Calcium, Phosphorus, and Vitamin D Levels in a Series of Cystic Fibrosis Patients: A Cross-Sectional Study

Abstract

Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses.

Calcium, Phosphate, and Vitamin D in Children and Adolescents with Chronic Diseases: A Cross-Sectional Study

“…In contrast, in the European region, the prevalence of serum Vit-D levels < 12 and 20 ng/mL was 18% and 53%, respectively [45]. In a series of CF patients, 35% had VDD and another 35% had insufficient levels [18]. In this study, only 18% of subjects had serum Vit-D levels for adequate bone health (>30 ng/mL), which prevents bone diseases and reduces the risk of many common cancers [66].…”

“…In this study, only 18% of subjects had serum Vit-D levels for adequate bone health (>30 ng/mL), which prevents bone diseases and reduces the risk of many common cancers [66]. Levels from 40 to 60 ng/mL, 10% in our study, decrease the risk of infection diseases, CVD, neurocognitive disfunction, and several types of cancer [18]. Also, in this series, serum Vit-D levels were also lower in males than in females, especially in the underfed group.…”

“…Calcium, P, and Vit-D, which are the nutrients' objects of interest in this study, play important roles in the growth and development of during pediatric stage [10,11]. Even though several studies describe the prevalence of abnormal Ca, P, and Vit-D levels in specific chronic conditions, such as chronic kidney disease, conditions related to mineral and bone disorders (CKD-MBD) [35] or in CF [18] patients, little is known about these nutrients in children and adolescents with other chronic health conditions.…”

“…Chronic diseases include malnutrition (cause unknown), syndromic diseases, encephalopathies, renal diseases, hyperlipidemia, insulin-dependent diabetes mellitus (IDDM), and eating disorders. The exclusion criteria were patients with cystic fibrosis (CF) [18], other gastrointestinal and malabsorptive conditions, acute infection, hospitalized patients, and those who refused to participate.…”

“…Serum P ranged from 4.5 to 6.5 mg/dL [18,29], hypophosphatemia < 4.5 mg/dL, and hyperphosphatemia > 6.5 mg/dL. The serum Ca/P ratio < 18 years 1.7-2.7 and >18-34 years 2.2-3.2 [31].…”