A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis

Vitamin D deficiency is common in the general population, and even more so in patients with cystic fibrosis. Deficiency is exacerbated in cystic fibrosis patients because of a myriad of causes including malabsorption, decreased fat mass, reduced 25-hydroxylation of vitamin D, reduced exposure to sun...

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Autores principales:	Colleen Wood, Sana Hasan, Amy Darukhanavala, Vin Tangpricha
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Vitamin D Cystic fibrosis Supplementation Treatment Review Metabolism Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/035b608bb2f14e5db85b4a9ac6b363e4
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spelling	oai:doaj.org-article:035b608bb2f14e5db85b4a9ac6b363e42021-11-14T04:33:05ZA Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis2214-623710.1016/j.jcte.2021.100273https://doaj.org/article/035b608bb2f14e5db85b4a9ac6b363e42021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214623721000259https://doaj.org/toc/2214-6237Vitamin D deficiency is common in the general population, and even more so in patients with cystic fibrosis. Deficiency is exacerbated in cystic fibrosis patients because of a myriad of causes including malabsorption, decreased fat mass, reduced 25-hydroxylation of vitamin D, reduced exposure to sunlight, decreased vitamin D binding protein, and exposure to drugs that increase catabolism. In turn, vitamin D deficiency can contribute to poor bone health. Additionally, it may contribute to pulmonary decline in the form of worsening pulmonary function, increased colonization with pathogens, and increased pulmonary exacerbation. Because vitamin D deficiency is correlated with negative clinical effects in multiple organ systems of patients with cystic fibrosis, it is important to screen for and treat deficiency in these patients. The Cystic Fibrosis Foundation has issued guidelines for the treatment of vitamin D deficiency, targeting serum levels of 25-hydroxyvitamin D of at least 30 ng/ml. The guidelines offer age-specific escalating dose regimens depending on serum vitamin D levels, with monitoring at 12- week intervals after changing therapy. They address the literature on alternative vitamin D sources, such as UV lamps, ideal formulations (cholecalciferol in preference to ergocalciferol), and optimal vehicles of administration. Despite these detailed recommendations, most centers are still unable to achieve in-target serum vitamin D levels for many of their patients. Future research examining ideal treatment regimens to achieve serum targets and maximize clinical effects are needed. Moreover, it is unknown whether vitamin D sufficiency will be easier to achieve on new triple therapy cystic fibrosis drug combinations, and how these drugs will contribute to vitamin D-related clinical outcomes.Colleen WoodSana HasanAmy DarukhanavalaVin TangprichaElsevierarticleVitamin DCystic fibrosisSupplementationTreatmentReviewMetabolismDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENJournal of Clinical & Translational Endocrinology, Vol 26, Iss , Pp 100273- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vitamin D Cystic fibrosis Supplementation Treatment Review Metabolism Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Vitamin D Cystic fibrosis Supplementation Treatment Review Metabolism Diseases of the endocrine glands. Clinical endocrinology RC648-665 Colleen Wood Sana Hasan Amy Darukhanavala Vin Tangpricha A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
description	Vitamin D deficiency is common in the general population, and even more so in patients with cystic fibrosis. Deficiency is exacerbated in cystic fibrosis patients because of a myriad of causes including malabsorption, decreased fat mass, reduced 25-hydroxylation of vitamin D, reduced exposure to sunlight, decreased vitamin D binding protein, and exposure to drugs that increase catabolism. In turn, vitamin D deficiency can contribute to poor bone health. Additionally, it may contribute to pulmonary decline in the form of worsening pulmonary function, increased colonization with pathogens, and increased pulmonary exacerbation. Because vitamin D deficiency is correlated with negative clinical effects in multiple organ systems of patients with cystic fibrosis, it is important to screen for and treat deficiency in these patients. The Cystic Fibrosis Foundation has issued guidelines for the treatment of vitamin D deficiency, targeting serum levels of 25-hydroxyvitamin D of at least 30 ng/ml. The guidelines offer age-specific escalating dose regimens depending on serum vitamin D levels, with monitoring at 12- week intervals after changing therapy. They address the literature on alternative vitamin D sources, such as UV lamps, ideal formulations (cholecalciferol in preference to ergocalciferol), and optimal vehicles of administration. Despite these detailed recommendations, most centers are still unable to achieve in-target serum vitamin D levels for many of their patients. Future research examining ideal treatment regimens to achieve serum targets and maximize clinical effects are needed. Moreover, it is unknown whether vitamin D sufficiency will be easier to achieve on new triple therapy cystic fibrosis drug combinations, and how these drugs will contribute to vitamin D-related clinical outcomes.
format	article
author	Colleen Wood Sana Hasan Amy Darukhanavala Vin Tangpricha
author_facet	Colleen Wood Sana Hasan Amy Darukhanavala Vin Tangpricha
author_sort	Colleen Wood
title	A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
title_short	A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
title_full	A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
title_fullStr	A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
title_full_unstemmed	A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
title_sort	clinician’s guide to vitamin d supplementation for patients with cystic fibrosis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/035b608bb2f14e5db85b4a9ac6b363e4
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A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis

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