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

J Pediatr. 2008 Oct;153(4):554-9. doi: 10.1016/j.jpeds.2008.04.058. Epub 2008 Jun 27.

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.

MeSH terms

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

Substances

  • Ergocalciferols
  • Vitamins