Transient effectiveness of vitamin D2 therapy in pediatric cystic fibrosis patients

Green, Deanna M.; Leonard, Amanda; Paranjape, Shruti; Rosenstein, Beryl J.; Zeitlin, Pamela L.; Mogayzel, Peter J.

doi:10.1016/j.jcf.2010.01.002

Cited by 29 publications

(27 citation statements)

References 31 publications

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“…In the present sample, 50% had low (<30 ng/mL) 25D, which was an improvement from the 90% of children and young adults found insufficient in CF Bones Study. It was similar to the 46 to 56% insufficiency found in more recent studies in the US, UK and Australia (14, 38, 41–43). The serum 25D improvement over time was likely due to enhanced clinical monitoring and increased vitamin D supplementation in patients with CF and PI.…”

Section: Discussionsupporting

confidence: 91%

Fat‐Soluble Vitamins in Cystic Fibrosis and Pancreatic Insufficiency

Bertolaso

Groleau²,

Schall³

et al. 2014

J. pediatr. gastroenterol. nutr.

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Objectives To assess the impact of LYM-X-SORB™ (LXS), an organized lipid matrix that has previously been shown to be absorbable without pancreatic enzyme therapy on fat soluble vitamin status in children with CF and PI. Methods Children with CF and PI were randomized to daily LXS or an iso-caloric placebo comparison supplement for 12 months. Serum vitamins A (retinol), D (25-hydroxyvitamin D[25D]), E (α-tocopherol, α-tocopherol:cholesterol ratio) and K (%undercarboxylated osteocalcin [%ucOC] and plasma proteins induced by vitamin K absence factor II [PIVKA II]) were assessed at baseline and 12 months. Dietary intake was determined using 3-day weighed food records, and supplemental vitamin intake by a comprehensive questionnaire. Results 58 subjects (32 males, age 10.3±2.9 yrs [mean±SD]) with complete serum vitamin, dietary and supplemental vitamin data were analyzed. After adjusting for dietary and supplemental vitamin intake, serum retinol increased 3.0±1.4 μg/dL (coefficient±SE) (Adj R2=0.02, p=0.03) and vitamin K status improved as demonstrated by a decreased %ucOC of −6.0±1.6% by 12 months (Adj R2=0.15, p<0.001). These changes occurred in both the LXS and placebo comparison groups. No changes in serum 25D or α-tocopherol were detected. Both nutrition interventions increased caloric intake a mean of 83±666 kcal/d by 12 months. Conclusions Vitamin A and K status improved, while vitamin D and E status was unchanged over 12 month of LXS and iso-caloric placebo comparison supplement in children with CF and PI.

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Section: Discussionsupporting

confidence: 91%

Fat‐Soluble Vitamins in Cystic Fibrosis and Pancreatic Insufficiency

Bertolaso

Groleau²,

Schall³

et al. 2014

J. pediatr. gastroenterol. nutr.

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“…However, if concentrations constantly above 30 ng/ml are to be reached, as recommended, (Aris et al, 2005) current guidelines seem inadequate, and a supplementation with higher doses of vitamin D would be required. This brings us to the problem that in CF patients it proves extremely difficult to correct low 25 (OH) D serum concentrations with the aid of oral supplements Green et al, 2008Green et al, , 2010. High doses of oral vitamin D supplements for example, 50 000 IU of ergocalciferol daily for 28 days was effective in correcting vitamin D insufficiency in 50% of the subjects.…”

Section: Discussionmentioning

confidence: 99%

“…High doses of oral vitamin D supplements for example, 50 000 IU of ergocalciferol daily for 28 days was effective in correcting vitamin D insufficiency in 50% of the subjects. However, almost half of the successfully Sunlight determines vitamin D concentration in CF E Robberecht et al treated patients were unable to maintain normal 25 (OH) D levels more than 6 months after completion of the therapy (Green et al, 2010). A recent study of Khazai et al (2009), compared three treatment modes to correct low 25 (OH) concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Data on serum concentrations of 25-OH cholecalciferol (25 (OH) D) in CF are, however, not unequivocal, as they have been reported as too low by some authors (Donovan et al, 1998;Mortensen et al, 2000;Rovner et al, 2007), whereas others disagree (Buntain et al, 2004;Chavasse et al, 2004). Moreover, the failure of oral supplement treatments is common and has been widely published (Donovan et al, 1998;Boyle et al, 2005;Green et al, 2008;Green et al, 2010). Holding fat malabsorption solely responsible for vitamin D deficiency overlooks the importance of the dermal supply, which in healthy people determines up to 85% of 25 (OH) D concentrations in conditions of sunshine (Heaney et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Sunlight is an important determinant of vitamin D serum concentrations in cystic fibrosis

et al. 2011

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“…The majority of children and adults with cystic fibrosis worldwide are vitamin D insufficient, irrespective of their exocrine pancreatic function [4][5][6][7]. However, there is as yet no evidence for a benefit of vitamin D supplementation in cystic fibrosis, not even for bone health [8].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study

et al. 2011

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Aims/hypothesis Many cystic fibrosis patients are vitamin D-insufficient. Cystic fibrosis-related diabetes is a major complication of cystic fibrosis. The literature suggests that vitamin D might possess certain glucose-lowering properties. We aimed to assess the relationship between vitamin D and cystic fibrosis-related glucose intolerance. Methods We enrolled 898 cystic fibrosis patients from Sweden, Norway and Denmark. Vitamin D intake was assessed using a seven-day food record. Serum 25-hydroxyvitamin D (s25OHD) and HbA 1c were measured, and an OGTT was carried out. Multiple linear and logistic regressions were used for HbA 1c and cystic fibrosis-related diabetes/OGTT result as outcome variables, respectively. Each model was controlled for country, and for known cystic fibrosis-related diabetes risk factors: age, sex, genotype, liver dysfunction, long-term corticosteroid treatment, and lung and pancreatic function. Results Degree of vitamin D insufficiency (OR 1.36; p=0.032) and s25OHD<30 nmol/l (OR 1.79; p=0.042) were significant risk factors for cystic fibrosis-related diabetes. Accordingly, HbA 1c value was positively associated with s25OHD< 30 nmol/l and<50 nmol/l, as well as with degree of vitamin D insufficiency (adjusted R 2 =20.5% and p<0.05 in all).Electronic supplementary material The online version of this article

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Transient effectiveness of vitamin D2 therapy in pediatric cystic fibrosis patients

Cited by 29 publications

References 31 publications

Fat‐Soluble Vitamins in Cystic Fibrosis and Pancreatic Insufficiency

Fat‐Soluble Vitamins in Cystic Fibrosis and Pancreatic Insufficiency

Sunlight is an important determinant of vitamin D serum concentrations in cystic fibrosis

Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study

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