Vitamin D and Bone Health in Adults with Cystic Fibrosis
Overview
Affiliations
Background: Cystic fibrosis (CF) patients have chronic pancreatic insufficiency leading to malabsorption of fat-soluble vitamins, including vitamin D which can contribute to poor skeletal health and respiratory function.
Objective: This study evaluated the prevalence of vitamin D insufficiency and its impact on bone and respiratory health in adults with CF.
Design And Measurements: This was a retrospective study in which data were collected from medical records over a 2-year period. Data included patient demographics, lung function, biochemical data, bone mineral densities, X-rays and ascertainment of use of vitamin supplements. Data were collected from medical records at a single accredited CF Center. Serum 25-hydroxyvitamin D [25(OH)D] levels and bone mineral density studies were also collected.
Patients: A total of 185 adults with CF were identified with a mean age of 29 +/- 9 years.
Results: The prevalence of vitamin D insufficiency [25(OH)D < 75 nmol/l] was 76%. Mean serum 25(OH)D concentrations were 58.8 +/- 30 nmol/l. Use of specific vitamin D supplementation was protective against vitamin D insufficiency whereas use of multivitamins was not. There was a small, but significant, positive association between serum 25(OH)D and FEV(1) per cent predicted after controlling for age, gender, BMI and race (R(2) = 0.30, P < 0.001). A high prevalence (27%) of vertebral fractures was detected on lateral chest X-ray.
Conclusions: The prevalence of vitamin D insufficiency and poor skeletal health is high in the US CF population. Vitamin D status appears to be positively associated with lung function. Prospective studies to examine the impact of correction of vitamin D insufficiency on skeletal and lung health in adult CF are warranted.
Sivapiromrat A, Suppakitjanusant P, Wang Y, Hu C, Binongo J, Hunt W Contemp Clin Trials Commun. 2024; 38:101278.
PMID: 38435430 PMC: 10904905. DOI: 10.1016/j.conctc.2024.101278.
Sivapiromrat A, Suppakitjanusant P, Wang Y, Binongo J, Hunt W, Gewirtz A medRxiv. 2024; .
PMID: 38343811 PMC: 10854319. DOI: 10.1101/2024.01.04.24300860.
Vitamin D deficiency in patients with cystic fibrosis: a systematic review and meta-analysis.
Farahbakhsh N, Fatahi S, Shirvani A, Motaharifard M, Mohkam M, Tabatabaii S J Health Popul Nutr. 2024; 43(1):11.
PMID: 38233891 PMC: 10795301. DOI: 10.1186/s41043-024-00499-2.
Wu M, Bhimavarapu A, Alvarez J, Hunt W, Tangpricha V Bone. 2023; 174:116835.
PMID: 37390941 PMC: 10428002. DOI: 10.1016/j.bone.2023.116835.
The Crosstalk between Vitamin D and Pediatric Digestive Disorders.
Marginean C, Melit L, Borka Balas R, Vasiesiu A, Fleseriu T Diagnostics (Basel). 2022; 12(10).
PMID: 36292016 PMC: 9600444. DOI: 10.3390/diagnostics12102328.