The impact of plasma 25-hydroxyvitamin D on pulmonary function and exercise physiology in cystic fibrosis: a multicentre retrospective study

Raquel Revuelta Iniesta, Adam J Causer, Irantzu Arregui-Fresneda, Gary Connett, Mark I Allenby, Thomas Daniels, Mary P Carroll, Don S Urquhart, Zoe L Saynor

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A 25-hydroxyvitamin D (25OHD) may exert immunomodulatory effects on respiratory health, which may translate to improvements in exercise physiology. Thus, we aimed to investigate whether plasma 25OHD is associated with lung function and aerobic fitness in people with cystic fibrosis (pwCF). Methods: A multicentre retrospective review of pwCF (> 9 years old) attending the Royal Hospital for Sick Children (Edinburgh) or Wessex CF-Unit (Southampton) was performed between July 2017 and October 2019. Demographic and clinical data were collected. Plasma 25OHD measured closest in time to clinical cardiopulmonary exercise testing and/or spirometry [forced expiratory volume (FEV 1)% predicted] was recorded. Pancreatic insufficiency was diagnosed based on faecal elastase of < 100 µg g −1. We performed multiple-regression analysis with aerobic fitness outcomes [peak oxygen uptake (VO 2 peak)] and FEV 1% predicted as primary outcomes. Results: Ninety pwCF [mean ± SD age: 19.1 ± 8.6 years, 54 (60%) children, 48 (53%) males and 88 (98%) Caucasian] were included. 25OHD deficiency and insufficiency was 15 (17%) and 44 (49%), respectively. 25OHD deficiency and insufficiency was significantly associated with pancreatic insufficiency (χ 2 = 4.8, p = 0.02). Plasma 25OHD was not significantly associated with FEV 1% predicted (r 2 = 0.06, p = 0.42, 95% CI = −0.09 to 0.19) or VO 2 peak (r 2 = 0.04, p = 0.07, 95% CI = −011 to 0.005) in all pwCF. However, 25OHD was significantly associated with both FEV 1% (r 2 = 0.15, p = 0.02, 95% CI = 1.99–2.64) and VO 2 peak (r 2 = 0.13, p = 0.05, 95% CI = −0.26 to −0.005) in the paediatric cohort. Conclusions: We showed that 25OHD is associated with improved lung function and aerobic fitness in children and adolescents with CF. Mechanistic and high-quality prospective studies including both lung function and aerobic fitness as primary outcomes are now warranted.

Original languageEnglish
Pages (from-to)363-375
Number of pages13
JournalJournal of Human Nutrition and Dietetics
Volume35
Issue number2
Early online date28 Apr 2021
DOIs
Publication statusPublished - 30 Apr 2022

Keywords

  • cardiopulmonary exercise testing
  • cystic fibrosis
  • lung function
  • ventilation
  • vitamin D

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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