Relationship between vitamin D levels and glucose tolerance in an adult population with cystic fibrosis

Coriati, Adèle; Dubois, Catherine; Phaneuf, M.; Mailhot, M.; Lavoie, Annick; Berthiaume, Yves; Rabasa‐Lhoret, Rémi

doi:10.1016/j.diabet.2015.11.002

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…The investigators found the association between vitamin D status and HbA1c in children, but such an association was not as strong in adults with CF [12]. In contrast, a similar study performed by Coriati et al found no relationship between the serum 25(OH)D and measures of glucose status performed by an oral glucose tolerance test in 270 adults with CF in Canada [15].…”

Section: Discussionmentioning

confidence: 88%

Vitamin D Status and Risk of Cystic Fibrosis-Related Diabetes: A Retrospective Single Center Cohort Study

Peng

Alvarez

et al. 2021

Nutrients

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Objective: Cystic fibrosis-related diabetes (CFRD) affects up to half of the people with cystic fibrosis (CF) by adulthood. CFRD is primarily caused by pancreatic dysfunction that leads to insufficient insulin release and/or insulin resistance. Exocrine pancreatic insufficiency in people with CF is associated with fat-soluble vitamin malabsorption, including vitamins A, D, E, and K. This study examined the relationship between vitamin D status, assessed by serum 25-hydroxyvitamin D (25(OH)D), and the development of CF-related diabetes (CFRD) in adults with CF. Methods: This was a retrospective cohort study of adults seen at a single CF center. The data were extracted from the electronic medical records and the Emory Clinical Data Warehouse, a data repository of health information from patients seen at Emory Healthcare. We collected age, race, the first recorded serum 25-hydroxyvitamin D (25(OH)D) concentration, body mass index (BMI), and onset of diabetes diagnosis. Log-rank (Mantel–Cox) tests were used to compare the relative risk of CFRD onset in the subjects with stratified vitamin D status and weight status. A sub-group analysis using chi-square tests assessed the independence between vitamin D deficiency and CFRD risk factors, including gender and CF mutation types (homozygous or heterozygous for F508del, or others). Unpaired t-tests were also used to compare the BMI values and serum 25(OH)D between the CF adults based on the CFRD development. Results: This study included 253 subjects with a mean age of 27.1 years (±9.0), a mean follow-up time period of 1917.1 (±1394.5) days, and a mean serum 25(OH)D concentration of 31.8 ng/mL (±14.0). The majority (52.6%) of the subjects developed CFRD during the study period. Vitamin D deficiency (defined as 25(OH)D < 20 ng/mL) was present in 25.3% of the subjects. Close to two thirds (64.1%) of the subjects with vitamin D deficiency developed CFRD during the study. Vitamin D deficiency increased the risk of developing CFRD (chi-square, p = 0.03) during the course of the study. The time to the onset of CFRD stratified by vitamin D status was also significant (25(OH)D < 20 ng/mL vs. 25(OH)D ≥ 20 ng/mL) (95% CI: 1.2, 2.7, p < 0.0078). Conclusion: Our findings support the hypothesis that adults with CF and vitamin D deficiency are at a higher risk of developing CFRD and are at risk for earlier CFRD onset. The maintenance of a serum 25(OH)D concentration above 20 ng/mL may decrease the risk of progression to CFRD.

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Section: Discussionmentioning

confidence: 88%

Vitamin D Status and Risk of Cystic Fibrosis-Related Diabetes: A Retrospective Single Center Cohort Study

Peng

Alvarez

et al. 2021

Nutrients

View full text Add to dashboard Cite

show abstract

“…As insulin production decreases over time due to exocrine pancreatic fibrosis and chronic beta cell stress, effect of vitamin D becomes less profound. Coriati, et al investigated the relationship between vitamin D levels and glucose tolerance in an adult population with CF and found no association between vitamin D and glucose metabolism, insulin secretion, or insulin resistance indices [61] . A possible explanation for the lack of association between vitamin D status and glucose metabolism in this study as compared to the positive association found in the Pincikova study is that the proportion of vitamin D deficiency was far lower in the Coriati study population, with 42.1% of patients having 25-hydroxyvitamin D levels>30 ng/ml, whereas the Pincikova study had only 16% of patients with 25(OH)D over 30 ng/ml [60] .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, seasonality may affect dosing needs. A single study looking at seasonal variation in dosing showed that the variations in vitamin D levels were mitigated by doubling the dose in the winter [61] .…”

Section: Introductionmentioning

confidence: 99%