid arthritis. Since there is great interindividual variability in the pharmacokinetics of HCQ and chloroquine is a potent inhibitor of CYP2D6-catalysed pathways in vitro, we wished to study the interaction of HCQ with CYP2D6-mediated metabolism of other drugs in vivo., Methods: Metoprolol and dextromethorphan (DM) were selected as probe drugs because they are well-studied and widely used test substrates of CYP2D6. In this randomized, double-blind crossover study, seven healthy volunteers with extensive metabolizer phenotype for CYP2D6 ingested either 400 mg hydroxychloroquine or placebo daily for 8 days after which single oral dose pharmacokinetics of metoprolol were investigated. Dextromethorphan metabolic ratio (DM-MR) was also determined at baseline and after the ingestion of HCQ or placebo., Results: Concomitant administration of HCQ increased the bioavailability of metoprolol, as indicated by significant increases in the area under the plasma concentration-time curve (65 +/- 4.6%) and maximal plasma concentrations (72 +/- 6.9%) of metoprolol. While the DM-MR values were not significantly changed, the phenotypic classification of one individual, who was heterozygous for a mutant CYP2D6 allele, was converted to a poor metabolizer by HCQ administration., Conclusions: HCQ inhibits metoprolol metabolism most probably by inhibiting its biotransformation by CYP2D6. The inhibitory effect of HCQ on dextromethorphan metabolism was not apparent when DM-MR was used as an indicator, except in an individual with limited CYP2D6 capacity.

1 Atipamezole (4-(2-ethyl-2,3-dihydro-1H-inden-2-yl)-1H-imidazole) was first introduced as a potent and specific alpha2-adrenoceptor antagonist, but in some tissues [3H]atipamezole identifies an additional population of binding sites, distinct from both classical alpha2-adrenoceptors and I1- and I2-imidazoline receptors identified with [3H]para-aminoclonidine or [3H]idazoxan. 2 In the present study we have characterized [3H]atipamezole binding sites in rat kidney by receptor autoradiography and membrane binding assays and determined whether they are pharmacologically identical with the previously described binding sites for [3H]para-aminoclonidine and [3H]idazoxan. [3H]RX821002 and [3H]rauwolscine were used to compare the regional distribution of alpha2-adrenoceptors to that of non-adrenergic binding sites of [3H]atipamezole. 3 Comparative autoradiographic experiments demonstrated the differential localisation of [3H]atipamezole, [3H]RX821002 and [3H]rauwolscine binding sites in rat kidney. The pattern of distribution of non-adrenergic [3H]atipamezole binding sites is clearly distinct from that of alpha2-adrenoceptors. 4 The non-adrenergic binding of [3H]atipamezole in rat kidney does not fall into any of the previously identified three classes of imidazoline receptors studied with [3H]para-aminoclonidine, [3H]idazoxan and [3H]RX821002. 5 Atipamezole had no inhibitory effect on MAO-A or MAO-B activity in renal membranes, which speaks against the involvement of MAOs in the observed radioligand binding.

Selegiline, an irreversible and selective inhibitor of monoamine oxidase type B (MAO-B), is metabolized into desmethylselegiline, levomethamphetamine, and levoamphetamine. In animal experiments, desmethylselegiline also has been shown to be an irreversible inhibitor of MAO-B. This study investigated the inhibitory potential of MAO-B and the pharmacokinetics of desmethylselegiline in humans. A double-blind, crossover trial was performed to compare the effects of a single dose (10 mg) of selegiline or desmethylselegiline on MAO-B platelet activity. The urinary excretion of phenylethylamine, which is considered to be a parameter of MAO-B inhibition, also was measured. The concentrations of selegiline, desmethylselegiline, and their metabolites were measured in plasma after administration of the two compounds. Ten healthy volunteers participated in the study. There was a clear inhibition of platelet MAO-B by both compounds. Desmethylselegiline caused a 63.7 +/- 12.7% inhibition of platelet MAO-B compared with 96.4 +/- 3.9% caused by selegiline. The maximal inhibition by desmethylselegiline was reached significantly later after desmethylselegiline (time to reach maximal inhibition [tmax], 27 +/- 20 hours) than after selegiline administration (tmax, 1.4 +/- 1.4 hours). The platelet MAO-B activity returned to baseline levels within 2 weeks, thus reflecting the irreversible nature of the inhibition by both compounds. The cumulative 48-hour excretion of phenylethylamine was 33% lower after desmethylselegiline than after selegiline administration. All three major metabolites of selegiline could be detected in plasma after selegiline administration. Levoamphetamine was the only metabolite of desmethylselegiline. The area under the concentration-time curve from time 0 to 24 hours (AUC0-24) of desmethylselegiline was 33 times higher than that of selegiline, suggesting a better bioavailability of desmethylselegiline. Desmethylselegiline is an orally active, irreversible inhibitor of MAO-B and could possibly be used to treat Parkinson's disease in the same way as selegiline.

