Hypovitaminosis <scp>D</scp> in patients with cystic fibrosis: a cross‐section study in <scp>S</scp>outh <scp>B</scp>razil

Marcondes, Natália Aydos; Raimundo, Fabiana Viegas; Vanacor, Roberta; Corte, Bruno Pellini; Ascoli, Aline Maria; Azambuja, Aline Zimmermann de; Scopel, Luciano; Santos, Patrícia Vargas dos; Dalcin, Paulo de Tarso Roth; Rotta, Liane Nanci; Furlanetto, Tânia Weber; Faulhaber, Gustavo Adolpho Moreira

doi:10.1111/crj.12097

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…These vitamin D-related effects are relevant to CF because vitamin D deficiency is very common in these individuals (10). Adequate vitamin D status in CF, as determined by blood 25-hydroxyvitamin D [25(OH)D] concentrations, correlates with improved lung function (11,12), reduced pulmonary exacerbations (12) and hospitalizations (13), improved glucose tolerance (14), reduced inflammation (15) and decreased lung bacterial colonization (16). In a pilot clinical trial, we showed that high-dose vitamin D 3 , given to hospitalized CF patients during an acute pulmonary exacerbation, reduced inflammation and improved one-year survival (4,5); however, the impact of underlying vitamin D status and high-dose vitamin D administration on systemic metabolism in CF remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Plasma metabolomics in adults with cystic fibrosis during a pulmonary exacerbation: A pilot randomized study of high-dose vitamin D 3 administration

et al. 2017

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Background Cystic fibrosis (CF) is a chronic catabolic disease often requiring hospitalization for acute episodes of worsening pulmonary exacerbations. Limited data suggest that vitamin D may have beneficial clinical effects, but the impact of vitamin D on systemic metabolism in this setting is unknown. Objective We used high-resolution metabolomics (HRM) to assess the impact of baseline vitamin D status and high-dose vitamin D3 administration on systemic metabolism in adults with CF with an acute pulmonary exacerbation. Design Twenty-five hospitalized adults with CF were enrolled in a randomized trial of high-dose vitamin D3 (250,000 IU vitamin D3 bolus) versus placebo. Age-matched healthy subjects served as a reference group for baseline comparisons. Plasma was analyzed with liquid chromatography/ultra-high resolution mass spectrometry. Using recent HRM bioinformatics and metabolic pathway enrichment methods, we examined associations with baseline vitamin D status (sufficient vs deficient per serum 25-hydroxyvitamin D concentrations) and the 7-day response to vitamin D3 supplementation. Results Several amino acids and lipid metabolites differed between CF and healthy control subjects, indicative of an overall catabolic state. In CF subjects, 343 metabolites differed (P<0.05) by baseline vitamin D status and were enriched within 7 metabolic pathways including fatty acid, amino acid, and carbohydrate metabolism. A total of 316 metabolites, which showed enrichment for 15 metabolic pathways--predominantly representing amino acid pathways-- differed between the vitamin D3- and placebo-treated CF subjects over time (P<0.05). In the placebo group, several tricarboxylic acid cycle intermediates increased while several amino acid-related metabolites decreased; in contrast, little change in these metabolites occurred with vitamin D3 treatment. Conclusions Numerous metabolic pathways detected by HRM varied in association with vitamin D status and high-dose vitamin D3 supplementation in adults with CF experiencing a pulmonary exacerbation. Overall, these pilot data suggest an anti-catabolic effect of high-dose vitamin D3 in this clinical setting.

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Section: Introductionmentioning

confidence: 99%

Plasma metabolomics in adults with cystic fibrosis during a pulmonary exacerbation: A pilot randomized study of high-dose vitamin D 3 administration

et al. 2017

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“…A significant number of patients with chronic respiratory disorders also show decreased levels of both vitamin D and calcium (88)(89)(90)(91). This circumstance, which can be partially related to a poor diet intake but also to a reduction in outside physical activities, may induce loss of bone and muscle mass, contributing to muscle dysfunction (89).…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations

Gea¹,

Sancho-Muñoz²,

Chalela³

2018

J. Thorac. Dis.

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Nutritional abnormalities are frequent in different chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis (CF), interstitial fibrosis and lung cancer, having important clinical consequences. However, nutritional abnormalities often remained underdiagnosed due to the relative lack of awareness of health professionals. Therefore, systematic anthropometry or even better, assessment of body composition, should be performed in all patients with chronic respiratory conditions, especially following exacerbation periods when malnutrition becomes more accentuated. Nutritional abnormalities very often include the loss of muscle mass, which is an important factor for the occurrence of muscle dysfunction. The latter can be easily detected with the specific assessment of muscle strength and endurance, and also negatively influences patients' quality of life and prognosis. Both nutritional abnormalities and muscle dysfunction result from the interaction of several factors, including tobacco smoking, low physical activity-sedentarism, systemic inflammation and the imbalance between energy supply and requirements, which essentially lead to a negative balance between protein breakdown and synthesis. Therapeutic approaches include improvements in lifestyle, nutritional supplementation and training. Anabolic drugs may be administered in some cases.

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Vitamin D and Bone Health

Alvarez

Tangpricha

2015

Nutrition in Cystic Fibrosis

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Hypovitaminosis D in patients with cystic fibrosis: a cross‐section study in South Brazil

Abstract: Vitamin D insufficiency is still a problem in CF patients, even in those receiving supplementation.

Cited by 5 publications

References 28 publications

Plasma metabolomics in adults with cystic fibrosis during a pulmonary exacerbation: A pilot randomized study of high-dose vitamin D 3 administration

Plasma metabolomics in adults with cystic fibrosis during a pulmonary exacerbation: A pilot randomized study of high-dose vitamin D 3 administration

Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations

Vitamin D and Bone Health

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