Vitamin D status and pulmonary exacerbations in children and adolescents with cystic fibrosis

Aziz, Danish Abdul; Fatima, Syeda Khadija; Iftikhar, Haissan; Mir, Fatima

doi:10.4103/lungindia.lungindia_589_20

Cited by 5 publications

(7 citation statements)

References 20 publications

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“…In contrast with our study, Sexauer et al studied 597 patients with a mean age of 22.2 ± 11.9 years, observing a significant relationship between serum levels of vitamin D and pulmonary function in CF patients (9). In addition, a study in Pakistan showed that 69 CF patients were deficient in vitamin D. Vitamin D deficiency was also associated with an increase in the number of annual pulmonary exacerbations and Pseudomonas infections (21). Moreover, Vanstone et al indicated that depleted vitamin D status was a significant cause of developing pulmonary exacerbations (22).…”

Section: Discussioncontrasting

confidence: 95%

The Association of Serum Elements’ Levels with the Severity of Pulmonary Involvement in Cystic Fibrosis Patients

et al. 2023

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Background: Cystic fibrosis (CF) is a multisystem disease presenting different manifestations, including the involvement of the respiratory and gastrointestinal tract. Patients may be at risk for micronutrient depletion, particularly during illness and infection. However, the relationship between micronutrient depletion and pulmonary involvement is not established well. Objectives: This study aimed to determine the relationship between serum levels of calcium, phosphorus, magnesium, zinc, copper, selenium, and vitamin D with the severity of pulmonary involvement in patients with CF. Methods: This cross-sectional study was performed on 84 patients with CF referred to Mofid Children’s Hospital, Tehran, Iran, in 2017. The collected data included demographic and anthropometric information. Laboratory evaluations included magnesium, copper, zinc, selenium, complete blood cell count (CBC), and vitamin D levels. The severity of pulmonary involvement was determined based on the Brasfield scoring system (BSS). Pearson correlation coefficient, t test, χ2 test, or Fisher exact test was used for analyses. Results: The mean age of the children was 6.8 ± 3.5 years, and 36 patients (43%) were female. Based on the z score, 53 patients (63%) were malnourished. The severity of pulmonary involvement was mild in 25 patients (30%), moderate in 39 patients (46%), and severe in 20 patients (24%). The percentages of deficiency related to vitamin D, zinc, copper, and selenium were 56%, 38%, 32.1%, and 21.4%, respectively. Among trace elements, there was a statistically significant relationship between the severity of pulmonary involvement according to BSS and serum copper (P = 0.007 and r = -0.229) and selenium deficiency (P < 0.001 and r = -0.418). There was a significant relationship between malnutrition and vitamin D deficiency in patients (P = 0.034, r = 0.231). Conclusions: Serum copper concentration might affect respiratory function in CF patients. Selenium supplements should be added to patients’ diets. However, further interventional studies are required to investigate the possible causal relationships.

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Section: Discussioncontrasting

confidence: 95%

The Association of Serum Elements’ Levels with the Severity of Pulmonary Involvement in Cystic Fibrosis Patients

et al. 2023

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“…All articles were published between 1981 and 2018. Among the studies integrated in this systematic review, 8 studies were case–control [ 21 – 28 ] and 12 studies had a cross-sectional design [ 29 – 40 ]. The total sample size was 1,157 in the case control studies and 1622 patients in the cross-sectional studies.…”

Section: Resultsmentioning

confidence: 99%

“…J Chin Endocrunol 197 l;33:992–5.) YES YES – 6 Jakovska et al [ 26 ] 2018 Macedonia stable CF children – – – 8.25 ± 1.9 7.5 ± 1.9 35 23/8 ± 10.9 21 25/6 ± 11.5 Electrohemiluminiscent method NO NR – 7 Stead et al [ 29 ] 1988 London CF Both The mean daily intake of vitamin D was 19 1 jg (764 IU), range 0 6–54 3 pg (24–2172 IU). Only seven of the 31 patients were not taking supplements of vitamin D All or some received vitamin D supplements 25/5 24.…”

Section: Resultsmentioning

confidence: 99%

Vitamin D deficiency in patients with cystic fibrosis: a systematic review and meta-analysis

