A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis
| العنوان: | A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis |
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| المؤلفون: | Sana Hasan, Vin Tangpricha, Colleen L. Wood, Amy Darukhanavala |
| المصدر: | Journal of Clinical & Translational Endocrinology Journal of Clinical & Translational Endocrinology, Vol 26, Iss, Pp 100273-(2021) |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Vitamin, medicine.medical_specialty, Malabsorption, Supplementation, Endocrinology, Diabetes and Metabolism, Population, D2, ergocalciferol, BMD, bone mineral density, Review, Gastroenterology, Cystic fibrosis, Special Issue: CF Endocrinology Advance, Diseases of the endocrine glands. Clinical endocrinology, vitamin D deficiency, chemistry.chemical_compound, Endocrinology, 25(OH)D, 25-hydroxyvitamin D, Internal medicine, D3, cholecalciferol, medicine, Vitamin D and neurology, RTC, randomized control trial, CFTR, cystic fibrosis transmembrane conductance regulator, PTH, parathyroid hormone, Vitamin D, education, Cholecalciferol, CF, cystic fibrosis, education.field_of_study, business.industry, NTM, nontuberculous mycobacteria, RC648-665, medicine.disease, Treatment, Ergocalciferol, Metabolism, chemistry, business, CFRD, cystic fibrosis-related diabetes, medicine.drug |
| الوصف: | Highlights • Vitamin D deficiency is multifactorial in the cystic fibrosis population. • Vitamin D deficiency can adversely affect multiple organ systems in the cystic fibrosis population. • In the cystic fibrosis population in the United States, we aim to treat to serum 25-hydroxyvitamin D levels over 30 ng/ml. • Cholecalciferol is used in preference to ergocalciferol. • Daily or once weekly dosing regimens are chosen according to patient preference and compliance. 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. |
| اللغة: | English |
| تدمد: | 2214-6237 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::644d6835ee211720e7125140cd9734b1 http://europepmc.org/articles/PMC8593649 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....644d6835ee211720e7125140cd9734b1 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 22146237 |
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