Factors Contributing to Vitamin D Status at Hospital Admission for Pulmonary Exacerbation in Adults With Cystic Fibrosis

• Type of Material: Article
• Authors: A Bhimavarapu, Emory University; Q Deng, Emory University; M Bean, Emory University; N Lee, Emory University; Thomas Ziegler, Emory University; Jessica Alvarez, Emory University; Vin Tangpricha, Emory University
• Language: English
• Date: 2021-01-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjms.2020.08.020
• Title of Journal or Parent Work: AMERICAN JOURNAL OF THE MEDICAL SCIENCES
• Volume: 361
• Issue: 1
• Start Page: 75
• End Page: 82
• Grant/Funding Information: This work was supported by grants from NIH/NCATS UL1 TR002378 (Georgia Clinical and Translational Science Alliance), NIH R03 DK117246, and the Cystic Fibrosis Foundation Clinical Research Award #TANGPR11A0. This project partially fulfilled the requirements of the Emory Discovery Program for Marta Bean.
• Keywords: Science & Technology; Medicine, General & Internal; SMOKING; Cystic fibrosis; Life Sciences & Biomedicine; Pulmonary exacerbation; CHILDREN; INSUFFICIENCY; DOUBLE-BLIND; General & Internal Medicine; VALIDITY; D DEFICIENCY; D LEVEL; Nutrition; Vitamin D; D SUPPLEMENTATION; IMPACT

Abstract

Background: Individuals with cystic fibrosis (CF) have difficulty maintaining optimal vitamin D status due to pancreatic insufficiency-induced malabsorption, inadequate sunlight exposure, and poor intake of vitamin D containing foods. Vitamin D deficiency may increase the risk of pulmonary exacerbations of CF. The objective of this study was to assess factors impacting vitamin D status in patients with CF recently hospitalized for a pulmonary exacerbation of CF. Methods: This was a pre-planned analysis of vitamin D intake in patients enrolled in a multi-center, double-blind, randomized controlled study examining vitamin D therapy for pulmonary exacerbation of CF. Demographic information, responses from a habitual sun exposure questionnaire and food frequency questionnaire, and vitamin D supplement usage were queried and compared to serum 25-hydroxyvitamin D (25(OH)D) concentrations. Results: A total of 48 subjects were included in this analysis. Subjects were taking approximately 1,200 IU of vitamin D daily. Reported vitamin D intake, age, race, employment, and education were not significantly associated with vitamin D status in this population. However, smoking status, sunlight exposure in the last 3 years, and skin type (in the bivariate model) were all significantly associated with vitamin D status (all p<0.05). Conclusions: Sunlight exposure was the most predictive determinant of vitamin D status in patients with CF prior to pulmonary exacerbation. Subjects reported vitamin D intake below the recommended amounts. The role and mode of optimizing vitamin D status prior to a pulmonary exacerbation needs further investigation.