Vitamin D in children with cystic fibrosis.

Arch Dis Child. 2012 Aug 4.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

Malcolm Brodlie 1,2 m.j.brodlie@ncl.ac.uk, William A Orchard 2, Gordon A Reeks 2, Stewart Pattman 3, Helen McCabe 2, Christopher J O'Brien 2, Matthew F Thomas 2, David Anthony Spencer 2
1 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
2 Regional Paediatric Cystic Fibrosis Service, Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
3 Chemical Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

PURPOSE:
The Cystic Fibrosis Trust in 2007 published a recommended target of 75-150 nmol/L for 25-hydroxyvitamin D (25-OHD).
In 2008 we found that only 10% of pancreatic insufficient (PI) children met this target.
An increase in supplementation was implemented and a repeat audit performed in 2010.

METHODS:
PI children ?1 year under sole-care in our regional centre were included.
Vitamin D3 supplementation increased by > 450% to either 3800 IU/day liquid or 800 IU daily plus 20,000 IU weekly tablets.
In 2010 pancreatic sufficient (PS) children were also audited separately.

RESULTS:
The median 25-OHD level increased from 51.5 nmol/L in 2008 (n=78, 10% >75 nmol/L) to 72 nmol/L in 2010 (n=72, 51% >75 nmol/L), p<0.0001.
In PS children (n=15 in 2010) 87% had 25-OHD levels <75 nmol/L.

CONCLUSIONS:
A substantial increase in supplementation led to a significant increase in 25-OHD levels but around half still failed to reach the recommended target.

PMID: 22863689
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Summary by VitaminDWiki

Target of > 30 ng of vitamin D
Iniitlally 10% of the 72 children with cystic fibrosis >30 ng
Supplemented with 3800 IU of vitamin D
After two years 51% of the children had >30 ng
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See also VitaminDWiki

• Category of Cystic Fibrosis 52 items
• Cystic fibrosis associated with low vitamin D – May 2012
• Overview Vitamin K and Vitamin D Vitamin K is also important
  see also 2010 PDF attached at the bottom of this page
  A type of vitamin D by Biotics Research for mal-absorption probably works for Cystic Fibrosis as well
• Death due to cystic fibrosis reduced about 4X due to 250000 IU of vitamin D – RCT June 2012 which has the following chart

Suspect that it will be difficult to get approval for a large CF RCT in the future.
The ethics committee would have a hard time allowing scores of CF deaths for the placebo group.

See also wikipedia - graphic shows the digestion problems with CF