Lung disease and vitamin D levels in cystic fibrosis infants and preschoolers

Abstract

Introduction: Vitamin D acts on the immune system and lung response. Patients with cystic fibrosis (CF) may be deficient in this vitamin. The aims of the study were to evaluate vitamin D levels and severity of lung disease in infants and preschoolers diagnosed with CF, and to compare them to a group of children without pancreatic insufficiency (PI). Methods: Patients with CF up to 4 years old were included, and compared to an agematched group of children without diagnosis of CF. CF group had medical records and High Resolution Thorax Computed Tomography (HRCCT) evaluated in order to verify the severity of lung disease. Information on demographic data, sun exposure habits, supplemental vitamin D therapy, and on the season at the time of vitamin D sampling were collected for both groups.Results: This study included 45 patients in the CF group and 102 in the non-CF group, with no differences in age (P = 0.327) between them. There was no association between vitamin D levels and markers of lung disease in the CF group. The non-CF group had lower daily sun exposure (P = 0.034), and lower supplementation than the CF group (P < 0.001). Supplementation and seasonality were the determinant variables for vitamin D levels, which were lower for non-supplemented children and for assessments during fall/winter. Conclusion:There was no association between lung disease severity and vitamin D levels in CF group. Supplementation and seasonality were associated to higher vitamin levels. K E Y W O R D Scystic fibrosis, infants and preschoolers, lung disease, neonatal screening, vitamin D

Targeting Vitamin D Deficiency to Limit Exacerbations in Respiratory Diseases: Utopia or Strategy With Potential?

“…Associations between vitamin D status, lung function, and exacerbations are unclear. Indeed, some studies found positive associations with levels of vitamin D and lung function, as measured by FEV1 [47,[49][50][51][52][53][54] while others found no relationship [55][56][57][58]. When we focus on the relationship between serum 25(OH)D levels and exacerbations in CF, most studies reported that deficient vitamin D levels (25(OH)D < 20 ng/ml) are associated with more exacerbations [47,49,50] and more bacterial colonizations [59].…”

Cystic fibrosis year in review 2019: Section 2 pulmonary disease and infections

“…Vitamin D status can affect growth and immunity and could influence pulmonary function in CF. One 2019 study in 39 children diagnosed by newborn screening found that Vitamin D levels were not correlated with lung disease, body mass index, age, gender, ethnicity, or F508del mutation 64 . In contrast, vitamin D levels were positively correlated with lung function in a longitudinal study of 6 to 20 year olds, but no difference in lung function was found in those with vitamin D levels of 20–30 compared with greater than 30 65 …”

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

“…Effects/impact of vitamin D supplementation on 25OHD status in cypCF Table 3 summarises 9 out 21 (42.8%) studies reporting 25OHD concentration following vitamin D supplementation. Of these, 1 (11.1%) [51] described 25OHD concentration at one time point and 8 studies (88.9%) investigated the impact of vitamin D supplementation on 25OHD concentration using either observational methodology (n ¼ 7; 77.8%) [39e41, 45,50,52,54] or randomised control trials (n ¼ 2; 22.2%) [22,23]. Fifty % (n ¼ 4) studies demonstrated a statistically significant improvement in 25OHD concentration following vitamin D supplementation (Fig.…”