Current treatment recommendations for correcting vitamin D deficiency in pediatric patients with cystic fibrosis are inadequate.

Abstract

OBJECTIVES:

To determine the prevalence of vitamin D deficiency (25-hydroxy vitamin D [25-OHD] levels in plasma <30 ng/mL) in pediatric patients with cystic fibrosis (CF), elucidate contributing factors for vitamin D deficiency, and determine the efficacy of ergocalciferol repletion strategies.

STUDY DESIGN:

Retrospective chart review of 262 pediatric patients from January 2003 to December 2006 with linear and logistic regression analyses.

RESULTS:

Vitamin D deficiency prevalence declined in the years studied from 86.5% to 46.2%. Patients >12 years old were more likely to have deficiency than patients <5 years old (odds ratio [OR], 3.44; 95% CI, 1.73-6.84). Levels obtained in spring and summer were less likely to be deficient compared with those obatained in fall (OR, 0.24; 95% CI, 0.10-0.61; and OR, 0.25; 95% CI, 0.11-0.61; respectively). Success of treatment with 50,000 IU of ergocalciferol once, twice, or 3 times weekly was 33%, 26%, and 43%, respectively. Ergocalciferol, when compared with no treatment, did not significantly increase the proportion of patients with follow-up levels > or =30 ng/mL (chi(2)P value = .80, .34, and .22, respectively).

CONCLUSIONS:

The prevalence of vitamin D deficiency is high, but declined with time. Age, forced expiratory volume in 1 second, and season were associated with 25-OHD levels. Despite 33% of patients responding to 50 000 IU of ergocalciferol once a week, this recommendation does not adequately treat most patients with CF who have vitamin D deficiency.

• Authors: Deanna Green, Kathryn Carson, Amanda Leonard, J Erin Davis, Beryl Rosenstein, Pamela Zeitlin, Peter Mogayzel Jr
• Journal: The Journal of pediatrics (J Pediatr) Vol. 153 Issue 4 Pg. 554-9 (Oct 2008) ISSN: 1097-6833 [Electronic] United States
• PMID: 18589445 (Publication Type: Journal Article)

Chemical References

• Ergocalciferols
• Vitamins

Topics

• Child
• Cystic Fibrosis (blood, epidemiology)
• Ergocalciferols (administration & dosage)
• Forced Expiratory Volume
• Humans
• Logistic Models
• Prevalence
• Retrospective Studies
• Risk Factors
• Seasons
• Vitamin D Deficiency (epidemiology)
• Vitamins (administration & dosage)