The impact of plasma 25‐hydroxyvitamin D on pulmonary function and exercise physiology in cystic fibrosis: A multicentre retrospective study

Abstract

Background A 25‐hydroxyvitamin D (25OHD) may exert immunomodulatory effects on respiratory health, which may translate to improvements in exercise physiology. Thus, we aimed to investigate whether plasma 25OHD is associated with lung function and aerobic fitness in people with cystic fibrosis (pwCF). Methods A multicentre retrospective review of pwCF (> 9 years old) attending the Royal Hospital for Sick Children (Edinburgh) or Wessex CF‐Unit (Southampton) was performed between July 2017 and October 2019. Demographic and clinical data were collected. Plasma 25OHD measured closest in time to clinical cardiopulmonary exercise testing and/or spirometry [forced expiratory volume (FEV1)% predicted] was recorded. Pancreatic insufficiency was diagnosed based on faecal elastase of < 100 µg g−1. We performed multiple‐regression analysis with aerobic fitness outcomes [peak oxygen uptake (VO2 peak)] and FEV1% predicted as primary outcomes. Results Ninety pwCF [mean ± SD age: 19.1 ± 8.6 years, 54 (60%) children, 48 (53%) males and 88 (98%) Caucasian] were included. 25OHD deficiency and insufficiency was 15 (17%) and 44 (49%), respectively. 25OHD deficiency and insufficiency was significantly associated with pancreatic insufficiency (χ2 = 4.8, p = 0.02). Plasma 25OHD was not significantly associated with FEV1% predicted (r2 = 0.06, p = 0.42, 95% CI = −0.09 to 0.19) or VO2 peak (r2 = 0.04, p = 0.07, 95% CI = −011 to 0.005) in all pwCF. However, 25OHD was significantly associated with both FEV1% (r2 = 0.15, p = 0.02, 95% CI = 1.99–2.64) and VO2 peak (r2 = 0.13, p = 0.05, 95% CI = −0.26 to −0.005) in the paediatric cohort. Conclusions We showed that 25OHD is associated with improved lung function and aerobic fitness in children and adolescents with CF. Mechanistic and high‐quality prospective studies including both lung function and aerobic fitness as primary outcomes are now warranted.

Systematic review and meta-analysis: Associations of vitamin D with pulmonary function in children and young people with cystic fibrosis

“…Therefore the associations between basal 25OHD concentration and pulmonary exacerbations (before vitamin D supplementation intake) is unknown. A single study performed by members of our group [43] reported a positive association between 25OHD and aerobic fitness measured using (Timmers, Stellato et CPET (VO 2peak ). Noteworthy, as all studies looking at 25OHD and lung health outcomes in cypCF are of epidemiological nature, these findings are not causal.…”

“…Only one study (4.8%) [43] explored the relationship between 25OHD and aerobic fitness expressed as maximal aerobic fitness (VO 2peak ) in cypCF and reported a statistically significant association between 25OHD and VO 2peak (Table 4).…”

“…Of note, no study reported nutritional intake and only three controlled for the time taken between 25OHD sampling and outcome measures. The half-life of 25OHD ranges between 15 and 45 days [77] and therefore any associations performed outwit this range may be inaccurate [43].…”

Mass Sportrometry: An annual look back at applications of mass spectrometry in sport and exercise science

“…In 2022, targeted analyses were the most commonly applied approach for MS-based research in SES, with 52 human participant studies published. These experiments were predominantly performed in plasma 6,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] or serum, [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] with other biosamples mediums utilized such as urine, [51][52][53][54][55] fecal matter, 56,57 breath gases, [58][59][60][61][62][63] red blood cells, …”

“…Vitamin D metabolites were a commonly investigated target in 2022, being investigated in six separate publications. 22,31,37,43,48,49 Three of these studies were cross-sectional in design, 22,31,37 with the remaining studies applying dietary and/or exercise interventions to target vitamin D status. 43,48,49 Vitamin D is a group of prohormones that play an important role in maintaining serum mineral status (notably calcium (Ca 2+ ) and phosphate (PO 4 − ) ions) which is integral to the formation and maintenance of bone mineral density.…”