Selegiline is an irreversible inhibitor of monoamine oxidase type B (MAO-B). No comparative data are available on the MAO-B inhibition caused by orally and intravenously administered selegiline. This study aimed to clarify this matter and to investigate the dose-response of MAO inhibition caused by orally administered selegiline. Sixteen healthy volunteers were given selegiline as a single intravenous dose (0.5 mg) and in three low oral doses (0.5 mg, 1.0 mg, and 1.5 mg) in an open-label randomized crossover trial. The MAO-B inhibition after the 0.5-mg intravenous dose was 79.6 +/- 15.1%. The dose-response of the three oral doses causing MAO-B inhibition was logistic. To check whether this equation could be applied to higher doses, eight of the volunteers were given 5-mg and 10-mg oral doses. The MAO-B inhibition after these doses (84.9 +/- 11.9% and 95.6 +/- 4.5, respectively) fitted well with the logistic model. With this equation obtained, it was calculated that a 3.4-mg oral dose of selegiline would be needed to obtain the same degree of MAO-B inhibition as after the intravenous dose of 0.5 mg. Therefore, the ratio of MAO-B inhibitory potential of intravenously and orally given selegiline is approximately 7 to 1, which fits well with the low bioavailability of the drug after oral administration.

Aryl hydrocarbon hydroxylase (AHH) and NADPH-cytochrome P450 reductase (NCR) activity of microsomes from liver, lungs, uterus and mammary tumors in dimethylbenzanthracene-induced and toremifene-treated female Sprague-Dawley rats were studied. AHH and NCR activity in tumors and uteri was low compared with that in livers and lungs. The distribution of AHH in tumors was wide and skewed. It varied in different tumors of the same animal as widely as between different animals. The enzyme activity in tumors did not correlate with that in the liver, lungs or uterus of the same animal. Toremifene had no effect on AHH or NCR in tumor or liver, but it decreased them in lungs. Tumor AHH activity correlated with its overall growth rate and development stage. The results suggest that malignant transformation leading to the defect in growth regulation also confuses the complex regulatory system of AHH activity.

The development of spontaneous mammary tumors was observed for about 2 years in a group of 25 female Sprague-Dawley rats aged over 1 year at the beginning of the study. All younger females in our animal facility were similarly monitored. In old females, the incidence of spontaneous mammary tumors was 64%. The parity of rats did not protect them from tumorigenesis, but the proportion of malignant tumors was higher in virgin (57%) than in parous (13%) rats. Activities of cytochrome P450IA1-dependent enzyme (aryl hydrocarbon hydroxylase, AHH) and NADPH-cytochrome P450 reductase (NCR) were determined in microsome fractions isolated from livers, lungs, uteri and tumors of rats. AHH and NCR activities in tumors and uteri were low compared to those in livers or lungs. In tumors, the activity distributions were wide, even in different tumors of the same animal the AHH activities varied as widely as between different animals. The activities in benign and malignant tumors were not statistically significantly different. No correlation with liver, lung or uterine activities was found either. With ageing of the rat, the AHH activities in tumors, liver and lungs decreased. The behavior of AHH in spontaneous mammary tumors in rats seems to be similar to that found in chemically induced tumors and seems to show individual regulation, possibly altered by tumorigenesis in each individual tumor.

