Norton Laura, Page Sarah, Sheehan Melissa, Mazurak Vera, Brunet-Wood Kim, Larsen Bodil
Faculty of Agriculture, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada Alberta Health Services, Edmonton, Alberta, Canada.
Alberta Health Services, Edmonton, Alberta, Canada.
Nutr Clin Pract. 2015 Feb;30(1):111-6. doi: 10.1177/0884533614562839. Epub 2014 Dec 30.
This study aimed to determine the prevalence of inadequate serum 25-hydroxyvitamin D (25(OH)D) levels in a pediatric Canadian cystic fibrosis (CF) population and to assess the effectiveness of a vitamin D supplementation protocol on improving vitamin D status. A secondary objective was to analyze factors that may be associated with inadequate 25(OH)D levels.
Vitamin D supplementation, 25(OH)D levels, and factors hypothesized to be associated with 25(OH)D levels were collected through a retrospective chart review (2010 and 2011) of 96 patients (1-18 years) at one CF clinic in Canada. Adequacy of 25(OH)D was set at ≥75 nmol/L. Patients with inadequate 25(OH)D levels in 2010 were prescribed an additional 1000 IU/d for levels <60 nmol/L or 400 IU/d for levels 60-75 nmol/L.
Inadequate 25(OH)D levels were observed in 26% of patients in 2010 and 23% in 2011. After supplementation was increased for those with inadequate 25(OH)D levels in 2010 (n = 20), a significant increase in 25(OH)D levels was observed in 2011 (P = .03). Adequate status was achieved in 50% of these patients (n = 10). Age was significantly negatively associated with 25(OH)D levels in both years (P = .002). Percentage of forced expiratory volume in 1 second was significantly positively associated with 25(OH)D levels in 2011 (P = .03).
While vitamin D supplementation was effective at increasing serum 25(OH)D, this protocol did not achieve optimal serum 25(OH)D levels in 25% of the population. Increasing age had the strongest association with 25(OH)D. Current supplementation protocols may require reevaluation based on emerging evidence and revised Cystic Fibrosis Foundation guidelines.
本研究旨在确定加拿大儿科囊性纤维化（CF）患者群体中血清25-羟维生素D（25(OH)D）水平不足的患病率，并评估维生素D补充方案对改善维生素D状态的有效性。次要目标是分析可能与25(OH)D水平不足相关的因素。
通过对加拿大一家CF诊所96名（1至18岁）患者（2010年和201年）的回顾性病历审查，收集维生素D补充情况、25(OH)D水平以及假设与25(OH)D水平相关的因素。25(OH)D充足水平设定为≥75 nmol/L。2010年25(OH)D水平不足的患者，若水平<60 nmol/L则额外补充1000 IU/d，若水平在60 - 75 nmol/L则额外补充400 IU/d。
2010年26%的患者和2011年23%的患者25(OH)D水平不足。2010年对25(OH)D水平不足的患者（n = 20）增加补充量后，2011年25(OH)D水平显著升高（P = .03）。这些患者中有50%（n = 10）达到了充足状态。两年中年龄均与25(OH)D水平显著负相关（P = .002）。2011年1秒用力呼气容积百分比与25(OH)D水平显著正相关（P = .03）。
虽然维生素D补充在提高血清25(OH)D方面有效，但该方案在25%的人群中未达到最佳血清25(OH)D水平。年龄增长与25(OH)D的关联最为强烈。当前的补充方案可能需要根据新出现的证据和修订后的囊性纤维化基金会指南进行重新评估。
