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

Abstract

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

Vitamin D(25-OH-cholecalciferol) in Cystic Fibrosis and the Relations with Cholesterol and Proteins

“…The correlation between vitamin D and Pearson's correlation coefficient r2 was -0.05, and 95% confidence interval (-1.556-69.522), with a p value of 0.667, denies the existence of a correlation between the two compared variables. We did not find any relation between the level of the vitamin D and the glycemia values in cystic fibrosis patients, although some studies suggest the effect of the vitamin D deficiency in diabetes occurrence and impaired glucose tolerance [23].…”

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

“…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.…”

Dietary intake and nutritional status of micronutrients in adults with cystic fibrosis in relation to current recommendations

“…For example, vitamin D is likely to improve respiratory function through its role in antimicrobial peptide and cytokine production and its association with muscle strength [40,41,43,44]. It is also associated with CFRD through potential involvement in islet function regulation, insulin production and secretion, and insulin sensitivity [42,46]. Its role in bone health and immune response has also implied an importance in pain management in CF [45].…”