Low vitamin D while Cystic Fibrosis is active – July 2018

Vitamin D Status Correlates With The Markers of Cystic Fibrosis-Related Pulmonary Disease

Pediatrics & Neonatology https://doi.org/10.1016/j.pedneo.2018.07.001

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Background
The prevalence of Vitamin D deficiency remains high in cystic fibrosis despite daily supplementation. Vitamin D as an immunomodulator has been related to lower respiratory tract infections in children.

Objective
The present study was undertaken to examine the association between vitamin D status and markers of cystic fibrosis-related pulmonary disease including exacerbations, bacterial colonization and pulmonary function.

Methods
The study includes review of records of 51 cystic fibrosis patients. Baseline patient variables and serum vitamin D levels were recorded. Based on vitamin D levels study patients were divided into three groups: vitamin-D sufficient (≥20 ng/mL), vitamin-D insufficient (12 to 20 ng/mL), and vitamin D-deficient (≤12 ng/ml).

Results
The proportion of children with deficient, insufficient and sufficient vitamin D levels were 47.1%, 15.7%, and 37.2%, respectively. Female sex, bacterial colonization and a greater number of exacerbations were associated with highest odds of developing vitamin D deficiency in patients with CF with 1.77(0.22‒14.61)(p = 0.002), 2.9(0.57‒14.82)(p = 0.011), and 5.12(1.28‒20.50)(p = 0.021) respectively.
The comparison of vitamin-D levels taken during exacerbations, colonization and during routine follow-up were significant [16.04(7.42‒27.91), 24.3(15.5‒32.4) and 48.54(18.37‒78.7)ng/ml, p <0.001].
The FEV1 was determined in 24 patients; the comparison was significant between vitamin D-deficient and -sufficient groups [0.75(0.717‒0.777) vs. 0.82(0.74‒0.92) p <0.05].

Conclusion
We concluded that vitamin D deficiency was highly prevalent in children with CF, despite daily supplementation of the vitamin in diet. Further, vitamin D deficiency was associated with a higher rate of pulmonary exacerbations and higher incidence of pulmonary bacterial colonization. In addition, in younger patients, low vitamin D levels were associated with reduced pulmonary function.