Fat-soluble vitamins in cystic fibrosis and pancreatic insufficiency: efficacy of a nutrition intervention

J Pediatr Gastroenterol Nutr. 2014 Apr;58(4):443-8. doi: 10.1097/MPG.0000000000000272.

Abstract

Objectives: The aim of the study was to assess the impact of LYM-X-SORB (LXS), an organized lipid matrix that has been shown to be absorbable without pancreatic enzyme therapy on fat-soluble vitamin status in children with cystic fibrosis (CF) and pancreatic insufficiency (PI).

Methods: Children with CF and PI were randomized to daily LXS or an isocaloric placebo comparison supplement for 12 months. Serum vitamins A (retinol), D (25-hydroxyvitamin D[25D]), E (α-tocopherol, α-tocopherol:cholesterol ratio), and K (percentage of undercarboxylated osteocalcin [%ucOC] and plasma proteins induced by vitamin K absence factor II [PIVKA II]) were assessed at baseline and 12 months. Dietary intake was determined using 3-day weighed food records and supplemental vitamin intake by a comprehensive questionnaire.

Results: A total of 58 subjects (32 boys, age 10.3 ± 2.9 years [mean ± standard deviation]) with complete serum vitamin, dietary and supplemental vitamin data were analyzed. After adjusting for dietary and supplemental vitamin intake, serum retinol increased 3.0 ± 1.4 μg/dL (coefficient ± standard error) (adjusted R2 = 0.02, P = 0.03) and vitamin K status improved as demonstrated by a decreased percentage of undercarboxylated osteocalcin of -6.0% ± 1.6% by 12 months (adjusted R2 = 0.15, P < 0.001). These changes occurred in both the LXS and placebo comparison groups. No changes in serum 25D or α-tocopherol were detected. Both nutrition interventions increased caloric intake a mean of 83 ± 666 kcal/day by 12 months.

Conclusions: Vitamins A and K status improved, whereas vitamins D and E status was unchanged during 12 months of LXS and isocaloric placebo comparison supplement in children with CF and PI.

Trial registration: ClinicalTrials.gov NCT00406536.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cystic Fibrosis / blood
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / drug therapy*
  • Diet Records
  • Dietary Supplements*
  • Exocrine Pancreatic Insufficiency / blood
  • Exocrine Pancreatic Insufficiency / complications
  • Exocrine Pancreatic Insufficiency / drug therapy*
  • Female
  • Humans
  • Lipids / administration & dosage
  • Lipids / therapeutic use*
  • Male
  • Surveys and Questionnaires
  • Vitamin A / blood
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin K / blood
  • alpha-Tocopherol / blood

Substances

  • Lipids
  • Vitamin A
  • Vitamin K
  • Vitamin D
  • 25-hydroxyvitamin D
  • alpha-Tocopherol

Associated data

  • ClinicalTrials.gov/NCT00406536