Objective: To assess lipid peroxidation and antioxidant function in hypertensive complications of pregnancy., Design: Cross sectional study comparing pre-eclamptic and control patients., Setting: Tampere University Hospital, Finland., Subjects: Twenty healthy women with normal, uncomplicated pregnancy; 23 women with severe pre-eclampsia; 20 women with mild pre-eclampsia; and 13 women with pregnancy-induced hypertension., Main Outcome Measures: Conjugated dienes; thiobarbituric acid--reactive material or malondialdehyde (MDA); fluorescent chromolipids (FCL); glutathione peroxidase (GSHPx); selenium; uric acid; and vitamin E., Results: Lipid peroxidation assessed by the appearance of conjugated dienes and malondialdehyde was significantly increased in the hypertensive patients as compared with control patients. Lipid peroxidation products also showed high correlation to the level of blood pressure, but failed to show significant relation to the outcome of the fetus. The activities of erythrocyte and plasma glutathione peroxidase were increased in severe pre-eclampsia, and high levels of plasma or platelet glutathione peroxidase were found to have some association with fetal growth retardation or asphyxia., Conclusions: Our findings give support to those few studies considering lipid peroxidation as an important factor in the pathogenesis of pre-eclampsia. The rise in antioxidants is probably of compensatory nature responding to the increased peroxide load in pre-eclampsia and may reflect the severity of the disease.

The effect of chronic treatment with metformin (320 mg/kg/day) on plasma glucose and insulin as well as liver glycogen synthase activity and hepatic glycogen content was studied in obese hyperinsulinemic Zucker rats. Metformin significantly reduced both plasma glucose (by 10%) and insulin levels (by 39%) at fasting but had no effect on hepatic glycogen content or on the basal activity of liver glycogen synthase.

1. The pharmacokinetics of parenteral mecillinam (n = 27) and oral pivmecillinam (n = 12) were studied in pregnant (n = 27) and non-pregnant (n = 12) subjects. 2. In early pregnancy (9-14 weeks of gestation) the mean peak plasma drug concentration (Cmax = 19 +/- 9 micrograms ml-1) after an intravenous injection of 200 mg mecillinam was significantly lower (P less than 0.05) and the volume of distribution (V = 49 +/- 20.1) significantly larger (P less than 0.05) than in non-pregnant subjects (Cmax = 35 +/- 18 micrograms ml-1, V = 29 +/- 12.1). In late pregnancy (39-40 weeks of gestation) the plasma mean peak concentration (Cmax = (29 +/- 14 micrograms ml-1) after parenteral administration of 200 mg mecillinam was slightly lower and the volume of distribution (V = 65 +/- 29.1, V = 0.9 +/- 0.4 l kg-1) significantly larger than that in non-pregnant subjects (V = 0.4 +/- 0.3 l kg-1). Also after oral administration of 200 mg pivmecillinam, equimolar to 136.5 mg mecillinam, the mean peak plasma concentration in pregnant subjects (Cmax = 1.8 +/- 1.2 micrograms ml-1) was slightly lower than that in non-pregnant subjects (Cmax = 1.7 +/- 1.2 micrograms ml-1). 3. The mean half-life of elimination after parenteral administration of mecillinam was significantly longer during both early (t1/2,Z = 133 +/- 38 min, P less than 0.05) and late pregnancy (t1/2,Z = 107 +/- 41 min, P less than 0.05) as compared with the non-pregnant state (t1/2,Z = 75 +/- 21 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Twenty healthy women with normal pregnancy were simultaneously analysed with regard to lipid peroxidation products, selenium-dependent glutathione peroxidase and vitamin E. Conjugated diene double bonds, fluorescent chromolipids and thiobarbituric acid-reactive material were analysed as breakdown products of lipid peroxidation. The level of conjugated dienes in serum rose more than 45% when pregnancy advanced from the first to second trimester, but after that it declined almost to the same level as in the first trimester. The fluorescent chromolipids tended to behave in the same way. While the lipid peroxidation products reached their highest level in the second trimester, the activity of glutathione peroxidase rose progressively till the third trimester both in erythrocytes and platelets, in spite of the stable concentration of selenium in blood and plasma. The concentration of vitamin E in serum rose progressively till the end of pregnancy, but in the relation of vitamin E to cholesterol only a slight rising tendency was noted. We suggest that in normal pregnancy lipid peroxidation is controlled by adequate antioxidative response.

