Vitamin D deficiency is associated with pulmonary dysfunction in cystic fibrosis

William P Sexauer; Anas Hadeh; Pamela A Ohman-Strickland; Robert L Zanni; Laurie Varlotta; Douglas Holsclaw; Stanley Fiel; Gavin R Graff; Arthur Atlas; Dorothy Bisberg; Denis Hadjiliadis; Suzanne H Michel; Daria Mintz; Rebanta Chakraborty; Bridget Marra; Paula Lomas; Tara Ward; Meagen Sassman; Giovanna C Imbesi; Diane M Kitch; Allison M Mallowe

doi:10.1016/j.jcf.2014.12.006

Vitamin D deficiency is associated with pulmonary dysfunction in cystic fibrosis

J Cyst Fibros. 2015 Jul;14(4):497-506. doi: 10.1016/j.jcf.2014.12.006. Epub 2015 Jan 7.

Authors

William P Sexauer¹, Anas Hadeh², Pamela A Ohman-Strickland³, Robert L Zanni⁴, Laurie Varlotta⁵, Douglas Holsclaw⁶, Stanley Fiel⁷, Gavin R Graff⁸, Arthur Atlas⁹, Dorothy Bisberg¹⁰, Denis Hadjiliadis⁶, Suzanne H Michel¹¹, Daria Mintz¹², Rebanta Chakraborty¹³, Bridget Marra⁴, Paula Lomas⁷, Tara Ward¹⁴, Meagen Sassman¹⁵, Giovanna C Imbesi⁶, Diane M Kitch⁸, Allison M Mallowe¹⁶

Affiliations

¹ Pulmonary and Critical Care Division, Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: william.sexauer@jefferson.edu.
² Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Drexel University College of Medicine, Philadelphia, PA, USA; Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida, Weston, FL, USA.
³ Rutgers School of Public Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
⁴ Pulmonary Division, Department of Pediatrics, Monmouth Medical Center, Long Branch, NJ, USA.
⁵ Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA; Section of Pediatric Pulmonology, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
⁶ Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁷ Adult Cystic Fibrosis Center, Morristown Medical Center, Morristown, NJ, USA.
⁸ Pulmonary Division, Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
⁹ Pulmonary Division, Department of Pediatrics, Goryeb Children's Hospital, Morristown Medical Center, Morristown, NJ, USA.
¹⁰ Barnabas Health, West Orange, NJ, USA.
¹¹ Pulmonary Division, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
¹² Pulmonary Division, Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
¹³ Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
¹⁴ Department of Medicine, Morristown Medical Center, Morristown, NJ, USA.
¹⁵ Cystic Fibrosis Center, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
¹⁶ Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

PMID: 25577127
DOI: 10.1016/j.jcf.2014.12.006

Abstract

Background: Vitamin D deficiency is common in CF. Whether vitamin D affects pulmonary function in CF is unknown.

Methods: Data were abstracted from clinically stable CF patients who had pulmonary function studies and serum 25-hydroxyvitamin D [25(OH)D, ng/ml] levels drawn within 2 months of each other. Findings were adjusted for multiple variables known to affect pulmonary function in CF.

Results: Enrollees totaled 597. Overall mean 25(OH)D level was 29.6±12.8 ng/ml (SD). Serum 25(OH)D levels showed a significant correlation with forced expiratory volume in 1s (FEV1) % predicted (r=0.20, p<0.0001) and forced vital capacity % predicted (r=0.13, p=0.0019). Multivariate analysis revealed that serum 25(OH)D remained an independent predictor of FEV1 % predicted even after controlling for multiple other factors known to affect CF lung function.

Conclusions: Serum 25(OH)D levels are significantly associated with pulmonary function in CF. Further study is required to determine whether this association is causal.

Keywords: Cystic fibrosis; Lung function; Pulmonary function; Vitamin D.

MeSH terms

Adolescent
Adult
Child
Cystic Fibrosis / blood
Cystic Fibrosis / complications*
Cystic Fibrosis / physiopathology*
Female
Forced Expiratory Volume / physiology
Humans
Male
Retrospective Studies
Vital Capacity / physiology
Vitamin D / analogs & derivatives
Vitamin D / blood
Vitamin D Deficiency / blood
Vitamin D Deficiency / complications*
Vitamin D Deficiency / physiopathology*
Young Adult

Substances

Vitamin D
25-hydroxyvitamin D