Treatment and Prevention of Vitamin D Insufficiency in Cystic Fibrosis Patients: Comparative Efficacy of Ergocalciferol, Cholecalciferol, and UV Light

Khazai, Natasha; Judd, Suzanne E.; Jeng, Leo; Wolfenden, Linda L.; Stecenko, Arlene A.; Ziegler, Thomas R.; Tangpricha, Vin

doi:10.1210/jc.2008-2012

Cited by 91 publications

(65 citation statements)

References 31 publications

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“…This finding is in line with studies of other CF patient populations (Rovner et al, 2007;Stephenson et al, 2007;Neville and Ranganathan, 2009). With supplementation or UV-B exposure, 25OHD could, however, be safely increased over time (Stephenson et al, 2007;Khazai et al, 2009;Neville and Ranganathan, 2009 …”

Section: Discussionsupporting

confidence: 87%

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Pincikova

Nilsson²,

Moen³

et al. 2010

Eur J Clin Nutr

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Background/Objectives: The hallmark of cystic fibrosis (CF) is chronic lung inflammation. The severity of lung disease is closely correlated with immunoglobulin G (IgG) levels. Beyond its contribution to the bone health, the importance of vitamin D has not been fully recognized owing to the lack of human studies providing evidence of its benefit. In the context of the recently described immunomodulatory functions of vitamin D, we aimed to assess the relationship between vitamin D and IgG levels. Subjects/Methods: Eight hundred and ninety-six CF patients were included (0.53-65.9 years) from seven centers in Denmark, Norway and Sweden. Serum 25-hydroxyvitamin D (25OHD) and total IgG were measured, spirometry was carried out and vitamin D intake data were gathered using a 7-day dietary food record. Multiple linear regression analyses were performed for IgG and forced expiratory volume in 1ls (FEV1) as dependent variables, and serum 25OHD, daily food and supplemented vitamin D sources of intake as independent variables. The model was controlled for age, gender, genotype, CF-related diabetes, season, infection/colonization status, long-term oral corticosteroid treatment, long-term treatment with macrolide antibiotics, pancreatic insufficient phenotype and body mass index z-score. Results: Serum total IgG levels were negatively associated with serum 25OHD (adjusted R 2 ¼ 0.376; beta ¼ À0.02; Po0.001), supplemented vitamin D intake per kg bodyweight (adjusted R 2 ¼ 0.375; beta ¼ À0.82; Po0.001) and total vitamin D intake per kg bodyweight (adjusted R 2 ¼ 0.398; beta ¼ À0.60; P ¼ 0.002). Serum 25OHD was positively associated with FEV1 (adjusted R 2 ¼ 0.308; beta ¼ 0.0007; P ¼ 0.025). Conclusions: Increasing vitamin D intake may positively modulate inflammation in CF. This study supports the proposed role of vitamin D in the immune system during infection and substantiates prospective studies.

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Section: Discussionsupporting

confidence: 87%

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Pincikova

Nilsson²,

Moen³

et al. 2010

Eur J Clin Nutr

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“…However, almost half of the successfully Sunlight determines vitamin D concentration in CF E Robberecht et al treated patients were unable to maintain normal 25 (OH) D levels more than 6 months after completion of the therapy (Green et al, 2010). A recent study of Khazai et al (2009), compared three treatment modes to correct low 25 (OH) concentrations. These were 50 000 IU of ergocalciferol weekly, 50 000 IU cholecalciferol weekly or treatment with UV light five times a week.…”

Section: Discussionmentioning

confidence: 99%

Sunlight is an important determinant of vitamin D serum concentrations in cystic fibrosis

et al. 2011

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“…Studies are conflicting about the effectiveness of vitamin D2 versus D3, but recent studies indicate that D3 may be more effective (Khazai et al, 2009). D3 is readily available over the counter; D2 is only available through prescription and is not generally cost effective.…”

Section: Screening and Treatmentmentioning

confidence: 99%

Cystic fibrosis: A clinician's tool for management of care advancing into the adult population

Nast¹,

Paniagua

Anderson

2012

Journal of the American Academy of Nurse Practitioners

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Purpose: To discuss the role of the nurse practitioner in medical management of adult patients with cystic fibrosis (CF). Data sources: A systematic literature review was done by searching online databases: CINAHYL, OVID, and Medline. The Cystic Fibrosis Foundation (CFF) guidelines were reviewed. Tables were compiled for recommended screening and treatment for adult CF patients. Conclusions: Comorbidities occur among adult CF patients and include: CF‐related diabetes (CFRD), fertility issues, CF liver disease (CFLD), and CF bone disease. Diabetes management is reviewed. Current fertility surgical treatments for males and recommendations for females are discussed. Ursodiol is the main treatment regimen for those affected. Bone disease and CF has multiple etiologies and the focus of treatment is based on appropriate vitamin D replacement and bisphosphonates. New standards for vitamin D replacement are discussed. Implications for practice: Clinicians must be familiar with the current treatments and regimens of adults with CF including comorbidities. The CF adult population is expanding and care is extending beyond the CF clinic. More healthcare providers must be educated on the best practices of adult CF care. The importance of early identification and treatment of CF comorbidities cannot be overestimated. To obtain CE credit for this activity, go to http://www.aanp.org and click on the CE Center. Locate the listing for this article and complete the post‐test. Follow the instructions to print your CE certificate. Disclosures  The authors report no competing interests.

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Treatment and Prevention of Vitamin D Insufficiency in Cystic Fibrosis Patients: Comparative Efficacy of Ergocalciferol, Cholecalciferol, and UV Light

Cited by 91 publications

References 31 publications

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Inverse relation between vitamin D and serum total immunoglobulin G in the Scandinavian Cystic Fibrosis Nutritional Study

Sunlight is an important determinant of vitamin D serum concentrations in cystic fibrosis

Cystic fibrosis: A clinician's tool for management of care advancing into the adult population

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