The activity of four liver enzymes participating in the xenobiotic metabolism was determined in male and female obese hyperinsulinemic Zucker rats. When compared to lean normoinsulinemic control animals the obese male rats had lower hepatic aryl hydrocarbon hydroxylase and the female animals lower 7-ethoxycoumarine O-deethylase and N-nitrosodimethylamine N-demethylase activities. The results contrast those reported in the literature for hypoinsulinemic streptozotocin diabetic rats.

The material consisted of 32 patients, 12 of whom were selected for control. All were cases approaching the menopause and had been subject to oophorectomia bilateralis and hysterectomia for myomas. All 20 investigation patients received estradiol valerianate orally 4 mg/day of 6 mth. During the course the serum estradiol level increased 5--6-fold from the postmenopausal levels. No significant changes occurred in the serum triglycerides and total cholesterol, whereas in the control group the triglycerides decreased. The proportional concentration of beta-lipoproteins decreased. There was also a slight decrease in the pre-beta-lipoproteins. The proportional concentration of beta-lipoproteins increased, as also serum high density lipoprotein (HDL) cholesterol. In the liver enzymes no changes occurred. Blood pressure increased in one patient. There were no other complications.

The effects of pretreatment with toluene, o-, m-, p-xylene and mesitylene were investigated on the microsomal enzymes of liver, kidney and lung in rats. The activities of aminopyrine N-demethylase, aryl hydrocarbon hydroxylase, aniline hydroxylase, NADPH-cytochrome c reductase, as well as the concentrations of cytochrome P-450 and cytochrome b5 were determined. The effects were most marked in the liver, where toluene caused increase in aniline hydroxylase and cytochrome P-450; o-xylene in aminopyrine N-demethylase and cytochrome b5; m-xylene and mesitylene in all the enzymes investigated. In kidneys, all the compounds increased the activity of aniline hydroxylase; m-xylene induced cytochrome P-450 and b5 as well as NADPH-cytochrome c reductase; p-xylene induced cytochrome P-450, and mesitylene cytochrome P-450 and b5. Aminopyrine N-demethylase activity was decreased by toluene. In lungs, only mesitylene caused any significant differences from the controls: increase in aminopyrine N-demethylase and aryl hydrocarbon hydroxylase, decrease in aniline hydroxylase. The methylbenzenes tested induced the microsomal enzymes in a rough correlation to the number of their methyl groups and their hydrophobic properties.

1. Single oral doses (100, 200 and 300 mg) of moclobemide, a reversible inhibitor of monoamine oxidase (MAO) with predominant effects on the A-type of the enzyme, were administered to eight young, healthy male volunteers in a double-blind, random-order, placebo-controlled study. The investigation was thereafter continued in an open fashion by administering a single 10 mg dose of the MAO-B inhibitor deprenyl to the same subjects. 2. Deamination of catecholamines was powerfully and dose-dependently inhibited by moclobemide, as evidenced by up to 40% decreases in the urinary excretion of deaminated catecholamine metabolites, corresponding increases in the excretion of non-deaminated, methylated metabolites, and up to 79% average decreases in the plasma concentration of 3,4-dihydroxyphenylglycol (DHPG), a deaminated metabolite of noradrenaline (NA), and up to 75% average decreases in the plasma concentrations of 3,4-dihydroxyphenylacetic acid (DOPAC), a deaminated metabolite of dopamine. The urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) was only slightly reduced. In contrast, deprenyl, in a dose which almost totally inhibited MAO-B activity in blood platelets, did not appreciably affect the plasma concentrations of DHPG or DOPAC. 3. Due to the rapid, reversible, dose-dependent and MAO-A specific effect of moclobemide on plasma concentrations of DHPG, it is suggested that DHPG in plasma may be a useful indicator of the magnitude and duration of MAO-A inhibition in man. 4. Sympatho-adrenal function at rest was not significantly altered by moclobemide, as judged by unchanged plasma catecholamine concentrations and stable blood pressure and heart rate recordings. 5. Monoamine oxidase type B activity in blood platelets was slightly (less than 30%) and transiently inhibited after moclobemide. 6. The secretion of prolactin was dose-dependently stimulated by moclobemide, whereas the plasma concentrations of growth hormone (hGH) and cortisol remained unchanged.

