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Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study.
Diabetologia 2011; 54(12):3007-15D

Abstract

AIMS/HYPOTHESIS

Many cystic fibrosis patients are vitamin D-insufficient. Cystic fibrosis-related diabetes is a major complication of cystic fibrosis. The literature suggests that vitamin D might possess certain glucose-lowering properties. We aimed to assess the relationship between vitamin D and cystic fibrosis-related glucose intolerance.

METHODS

We enrolled 898 cystic fibrosis patients from Sweden, Norway and Denmark. Vitamin D intake was assessed using a seven-day food record. Serum 25-hydroxyvitamin D (s25OHD) and HbA(1c) were measured, and an OGTT was carried out. Multiple linear and logistic regressions were used for HbA(1c) and cystic fibrosis-related diabetes/OGTT result as outcome variables, respectively. Each model was controlled for country, and for known cystic fibrosis-related diabetes risk factors: age, sex, genotype, liver dysfunction, long-term corticosteroid treatment, and lung and pancreatic function.

RESULTS

Degree of vitamin D insufficiency (OR 1.36; p = 0.032) and s25OHD < 30 nmol/l (OR 1.79; p = 0.042) were significant risk factors for cystic fibrosis-related diabetes. Accordingly, HbA(1c) value was positively associated with s25OHD < 30 nmol/l and < 50 nmol/l, as well as with degree of vitamin D insufficiency (adjusted R (2) = 20.5% and p < 0.05 in all). In subgroup analyses, s25OHD < 30 nmol/l determined the HbA(1c) value in paediatric patients (adjusted R (2) = 20.2%; p = 0.017), but not in adults.

CONCLUSIONS/INTERPRETATION

Vitamin D status is associated with HbA(1c) and diabetes in cystic fibrosis, particularly in children. The study justifies prospective studies on the proposed role of vitamin D deficiency in the pathophysiology of diabetes mellitus.

Authors+Show Affiliations

Stockholm CF Centre, B 59, Karolinska Institutet, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Terezia.Pincikova@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21901282

Citation

Pincikova, T, et al. "Vitamin D Deficiency as a Risk Factor for Cystic Fibrosis-related Diabetes in the Scandinavian Cystic Fibrosis Nutritional Study." Diabetologia, vol. 54, no. 12, 2011, pp. 3007-15.
Pincikova T, Nilsson K, Moen IE, et al. Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia. 2011;54(12):3007-15.
Pincikova, T., Nilsson, K., Moen, I. E., Fluge, G., Hollsing, A., Knudsen, P. K., ... Hjelte, L. (2011). Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia, 54(12), pp. 3007-15. doi:10.1007/s00125-011-2287-1.
Pincikova T, et al. Vitamin D Deficiency as a Risk Factor for Cystic Fibrosis-related Diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. Diabetologia. 2011;54(12):3007-15. PubMed PMID: 21901282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study. AU - Pincikova,T, AU - Nilsson,K, AU - Moen,I E, AU - Fluge,G, AU - Hollsing,A, AU - Knudsen,P K, AU - Lindblad,A, AU - Mared,L, AU - Pressler,T, AU - Hjelte,L, AU - ,, Y1 - 2011/09/07/ PY - 2011/01/19/received PY - 2011/07/26/accepted PY - 2011/9/9/entrez PY - 2011/9/9/pubmed PY - 2012/3/20/medline SP - 3007 EP - 15 JF - Diabetologia JO - Diabetologia VL - 54 IS - 12 N2 - AIMS/HYPOTHESIS: Many cystic fibrosis patients are vitamin D-insufficient. Cystic fibrosis-related diabetes is a major complication of cystic fibrosis. The literature suggests that vitamin D might possess certain glucose-lowering properties. We aimed to assess the relationship between vitamin D and cystic fibrosis-related glucose intolerance. METHODS: We enrolled 898 cystic fibrosis patients from Sweden, Norway and Denmark. Vitamin D intake was assessed using a seven-day food record. Serum 25-hydroxyvitamin D (s25OHD) and HbA(1c) were measured, and an OGTT was carried out. Multiple linear and logistic regressions were used for HbA(1c) and cystic fibrosis-related diabetes/OGTT result as outcome variables, respectively. Each model was controlled for country, and for known cystic fibrosis-related diabetes risk factors: age, sex, genotype, liver dysfunction, long-term corticosteroid treatment, and lung and pancreatic function. RESULTS: Degree of vitamin D insufficiency (OR 1.36; p = 0.032) and s25OHD < 30 nmol/l (OR 1.79; p = 0.042) were significant risk factors for cystic fibrosis-related diabetes. Accordingly, HbA(1c) value was positively associated with s25OHD < 30 nmol/l and < 50 nmol/l, as well as with degree of vitamin D insufficiency (adjusted R (2) = 20.5% and p < 0.05 in all). In subgroup analyses, s25OHD < 30 nmol/l determined the HbA(1c) value in paediatric patients (adjusted R (2) = 20.2%; p = 0.017), but not in adults. CONCLUSIONS/INTERPRETATION: Vitamin D status is associated with HbA(1c) and diabetes in cystic fibrosis, particularly in children. The study justifies prospective studies on the proposed role of vitamin D deficiency in the pathophysiology of diabetes mellitus. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/21901282/Vitamin_D_deficiency_as_a_risk_factor_for_cystic_fibrosis_related_diabetes_in_the_Scandinavian_Cystic_Fibrosis_Nutritional_Study_ L2 - https://dx.doi.org/10.1007/s00125-011-2287-1 DB - PRIME DP - Unbound Medicine ER -