Farahbakhsh,

Fatahi,

Shirvani

et al. 2024

J Health Popul Nutr

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Aim Vitamin D is a prominent modulator of immunity and respiratory function. It plays a vital role in respiratory diseases such as cystic fibrosis (CF). S. However, there is a dearth of information on patients with CF. The purpose of the meta-analysis is to highlight the importance of following the existing guidelines regarding maintenance of Vitamin D serum levels in patients with CF. Methods The systematic search was conducted without utilizing any time or language limitations in original database from the beginning until March 2022. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I2 statistics and Cochrane Q test. Results Pooled analysis using the random-effects model of the 8 case–control studies with 13 effect sizes revealed that the serum 25-OH-vitamin D in participants with cystic fibrosis was significantly lower than controls in pediatrics and adolescences (WMD: − 3.41 ng/ml, 95% CI − 5.02, − 1.80, p = < 0.001) and adults (WMD: − 2.60 ng/ml, 95% CI − 4.32, − 0.89, p = 0.003). Based on data from 12 studies (21 effect sizes) with a total of 1622 participants, the prevalence of vitamin D levels of 20–30 ng/ml in CF patients was 36% among pediatrics/adolescents and 63% among adults. In addition, 27% of pediatric/adolescent CF patients and 35% of adult CF patients had vitamin D levels of below 20 ng/ml. Conclusions As a result, according to the existing guidelines, our results proved the need to pay attention to the level of vitamin D in these patients.

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“…McCauley LA et al found that adolescents aged 15-18 years with vitamin D deficiency had a higher rate of exacerbations than those with insufficient or sufficient levels of vitamin D, 13 per 10 patient-years (95% CI, 6-31; p < 0.05) vs. 4.3 per 10 patient-years (95% CI, 2-8; p < 0.05), respectively [149]. A report by Aziz D et al of 69 children with CF aged 3 to 18 years found that children with vitamin D deficiency had significantly more pulmonary exacerbations per year than patients with insufficient or sufficient levels (n = 28, 3.71 ± 0.96; n = 22, 3.18 ± 1.09; and n = 19, 2.26 ± 0.93; respectively; p < 0.001 [145]. In another study, 148 children from 10 months to 12 years of age were evaluated for inflammation and bacterial colonization.…”

Section: The Presence Of Inadequate and Deficient Levels Of Vitamin D...mentioning

confidence: 93%

“…A child with cystic fibrosis (CF) is likely to have insufficient or deficient levels of fat-soluble vitamins because of the malabsorption of fat-soluble vitamins caused by exocrine pancreatic insufficiency, poor nutritional intake, changes in metabolism, and other factors [99,145,146]. These vitamins are routinely supplemented to CF patients to avoid deficiencies.…”

Section: Cystic Fibrosismentioning

confidence: 99%

Macronutrient and Micronutrient Intake in Children with Lung Disease

Knebusch,

Mansour,

Vazquez

et al. 2023

Nutrients

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This review article aims to summarize the literature findings regarding the role of micronutrients in children with lung disease. The nutritional and respiratory statuses of critically ill children are interrelated, and malnutrition is commonly associated with respiratory failure. The most recent nutrition support guidelines for critically ill children have recommended an adequate macronutrient intake in the first week of admission due to its association with good outcomes. In children with lung disease, it is important not to exceed the proportion of carbohydrates in the diet to avoid increased carbon dioxide production and increased work of breathing, which potentially could delay the weaning of the ventilator. Indirect calorimetry can guide the process of estimating adequate caloric intake and adjusting the proportion of carbohydrates in the diet based on the results of the respiratory quotient. Micronutrients, including vitamins, trace elements, and others, have been shown to play a role in the structure and function of the immune system, antioxidant properties, and the production of antimicrobial proteins supporting the defense mechanisms against infections. Sufficient levels of micronutrients and adequate supplementation have been associated with better outcomes in children with lung diseases, including pneumonia, cystic fibrosis, asthma, bronchiolitis, and acute respiratory failure.

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Vitamin D status and pulmonary exacerbations in children and adolescents with cystic fibrosis

Cited by 5 publications

References 20 publications

The Association of Serum Elements’ Levels with the Severity of Pulmonary Involvement in Cystic Fibrosis Patients

The Association of Serum Elements’ Levels with the Severity of Pulmonary Involvement in Cystic Fibrosis Patients

Vitamin D deficiency in patients with cystic fibrosis: a systematic review and meta-analysis

Macronutrient and Micronutrient Intake in Children with Lung Disease

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