The effects of pretreatment with benzene and various methylbenzenes, ethyl- and propylbenzene, cumene and styrene on hepatic and pulmonary microsomal enzymes were studied in male rats. In the lungs, all the substituted benzenes, but not benzene itself, decreased cytochrome P-450 concentration, and most of them also decreased 7-ethoxycoumarin O-deethylase activity, whereas 7-ethoxyresorufin O-deethylase activity was increased by the same treatment. The change in aryl hydrocarbon hydroxylase activity was negligible. Neither NADPH-cytochrome c reductase activity, nor cytochrome b5 concentration were changed after hydrocarbon treatment. In the liver, all the compounds studied, except for benzene, increased 7-ethoxycoumarin O-deethylase and 7-ethoxyresorufin O-deethylase, and most of them also cytochrome P-450, aryl hydrocarbon hydroxylate and NADPH-cytochrome c reductase. The effect on cytochrome b5 in the liver was less marked. In the liver, all the monooxygenases studied seemed to be inducible by alkylbenzenes and styrene, whereas the effect was selective in the lung; depending on the monooxygenase, the activity can increase, decrease or remain unchanged.

Concentrations of selenium in the soil are very low in most regions in Finland, which explains the low selenium contents of agricultural plants and the low dietary intake of selenium. The poor selenium status of the population in Finland has been considered a possible risk to public health. In 1984, it was decided to increase the selenium intake by adding selenate to common agricultural fertilizers. In this study, the selenium concentrations of whole blood and plasma, as well as erythrocyte glutathione peroxidase activities, were measured in blood samples from four different localities in Finland, in 1984 and 1986, before and during the agricultural selenium supplementation. A low blood level of selenium in the inhabitants of central Finland was demonstrated in 1984. The selenium level of people from the south-west archipelago was a little higher, and that from the northern part of Finland considerably higher than the level in the rest of the country. By 1986, differences between these localities had almost disappeared, and most levels had increased. Plasma selenium concentrations were lower than those in whole blood samples; the concentrations showed a significant correlation. The glutathione peroxidase activities were at the same level in all four localities in 1984. By 1986, they had all increased to a slightly higher level. A weak correlation was found between erythrocyte glutathione peroxidase activity and blood selenium level.

The uptake, distribution, and elimination of 3H-toluene in various tissues of rats were studied after inhalation or after gastric intubation. The maximum radioactivity was measured 2--3 h after gastric intubation in tissues, except in white adipose tissue, where the peak radioactivity was reached at 5 h. After inhalation exposure, the uptake to various tissues was very rapid. The maximum radioactivity in most tissues was reached in 15--30 min. The accumulation was slowest in white adipose tissue, where it took 1--2 h. The radioactivity in tissues decreased after inhalation exposure more rapidly than after gastric intubation. Brown adipose tissue and white adipose tissue were different from other tissues in their ability to retain toluene. Twenty-four hours after exposures, only 1% or less of the initial radioactivity was found in tissues other than white adipose tissue, in which the corresponding value was 3.5--5%. The results show a very rapid absorption and distribution of toluene after inhalation and a retention of radioactivity in white adipose tissue. After oral ingestion the distribution showed a similar but much slower pattern.

The limit of the capacity of male adult Sprague-Dawley rats to metabolize toluene and excrete it as hippuric acid was reached at a dose of 10 mmol toluene/kg. At this dose of benzoic acid or hippuric acid, the excretion of hippuric acid was 1.5-fold and 4-fold, respectively, greater than that following this dose of toluene. When toluene was given after phenobarbital pretreatment the excretion rate of hippuric acid increased 3-4-fold, but 3-methylcholanthrene pretreatment had no effect. Consecutive toluene exposures increased hippuric acid excretion on the third day by about 2-fold. It seems that the side-chain oxidation is the rate-limiting step in toluene metabolism of uninduced rats, and toluene accelerates its own metabolism by inducing cytochrome P-450 dependent microsomal monooxygenases.

