Home A one-year retrospective review of vitamin D level, bone profile, liver function tests and body mass index in children with cystic fibrosis in a children’s university hospital
Article
Licensed
Unlicensed Requires Authentication

A one-year retrospective review of vitamin D level, bone profile, liver function tests and body mass index in children with cystic fibrosis in a children’s university hospital

  • Oneza Ahmareen EMAIL logo , Michaela Pentony , Fiona Healy and Ahmed Zaid
Published/Copyright: January 22, 2014

Abstract

Background: Vitamin D deficiency is common in young cystic fibrosis (CF), and is due to the impaired absorption of fat-soluble vitamins, decreased sun exposure, and suboptimal intake of vitamins-containing foods and/or supplements. Given that childhood is a critical period for the accrual of bone mass, with 90% peak bone mass laid in the first two decades of life, it is essential that optimal vitamin D levels are achieved in this time frame.

Methods: We conducted a retrospective review from January 1, 2012 to January 1, 2013, through which we reviewed levels of vitamin D and correlated with bone profile, liver function tests, lung function, genotype, age, dual-energy X-ray absorptiometry scan and body mass index z score.

Results: Of the 95 children with CF, 6 were excluded due to incomplete data, bringing our study population to a total of 89 children. Results showed 77.5% vitamin D deficiency (mean 59.42 nmol/L). No significant statistical correlation was found between vitamin D and the parameters described. Protocol supplementation did not raise vitamin D to therapeutic level in 63.2% of the study population. Those with genotype delta 508 (homozygous/heterozygous) had 92% vitamin D deficiency.

Conclusions: We attribute the non-responder group to vitamin D to poor compliance. Compliance level could not be addressed because our study is a retrospective review. Thus, further research is needed to define implications of pulmonary exacerbations on vitamin D and vice versa. Doing so can help assess the implication of genotype influence on vitamin D.


Corresponding author: Dr. Oneza Ahmareen, Children’s University Hospital – Respiratory Department, Dublin, Ireland, E-mail:

References

1. Cialdella P, Carella F. Hypervitaminosis D: case report of pediatric osteoporosis secondary to cystic fibrosis. Clin Cases Miner Bone Metab 2011;8:66–8.Search in Google Scholar

2. Ferguson JH, Chang AB. Vitamin D supplementation for cystic fibrosis. Cochrane Database Syst Rev 2012;4:CD007298.10.1002/14651858.CD007298.pub3Search in Google Scholar PubMed

3. Douros K, Loukou I, Nicolaidou P, Tzonou A, Doudounakis S. Bone mass density and associated factors in cystic fibrosis patients of young age. J Paediatr Child Health 2008;44:681–5.10.1111/j.1440-1754.2008.01406.xSearch in Google Scholar PubMed

4. Cobanoglu N, Atasoy H, Ozcelik U, Yalcin E, Dogru D, Kiper N, et al. Relation of bone mineral density with clinical and laboratory parameters in pre-pubertal children with cystic fibrosis. Pediatr Pulmonol 2009;44:706–2.10.1002/ppul.21050Search in Google Scholar PubMed

5. Grey V, Atkinson S, Drury D, Casey L, Ferland G, Gundberg C, et al. Prevalence of low bone mass and deficiencies of vitamins D and K in pediatric patients with cystic fibrosis from 3 Canadian centers. Pediatrics 2008;122:1014–20.10.1542/peds.2007-2336Search in Google Scholar PubMed

6. Pincikova T, Nilsson K, Moen IE, Fluge G, Hollsing A, Knudsen PK, et al. Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia 2011;54:3007–15.10.1007/s00125-011-2287-1Search in Google Scholar PubMed

7. Sathe MN, Patel AS. Update in pediatrics: focus on fat-soluble vitamins. Nutr Clin Pract 2010;25:340–6.10.1177/0884533610374198Search in Google Scholar PubMed

8. Tangpricha V, Kelly A, Stephenson A, Maguiness K, Enders J, Robinson KA, et al. An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation. J Clin Endocrinol Metab 2012;97:1082–93.10.1210/jc.2011-3050Search in Google Scholar PubMed

9. Hall WB, Sparks AA, Aris RM. Vitamin d deficiency in cystic fibrosis. Int J Endocrinol 2010;2010: Article ID 218691, 9 pages DOI: http://dx.doi.org/10.1155/2010/218691.10.1155/2010/218691Search in Google Scholar PubMed PubMed Central

10. Hill TR, Cotter AA, Mitchell S, Boreham CA, Dubitzky W, Murray L, et al. Vitamin D status and its determinants in adolescents from the Northern Ireland Young Hearts 2000 cohort. Br J Nutr 2008;99:1061–7.10.1017/S0007114507842826Search in Google Scholar PubMed

11. Brodlie M, Orchard WA, Reeks GA, Pattman S, McCabe H, O’Brien CJ, et al. Vitamin D in children with cystic fibrosis. Arch Dis Child 2012; 97:982–4.10.1136/archdischild-2011-301398Search in Google Scholar PubMed

12. Estivill X, Ortigosa L, Perez-Frias J, Dapena J, Ferrer J, Pena L, et al. Clinical characteristics of 16 cystic fibrosis patients with the missense mutation R334W, a pancreatic insufficiency mutation with variable age of onset and interfamilial clinical differences. Hum Genet 1995;95:331–6.10.1007/BF00225203Search in Google Scholar PubMed

13. Shepherd D, Belessis Y, Katz T, Morton J, Field P, Jaffe A. Single high-dose oral vitamin D(3) (stoss) therapy-A solution to vitamin D deficiency in children with cystic fibrosis? J Cyst Fibros 2012;12:177–82.10.1016/j.jcf.2012.08.007Search in Google Scholar PubMed

Received: 2013-7-3
Accepted: 2013-8-1
Published Online: 2014-1-22
Published in Print: 2015-2-1

©2015 by De Gruyter

Downloaded on 8.10.2025 from https://www.degruyterbrill.com/document/doi/10.1515/ijdhd-2013-0033/html
Scroll to top button