尽管进行常规口服补充，但患有囊性纤维化的儿童、青少年和年轻成人仍存在维生素D不足的情况。

Vitamin D insufficiency in children, adolescents, and young adults with cystic fibrosis despite routine oral supplementation.

作者信息

Rovner Alisha J, Stallings Virginia A, Schall Joan I, Leonard Mary B, Zemel Babette S

机构信息

Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

出版信息

Am J Clin Nutr. 2007 Dec;86(6):1694-9. doi: 10.1093/ajcn/86.5.1694.

DOI:10.1093/ajcn/86.5.1694

PMID:18065588

Abstract

BACKGROUND

Cystic fibrosis (CF) with pancreatic insufficiency is associated with poor absorption of fat and fat-soluble vitamins, including vitamin D. Pancreatic enzyme supplementation does not completely correct fat malabsorption in CF patients.

OBJECTIVE

The objective of the study was to compare the vitamin D status of children, adolescents, and young adults with CF who were treated with routine vitamin D and pancreatic enzyme supplements with the vitamin D status of a healthy reference group from a similar geographic area.

DESIGN

Growth, dietary intake, and serum concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and parathyroid hormone (PTH) were measured in 101 white subjects with CF and a reference group of 177 white subjects.

RESULTS

The median daily vitamin D supplementation in the CF group was 800 IU. The mean +/- SD serum concentrations of 25(OH)D were 20.7 +/- 6.5 ng/mL in the CF group and 26.2 +/- 8.6 ng/mL in the reference group (P < 0.001). Vitamin D deficiency and insufficiency were defined as 25(OH)D concentrations < 11 ng/mL and < 30 ng/mL, respectively. Seven percent of the CF group and 2% of the healthy reference group were vitamin D deficient (P < 0.03). Ninety percent of the CF group and 74% of the healthy reference group were vitamin D insufficient (P < 0.01). Twenty-five percent of the CF group and 9% of the healthy reference group had elevated PTH (P < 0.006). The odds of vitamin D insufficiency in the CF group, compared with the healthy reference group, were 1.2 (95% CI: 1.1, 1.3) after adjustment for season and age.

CONCLUSION

Despite daily vitamin D supplementation, serum 25(OH)D concentrations remain low in children, adolescents, and young adults with CF.

摘要

背景

伴有胰腺功能不全的囊性纤维化（CF）与脂肪及脂溶性维生素（包括维生素D）吸收不良有关。补充胰酶并不能完全纠正CF患者的脂肪吸收不良。

目的

本研究旨在比较接受常规维生素D和胰酶补充剂治疗的CF儿童、青少年及青年的维生素D状态与来自相似地理区域的健康对照组的维生素D状态。

设计

对101名患有CF的白人受试者和177名白人对照组受试者测量其生长情况、饮食摄入量以及血清25-羟基维生素D [25(OH)D]、1,25-二羟基维生素D [1,25(OH)(2)D]和甲状旁腺激素（PTH）的浓度。

结果

CF组每日维生素D补充量的中位数为800 IU。CF组血清25(OH)D的平均±标准差浓度为20.7±6.5 ng/mL，对照组为26.2±8.6 ng/mL（P<0.001）。维生素D缺乏和不足分别定义为25(OH)D浓度<11 ng/mL和<30 ng/mL。CF组7%的受试者和健康对照组2%的受试者维生素D缺乏（P<0.03）。CF组90%的受试者和健康对照组74%的受试者维生素D不足（P<0.01）。CF组25%的受试者和健康对照组9%的受试者PTH升高（P<0.006）。在对季节和年龄进行校正后，与健康对照组相比，CF组维生素D不足的比值比为1.2（95%CI：1.1, 1.3）。