- Evaluation of serum cholecalciferol in children with cystic fibrosis
Evaluation of serum cholecalciferol in children with cystic fibrosis
PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.3(75):82-87; doi 10.15574/PP.2018.75.82
Dudnуk V. M., Demianyshyna V. V.
National Pirogov Memorial Medical University, Vinnytsia, Ukraine
Objective: to estimate serum cholecalciferol in children with cystic fibrosis.
Materials and methods. In total 74 children aged up to 17 years were examined. Gender, age, physical development, exocrine pancreatic function, and functional state of the lungs were evaluated. The serum level of cholecalciferol was determined in all patients. For comparison, a group of healthy children was examined.
Results. The mean value of cholecalciferol was 28.9±0.86 ng/mL. Among the children examined, 36.5% had an optimum level of cholecalciferol, in 58.1% of patients decreased level were detected, and in 5.4% of patients its insufficiency was determined. In remission, the mean cholecalciferol level made up 26.16±1.21 ng/mL, which was significantly lower (p<0.05) as compared to the patients in the exacerbation phase — 29.85±1.04 ng/mL. In children with pancreatic deficiency, a decreased cholecalciferol level was observed — 28.77±0.85 ng/mL. In patients with faecal elastase$1 level (FE-1) less than 100 ng/mg, cholecalciferol was 24.67±1.33 ng/mL, and in case of FE-1 level from 100 to 200 ng/mg, cholecalciferol level was 37.57±5.57 ng/mL. In children with optimum cholecalciferol level, the parameters of the external respiratory function were higher, and the signs of obstructive$restrictive disorders were less severe.
Conclusions. Among the examined children, 63.5% had a reduced and insufficient cholecalciferol level. Insufficient level was observed most often among primary school$aged children. In remission, the mean level was 1.14 times lower compared with those indices at the exacerbation phase. In patients with low FE-1 level, cholecalciferol was 1.5 times lower as well. Spirometry indicators in children with low levels of cholecalciferol were, on average, 1.3 times lower than in children who had an optimum vitamin level.
Key words: cystic fibrosis, cholecalciferol, children.
1. Black PN, Scragg R. (2005). Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest. 128 (6): 3792—3798. https://doi.org/10.1378/chest.128.6.3792; PMid:16354847
2. Chesdachai S, Tangpricha V. (2016). Treatment of vitamin D deficiency in cystic fibrosis. The Journal of steroid biochemistry and molecular biology. 164: 36—39. https://doi.org/10.1016/j.jsbmb.2015.09.013; PMid:26365559 PMCid:PMC4786457
3. Ferguson JH, Chang AB. (2012). Vitamin D supplementation for cystic fibrosis. Cochrane Database of Systematic Reviews. (4): 1—29. https://doi.org/10.1002/14651858.CD007298.pub3
4. Finklea JD, Grossmann RE, Tangpricha V. (2011). Vitamin D and chronic lung disease: a review of molecular mechanisms and clinical studies. Advances in Nutrition. 2 (3): 244—253. https://doi.org/10.3945/an.111.000398; PMid:22332056 PMCid:PMC3090167
5. Gombart AF. (2009). The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future microbiology. 4 (9): 1151—1165. https://doi.org/10.2217/fmb.09.87; PMid:19895218 PMCid:PMC2821804
6. Hall WB, Sparks AA, Aris RM. (2010). Vitamin D deficiency in cystic fibrosis. International journal of endocrinology. 2010. https://doi.org/10.1155/2010/218691; PMid:20148079 PMCid:PMC2817861
7. Hughes DA, Norton R. (2009). Vitamin D and respiratory health. Clinical & Experimental Immunology. 158 (1): 20—25. https://doi.org/10.1111/j.1365-2249.2009.04001.x; PMid:19737226 PMCid:PMC2759054
8. Jassil NK, Sharma A, Bikle D, Wang X. (2017). Vitamin D binding protein and 25-hydroxyvitamin D levels: emerging clinical applications. Endocrine Practice. 23 (5): 605—613. https://doi.org/10.4158/EP161604.RA; PMid:28095044
9. Marquette M, Haworth CS. (2016). Bone health and disease in cystic fibrosis. Paediatric respiratory reviews. 20: 2—5. https://doi.org/10.1016/j.prrv.2016.06.003; PMid:27461283
10. Schrumpf JA, van Sterkenburg MA, Verhoosel JA, Zuyderduyn RM, Hiemstra PS. (2012). Interleukin 13 exposure enhances vitamin D-mediated expression of the human cathelicidin antimicrobial peptide 18/LL-37 in bronchial epithelial cells. Infection and immunity. 80(12): 4485—4494. https://doi.org/10.1128/IAI.06224-11; PMid:23045480 PMCid:PMC3497402
11. Sexauer WP, Hadeh A, Ohman-Strickland PA, Zanni RL, Varlotta L, Holsclaw D, Hadjiliadis D. (2015). Vitamin D deficiency is associated with pulmonary dysfunction in cystic fibrosis. Journal of Cystic Fibrosis. 14 (4): 497—506. https://doi.org/10.1016/j.jcf.2014.12.006; PMid:25577127
12. Simoneau T, Bazzaz O, Sawicki GS, Gordon C. (2014). Vitamin D status in children with cystic fibrosis. Associations with inflammation and bacterial colonization. Annals of the American Thoracic Society. 11 (2): 205—210. https://doi.org/10.1513/AnnalsATS.201306-171BC; PMid:24423241
13. Tangpricha V, Kelly A, Stephenson A, Maguiness K, Enders J, Robinson KA; Cystic Fibrosis Foundation Vitamin D Evidence-Based Review Committee. (2012). 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. The Journal of Clinical Endocrinology & Metabolism. 97 (4): 1082—1093. https://doi.org/10.1210/jc.2011-3050; PMid:22399505
14. Tangpricha V, Kelly A, Stephenson A, Maguiness K, Enders J, Robinson KA; Cystic Fibrosis Foundation Vitamin D Evidence-Based Review Committee. (2012). 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. The Journal of Clinical Endocrinology & Metabolism. 97(4). 1082–1093. https://doi.org/10.1210/jc.2011-3050; PMid:22399505
Article received: Jun 20, 2018. Accepted for publication: Sep 02, 2018.