Prevalence of Inadequate Vitamin D Status and Associated Factors in Children With Cystic Fibrosis

Norton, Laura E.; Page, Sarah M.; Sheehan, Melissa; Mazurak, Vera C.; Brunet‐Wood, Kim; Larsen, Bodil

doi:10.1177/0884533614562839

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…It is questionable whether an increase in the already high serum levels can be expected, as previous studies have indicated that vitamin D intake has to increase exponentially, as higher serum 25(OH)D levels are to be reached (13,25) . Previous studies also reported an inverse association between age and serum 25(OH)D (8,11,(26)(27)(28) in paediatric patients with CF, although no conclusive explanation was given. We found that children with higher levels of serum 25(OH)D were significantly younger, with the highest serum 25(OH)D levels in patients below the age of 4 years old.…”

Section: Discussionmentioning

confidence: 87%

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach

et al. 2018

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Pancreatic-insufficient children with cystic fibrosis (CF) receive age-group-specific vitamin D supplementation according to international CF nutritional guidelines. The potential advantageous immunomodulatory effect of serum 25-hydroxy vitamin D (25(OH)D) on pulmonary function (PF) is yet to be established and is complicated by CF-related vitamin D malabsorption. We aimed to assess whether current recommendations are optimal for preventing deficiencies and whether higher serum 25(OH)D levels have long-term beneficial effects on PF. We examined the longitudinal relationship between vitamin D intake, serum 25(OH)D and PF in 190 CF children during a 4-year follow-up period. We found a significant relationship between total vitamin D intake and serum 25(OH)D (β = 0·02; 95 % CI 0·01, 0·03; P = 0·000). However, serum 25(OH)D decreased with increasing body weight (β = –0·79; 95 % CI –1·28, –0·29; P = 0·002). Furthermore, we observed a significant relationship between serum 25(OH)D and forced expiratory volume in 1 s (β = 0·056; 95 % CI 0·01, 0·102; P = 0·018) and forced vital capacity (β = 0·045; 95 % CI 0·008, 0·082; P = 0·017). In the present large study sample, vitamin D intake is associated with serum 25(OH)D levels, and adequate serum 25(OH)D levels may contribute to the preservation of PF in children with CF. Furthermore, to maintain adequate levels of serum 25(OH)D, vitamin D supplementation should increase with increasing body weight. Adjustments of the international CF nutritional guidelines, in which vitamin D supplementation increases with increasing weight, should be considered.

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Section: Discussionmentioning

confidence: 87%

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach

et al. 2018

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“…1 Vitamin D insufficiency is common in CF despite vitamin D supplementation. 2,3 In addition to its importance for bone health, vitamin D acts as a potent immune modulatory agent with complex effects. 4,5 In CF, vitamin D concentrations have been associated with lung function, 2,6 annual number of pulmonary exacerbations 7 and with total serum IgG levels.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of vitamin D treatment in cystic fibrosis: a pilot randomized, controlled trial

et al. 2016

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BACKGROUND/OBJECTIVES: Vitamin D insufficiency in cystic fibrosis is common. Vitamin D3 is currently preferred over D2. We aimed to study the efficacy of vitamin D2 and D3 at increasing serum 25-hydroxyvitamin D (s25OHD) concentrations and their effect on respiratory health in cystic fibrosis. SUBJECTS/METHODS: Sixteen CF patients were randomized to receive vitamin D2 or D3 or to serve as controls. The starting dose of 5000 IU (o 16 years old) or 7143 IU/day (⩾16 years old) was further individually adjusted. Three months of intervention were followed by two of washout (ClinicalTrials.gov NCT01321905). RESULTS: To increase s25OHD, the mean daily dose of vitamin D2 and D3 had to be increased up to 15650 and 8184 IU, respectively. The combined group of vitamin D2 and D3 treated patients decreased plasma IL-8 (Po 0.05). Patients provided vitamin D3 improved FVC at the end of the trial (P o 0.05). Change in s25OHD was positively correlated with changes in the adult Quality-of-Life respiratory score at the end of supplementation (P = 0.006, r = 0.90), and with changes in FEV1 (P = 0.042, r = 0.62) and FVC (P = 0.036, r = 0.63) at one month of washout. CONCLUSIONS: Vitamin D supplementation may contribute to reduced inflammation and improved lung function in CF.

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“…This association was already expected due to the international recommendations of vitamin supplementation in patients with CF with pancreatic insufficiency. Studies present controversial results regarding PI, vitamin D supplementation, and vitamin D serum levels …”

Section: Discussionmentioning

confidence: 99%

Lung disease and vitamin D levels in cystic fibrosis infants and preschoolers

Oliveira¹,

Matsunaga²,

Rodrigues³

et al. 2019

Pediatric Pulmonology

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Introduction: Vitamin D acts on the immune system and lung response. Patients with cystic fibrosis (CF) may be deficient in this vitamin. The aims of the study were to evaluate vitamin D levels and severity of lung disease in infants and preschoolers diagnosed with CF, and to compare them to a group of children without pancreatic insufficiency (PI). Methods: Patients with CF up to 4 years old were included, and compared to an agematched group of children without diagnosis of CF. CF group had medical records and High Resolution Thorax Computed Tomography (HRCCT) evaluated in order to verify the severity of lung disease. Information on demographic data, sun exposure habits, supplemental vitamin D therapy, and on the season at the time of vitamin D sampling were collected for both groups.Results: This study included 45 patients in the CF group and 102 in the non-CF group, with no differences in age (P = 0.327) between them. There was no association between vitamin D levels and markers of lung disease in the CF group. The non-CF group had lower daily sun exposure (P = 0.034), and lower supplementation than the CF group (P < 0.001). Supplementation and seasonality were the determinant variables for vitamin D levels, which were lower for non-supplemented children and for assessments during fall/winter. Conclusion:There was no association between lung disease severity and vitamin D levels in CF group. Supplementation and seasonality were associated to higher vitamin levels. K E Y W O R D Scystic fibrosis, infants and preschoolers, lung disease, neonatal screening, vitamin D

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Prevalence of Inadequate Vitamin D Status and Associated Factors in Children With Cystic Fibrosis

Cited by 20 publications

References 23 publications

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach

Clinical impact of vitamin D treatment in cystic fibrosis: a pilot randomized, controlled trial

Lung disease and vitamin D levels in cystic fibrosis infants and preschoolers

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