Vitamin D and bone health in adults with cystic fibrosis

Wolfenden, Linda L.; Judd, Suzanne E.; Shah, Reshma; Sanyal, Rupan; Ziegler, Thomas R.; Tangpricha, Vin

doi:10.1111/j.1365-2265.2008.03216.x

Cited by 94 publications

(76 citation statements)

References 31 publications

(72 reference statements)

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“…These have found a positive association between serum 25OHD and FEV1. However, analyses were either not controlled for any confounders or controlled for only a few relevant factors, despite the substantial heterogeneity within the subject population (Black and Scragg, 2005;Green et al, 2008;Wolfenden et al, 2008). The positive association between 25OHD and FEV1 in our MLR model confirmed these previous observations in our large population of well-defined patients.…”

Section: Inverse Relation Between Vitamin D and Serum Igg T Pincikovasupporting

confidence: 81%

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: Inverse Relation Between Vitamin D and Serum Igg T Pincikovasupporting

confidence: 81%

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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“…Bone health is important for the quality of life in aging patients, and became more relevant in patients affected with CF [1][2][3][4] . Several studies described lower bone mass density (BMD) in patients with CF, which increases fracture risk [5][6][7][8] . Bone fractures can cause pain, decrease respiratory status, and are a contraindication for lung transplantation in these patients 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis

Vanacor

Raimundo

Marcondes

et al. 2014

Rev. Assoc. Med. Bras.

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Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis rev assoc med bras 2014; 60 (1) Conflict of interest: noneObjective: The aim of this cross-sectional study was to evaluate the prevalence of low bone mass density in cystic fibrosis patients as well as to evaluate the factors associated with bone mass in such patients. Methods: Bone mass density was measured by dual-photon X-ray absorptiometry of lumbar spine (L1-L4), in patients ≤19 years old, or lumbar spine and femur (total and neck) in patients ≥20 years old. Evaluations of nutritional status, biochemical parameters, and lung function were performed. Medication data were obtained from medical records. Results: Fifty-eight patients were included in the study (25 males/ 33 females), mean age 23.9 years (16-53years). The prevalence of bone mass below the expected range for age at any site was 20.7%. None of the subjects had history of fracture. Lumbar spine Z-score in cystic fibrosis patients correlated positively with body mass index (r= 0.3, p=0.001), and forced expiratory volume in the first second (% predicted) (r=0.415, p=0.022). Mean lumbar spine Z-score was higher in women (p=0.001), in patients with no pancreatic insufficiency (p=0.032), and in patients with no hospitalization in the last 3 months (p=0.02). After multivariate analysis, body mass index (p= 0.001) and sex (p=0.001) were independently associated with Z-score in lumbar spine. Conclusion: Low bone mass is a frequent problem in patients with CF, being independently associated with body mass index, and male sex.

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“…Studies on vitamin D and lung function in the CF population are lacking. Most studies focus on prevalence of vitamin D deficiency, supplementation, and bone health but comment on lung function as a possible predictor of vitamin D deficiency (22)(23)(24). These studies have had conflicting results, with only one study reporting a significant positive relationship between 25-OHD level and pulmonary function (23).…”

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confidence: 99%

Vitamin D Deficiency Is Associated with Pulmonary Exacerbations in Children with Cystic Fibrosis

et al. 2014

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Rationale: Recent literature suggests vitamin D has an effect on lung function and on the lung's ability to fight infection, both important in the cystic fibrosis (CF) population as predictors of morbidity and mortality.Objectives: Our study assessed associations between vitamin D and % predicted lung function, pulmonary exacerbations, and first Pseudomonas aeruginosa infection in children with CF. We hypothesized that children with CF who have 25-hydroxy vitamin D (25-OHD) levels less than 30 mg/L would have lower % predicted lung function and more pulmonary exacerbations than those with 25-OHD greater than or equal to 30 mg/L. Measurements and Main Results:The prevalence of vitamin D deficiency and insufficiency increased slowly through adolescence. The rate of exacerbations for the deficient vitamin D group, aged 15 to 18 years, was 13.1 per 10 patient-years, significantly higher than 4.3 per 10 patient-years for the insufficient and sufficient vitamin D groups (P , 0.05), which were not significantly different There were no differences between vitamin D groups in pulmonary function or incidence of first P. aeruginosa infection, which was about 2 per 10 patient-years.Conclusions: Higher 25-OHD levels in children with CF were associated with lower rates of pulmonary exacerbations and, in adolescents, higher FEV 1 .

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Vitamin D and bone health in adults with cystic fibrosis

Abstract: SummaryBackground-Cystic fibrosis (CF) patients have chronic pancreatic insufficiency leading to malabsorption of fat-soluble vitamins, including vitamin D which can contribute to poor skeletal health and respiratory function.

Cited by 94 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

Prevalence of low bone mineral density in adolescents and adults with cystic fibrosis

Vitamin D Deficiency Is Associated with Pulmonary Exacerbations in Children with Cystic Fibrosis

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