3800 IU of vitamin D is not enough for most children with cystic fibrosis

Vitamin D in children with cystic fibrosis.

Arch Dis Child. 2012 Aug 4.

Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

Malcolm Brodlie 1,2 m.j.brodlie@ncl.ac.uk, William A Orchard 2, Gordon A Reeks 2, Stewart Pattman 3, Helen McCabe 2, Christopher J O'Brien 2, Matthew F Thomas 2, David Anthony Spencer 2

1 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

2 Regional Paediatric Cystic Fibrosis Service, Department of Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

3 Chemical Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

PURPOSE:

The Cystic Fibrosis Trust in 2007 published a recommended target of 75-150 nmol/L for 25-hydroxyvitamin D (25-OHD).

In 2008 we found that only 10% of pancreatic insufficient (PI) children met this target.

An increase in supplementation was implemented and a repeat audit performed in 2010.

METHODS:

PI children ?1 year under sole-care in our regional centre were included.

Vitamin D3 supplementation increased by > 450% to either 3800 IU/day liquid or 800 IU daily plus 20,000 IU weekly tablets.

In 2010 pancreatic sufficient (PS) children were also audited separately.

RESULTS:

The median 25-OHD level increased from 51.5 nmol/L in 2008 (n=78, 10% >75 nmol/L) to 72 nmol/L in 2010 (n=72, 51% >75 nmol/L), p<0.0001.

In PS children (n=15 in 2010) 87% had 25-OHD levels <75 nmol/L.

CONCLUSIONS:

A substantial increase in supplementation led to a significant increase in 25-OHD levels but around half still failed to reach the recommended target.

PMID: 22863689

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Summary by VitaminDWiki

Target of > 30 ng of vitamin D

Iniitlally 10% of the 72 children with cystic fibrosis >30 ng

Supplemented with 3800 IU of vitamin D

After two years 51% of the children had >30 ng


See also VitaminDWiki

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Suspect that it will be difficult to get approval for a large CF RCT in the future.

The ethics committee would have a hard time allowing scores of CF deaths for the placebo group.

See also wikipedia - graphic shows the digestion problems with CF

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