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Vitamin A intake and serum retinol levels in children and adolescents with cystic fibrosis.
Clin Nutr 2016; 35(3):654-9CN

Abstract

BACKGROUND

Pancreatic insufficient cystic fibrosis (CF) patients receive vitamin A supplementation according to CF-specific recommendations to prevent deficiencies. Whether current recommendations are optimal for preventing both deficiency and toxicity is a subject of debate. We assessed the longitudinal relation between serum retinol levels and appropriate variables.

METHODS

We studied vitamin A intake, and the long-term effects of vitamin A intake, coefficient of fat absorption (CFA) and immunoglobulin G (IgG) on serum retinol levels in 221 paediatrics CF patients during a seven-year follow up period.

RESULTS

Total vitamin A intake, derived from 862 dietary assessments, exceeded the tolerable upper intake level in 30% of the assessments, mainly up to age six. Although CF patients failed to meet the CF-specific recommendations, serum retinol deficiency was found in only 17/862 (2%) of the measurements. Longitudinally, we observed no association to serum retinol levels for total vitamin A intake, CFA, gender or age but serum retinol levels were associated with serum IgG levels. Each g/L increase in serum IgG level would result in a 2.49% (95% CI -3.60 to -1.36%) reduction in serum retinol levels.

CONCLUSION

In this large sample of children and adolescents with CF, serum retinol deficiency was rare despite lower than the CF-specific recommendations. However, the TUL was commonly exceeded. A reduction in CF-specific vitamin A supplementation recommendations should therefore be considered. Moreover, serum retinol levels were not associated with vitamin A intake, CFA, gender or age, although a decreased serum retinol was associated with an increased serum IgG.

Authors+Show Affiliations

Internal Medicine and Dermatology, Dietetics and, Cystic Fibrosis Centre Utrecht, University Medical Centre Utrecht, KH.01.419.0, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: j.w.woestenenk@umcutrecht.nl.Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht, University Medical Centre Utrecht, KH.01.419.0, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.Department of Biostatistics, Julius Centre, University Medical Centre Utrecht, STR.7.125, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht, University Medical Centre Utrecht, KH.01.419.0, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht, University Medical Centre Utrecht, KH.01.419.0, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.Department of Paediatric Gastroenterology, and Cystic Fibrosis Centre, University Medical Centre Utrecht, KE.04.133.1, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25975494

Citation

Woestenenk, Janna W., et al. "Vitamin a Intake and Serum Retinol Levels in Children and Adolescents With Cystic Fibrosis." Clinical Nutrition (Edinburgh, Scotland), vol. 35, no. 3, 2016, pp. 654-9.
Woestenenk JW, Broos N, Stellato RK, et al. Vitamin A intake and serum retinol levels in children and adolescents with cystic fibrosis. Clin Nutr. 2016;35(3):654-9.
Woestenenk, J. W., Broos, N., Stellato, R. K., Arets, H. G., van der Ent, C. K., & Houwen, R. H. (2016). Vitamin A intake and serum retinol levels in children and adolescents with cystic fibrosis. Clinical Nutrition (Edinburgh, Scotland), 35(3), pp. 654-9. doi:10.1016/j.clnu.2015.04.010.
Woestenenk JW, et al. Vitamin a Intake and Serum Retinol Levels in Children and Adolescents With Cystic Fibrosis. Clin Nutr. 2016;35(3):654-9. PubMed PMID: 25975494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin A intake and serum retinol levels in children and adolescents with cystic fibrosis. AU - Woestenenk,Janna W, AU - Broos,Nancy, AU - Stellato,Rebecca K, AU - Arets,Hubertus G M, AU - van der Ent,Cornelis K, AU - Houwen,Roderick H J, Y1 - 2015/04/23/ PY - 2014/07/02/received PY - 2015/04/13/revised PY - 2015/04/15/accepted PY - 2015/5/16/entrez PY - 2015/5/16/pubmed PY - 2018/1/18/medline KW - Coefficient of fat absorption KW - Cystic fibrosis KW - Immunoglobulin G KW - Retinol KW - Vitamin A SP - 654 EP - 9 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 35 IS - 3 N2 - BACKGROUND: Pancreatic insufficient cystic fibrosis (CF) patients receive vitamin A supplementation according to CF-specific recommendations to prevent deficiencies. Whether current recommendations are optimal for preventing both deficiency and toxicity is a subject of debate. We assessed the longitudinal relation between serum retinol levels and appropriate variables. METHODS: We studied vitamin A intake, and the long-term effects of vitamin A intake, coefficient of fat absorption (CFA) and immunoglobulin G (IgG) on serum retinol levels in 221 paediatrics CF patients during a seven-year follow up period. RESULTS: Total vitamin A intake, derived from 862 dietary assessments, exceeded the tolerable upper intake level in 30% of the assessments, mainly up to age six. Although CF patients failed to meet the CF-specific recommendations, serum retinol deficiency was found in only 17/862 (2%) of the measurements. Longitudinally, we observed no association to serum retinol levels for total vitamin A intake, CFA, gender or age but serum retinol levels were associated with serum IgG levels. Each g/L increase in serum IgG level would result in a 2.49% (95% CI -3.60 to -1.36%) reduction in serum retinol levels. CONCLUSION: In this large sample of children and adolescents with CF, serum retinol deficiency was rare despite lower than the CF-specific recommendations. However, the TUL was commonly exceeded. A reduction in CF-specific vitamin A supplementation recommendations should therefore be considered. Moreover, serum retinol levels were not associated with vitamin A intake, CFA, gender or age, although a decreased serum retinol was associated with an increased serum IgG. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/25975494/Vitamin_A_intake_and_serum_retinol_levels_in_children_and_adolescents_with_cystic_fibrosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(15)00120-X DB - PRIME DP - Unbound Medicine ER -