Seguridad y eficacia de una nueva pauta de suplementación en pacientes con fibrosis quística e insuficiencia de vitamina D
- Carmen Mangas Sánchez
- María Garriga García
- María Juliana Serrano Nieto
- Ruth Garcia-Romero
- Marina Álvarez Beltrán
- Elena Crehuá-Gaudiza
- Saioa Vicente Santamaría
- Cecilia Martínez Costa
- Juan José Díaz Martín
- Carlos Bousoño García
- David González Jiménez
ISSN: 1695-4033, 1696-4608
Año de publicación: 2023
Volumen: 98
Número: 4
Páginas: 257-266
Tipo: Artículo
Otras publicaciones en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumen
Objectives Based on the European and American cystic fibrosis (CF) consensus recommendations, an increase in vitamin D (VD) supplementation in patients with CF and insufficient or deficient levels was proposed. The objective of our study was to determine the safety and efficacy of this new protocol. Material and methods Multicentre nonrandomized uncontrolled experimental study. Patients with insufficient levels (< 30 ng/mL) received increasing doses of VD (between 800 and 10,000 IU/day). Patients were followed up for 12 months, during which their vitamin and nutritional status, pulmonary function and calcium and phosphate metabolism were assessed. Statistical analysis: t test for paired data and multivariate logistic regression analysis. Results Thirty patients aged 1–39 years (median, 9.1) completed the follow-up. Two patients were dropped from the study on account of 25-OH VD levels greater than 100 ng/mL at 3 months without clinical or laboratory signs of hypercalcaemia. At 12 months, we observed an increase of 7.6 ng/mL (95% CI, 4.6–10 ng/mL) in the mean 25-OH VD level and an improvement in vitamin status: 37% achieved levels of 30 ng/mL or greater, 50% levels between 20 and 30 ng/mL and 13% remained with levels of less than 20 ng/mL. We found no association between improved VD levels and pulmonary function. Conclusions The proposed protocol achieved an increase in serum VD levels and a decrease in the percentage of patients with VD insufficiency, although it was still far from reaching the percentages of sufficiency recommended for this entity.