Objective

: By applying a joint medico-historical and paleopathological perspective, this paper aims to improve our understanding of factors influencing past vitamin D deficiency in ten Dutch 17th to 19th-century communities of varying socioeconomic status and settlement type.

Materials

: Vitamin D deficiency is evaluated in 733 individuals of both sexes and all age groups: Silvolde (n = 16), Rotterdam (n = 23), Rhenen (n = 24), Noordwijkerhout (n = 27), Gouda1and 2 (n = 40; n = 59), Roosendaal (n = 51), Den Haag (n = 93), Hattem (n = 113), and Beemster (n = 287).

Methods

: Rickets and residual rickets are macroscopically assessed using established criteria. Hypotheses formulated based on medico-historical texts are investigated via multivariate statistical analysis of vitamin D deficiency prevalence.

Results

: Vitamin D deficiency prevalence ranges from 13.7 % (7/51) in Roosendaal to 48.1 % (13/27) in Noordwijkerhout, with an onset of < 4 years, and higher rates in cities, conforming to medico-historical texts. Patterns of child labor are likely key. In contrast, socioeconomic status did not statistically significantly influence vitamin D deficiency prevalence rates.

Conclusion

: Systematically collected paleopathological data enabled evaluation of medico-historical texts and provided insights into the role that socioeconomic status and settlement type played on the prevalence of vitamin D deficiency.

Significance

: Combining medico-historical texts and large-scale paleopathological data enables disease patterning to be embedded in a comprehensive biocultural perspective.

Limitations

: Comparisons may be limited by the small sample size of high socioeconomic status nonadults and some of the collections.

Suggestions for future research

: Analysis of more individuals and sites would improve our understanding of disease patterns.

中文翻译：

---

后中世纪荷兰维生素 D 缺乏流行的医学历史和古病理学联合观点

客观的

：通过应用医学历史和古病理学的联合观点，本文旨在提高我们对影响不同社会经济地位和定居类型的 17 至 19 世纪荷兰 10 个社区过去维生素 D 缺乏症的因素的理解。

材料

：对 733 名男女老少的维生素 D 缺乏症进行了评估：Silvolde (n = 16)、鹿特丹 (n = 23)、Rhenen (n = 24)、Noordwijkerhout (n = 27)、Gouda1 和 2 (n = 40；n = 59)、Roosendaal (n = 51)、Den Haag (n = 93)、Hattem (n = 113) 和 Beemster (n = 287)。

方法

：佝偻病和残余佝偻病是使用既定标准进行宏观评估。通过维生素 D 缺乏流行率的多变量统计分析，研究了基于医学历史文本制定的假设。

结果

：维生素 D 缺乏患病率从 Roosendaal 的 13.7 % (7/51) 到 Noordwijkerhout 的 48.1 % (13/27)，发病时间 < 4 年，城市中的比率更高，符合医学历史文本。童工模式可能是关键。相比之下，社会经济地位在统计上对维生素 D 缺乏症的患病率没有显着影响。

结论

：系统收集的古病理学数据有助于对医学历史文本进行评估，并深入了解社会经济地位和定居类型对维生素 D 缺乏症患病率的影响。

意义

：结合医学历史文本和大规模古病理学数据，可以将疾病模式嵌入到综合的生物文化视角中。

限制

：比较可能会受到高社会经济地位的非成年人和一些集合的小样本量的限制。

对未来研究的建议

：对更多个体和地点的分析将提高我们对疾病模式的理解。