Inhalation of toluene vapour of 2000 ppm increased the activities of aniline hydroxylase, aminopyrine N-demethylase, aryl hydrocarbon hydroxylase and NADPH-cytochrome c reductase and the concentrations of cytochromes P-450 and b5 in liver microsomes of adult male rats after an exposure period of 1 day or less. Repeated treatments, 8 h daily for 1-16 days, had only a slight further effect. In lung microsomes, the activities of monooxygenases and the concentration of cytochrome P-450 decreased after 6-24 h toluene exposure, but those of cytochrome b5 and NADPH-cytochrome c reductase did not change. In kidney microsomes the changes were mostly insignificant. After discontinuation of exposure the activities of enzymes and the concentrations of cytochromes returned to the control level in 1-4 days. The results obtained resemble the time-courses for the induction of monooxygenases by other inducers. The tissue differences suggest the unequal distribution of various cytochrome P-450 forms and their individual responsiveness to induction in liver, kidneys and lungs.

In the liver microsomes of toluene-treated and control Sprague-Dawley rats (n = 148, males and females aged 13-93 days), the contents of cytochrome P-450 and b5 and the activities of NADPH-cytochrome c reductase and four monooxygenases were studied. In male control rats, cytochrome contents and NADPH-cytochrome c reductase, aminopyrine N-demethylase and aniline hydroxylase activities increased to the age of one month, and after a slight decrease in cytochrome concentrations, the average adult level was reached by the age of two months. Aniline hydroxylase and 7-ethoxycoumarine O-deethylase activities decreased to about half at the same age period. In control female rats, the activities of aminopyrine N-demethylase and aniline hydroxylase decreased after the age of one month, and they remained at a considerably lower level in adult females than in males. The sex-dependence of other enzymes was negligible. Toluene induction was already well developed in the youngest age group of both sexes; in most cases the induced enzyme levels in young rats were as high or higher than in adults. In adult female rats, toluene induction of all enzymes was weaker than in males. In male rats, the toluene-induced level of aniline hydroxylase and 7-ethoxycoumarine O-deethylase showed deep minima at the age of 43-53 days, at the puberty of rats.

Serum concentrations of oestrone, oestradiol and oestriol were measured in 23 postmenopausal women, 12 with ovarian cancer and 11 with genital prolapse. Oestrone (387.6 pmol/l) and oestradiol (72.7 pmol/l) levels were higher in the cancer group than those in the control group (159.8 and 27.5 pmol/l respectively), while oestriol levels did not differ (434.5-270.8 pmol/l). The results indicate abnormal ovarian function in postmenopausal patients with ovarian cancer.

Serum concentrations of vitamins A and E, selenium, and cholesterol were measured in 30 Finnish and 30 Japanese postmenopausal women. While both groups had identical serum vitamin A levels, the other serum factors differed significantly between the groups, the Finns having higher serum vitamin E and cholesterol and lower serum selenium levels. Adjusted to serum cholesterol, which correlated significantly with vitamin E in both groups, the vitamin E levels were, however, similar in the groups. The differences in the serum levels of these nutritional factors may be associated with the differences in the risk of coronary heart disease and cancer between Finnish and Japanese populations.

Serum levels of 25-hydroxyvitamin D (25-OHD) in summer and winter were studied in 564 children aged 2-17 years living in the northern, central or southern parts of Finland. The mean levels of 25-OHD were significantly lower in winter (13.3 +/- 10.8 ng/ml) than in summer (27.2 +/- 10.3 ng/ml) in all age groups (p less than 0.001). The mean 25-OHD levels in the northern part of the country did not differ significantly from the others. In both seasons the levels of 25-OHD were lower in the 11-17 year age group than in younger children. In that age group 22.4% of the children had serum levels of 25-OHD below 5 ng/ml (the limit of risk for rickets), compared to 16.8% of children 6-10 years old and 7.5% of children 2-5 years old, but none of the children showed any laboratory evidence of rickets.