Vitamin D deficiency in cystic fibrosis patients tied to development of diabetes: Study
USA: Adults with cystic fibrosis and vitamin D deficiency are at a higher risk of developing cystic fibrosis-related diabetes (CFRD) and also at risk for earlier onset of CFRD, finds a recent study. The researchers further suggest that maintenance of a serum 25(OH)D concentration above 20 ng/mL may lower the risk of progression to CFRD. The study was published in the journal Nutrients on 12 November 2021.
Up to half of the people with cystic fibrosis are affected by CFRD by adulthood. CFD is caused primarily by pancreatic dysfunction leading to insufficient insulin release and/or insulin resistance. In people with CF, exocrine pancreatic insufficiency is associated with malabsorption of fat-soluble vitamins, including A, D, E, and K. Yiqing Peng, Emory College, Emory University, Atlanta, GA 30322, USA, and colleagues in this retrospective cohort study aimed to examine the relationship between vitamin D status, assessed by serum 25-hydroxyvitamin D (25(OH)D), and the development of CFRD in adults with CF.
The data for the study were extracted from the electronic medical records and the Emory Clinical Data Warehouse, a data repository of health information from patients seen at Emory Healthcare. The researchers collected age, race, the first recorded serum 25-hydroxyvitamin D (25(OH)D) concentration, body mass index (BMI), and the onset of a diabetes diagnosis. The relative risk of CFRD onset in the subjects with stratified vitamin D status and weight status were compared.
This study included 253 subjects with a mean age of 27.1 years who were followed for a mean follow-up time period of 1917.1 days, and a mean serum 25(OH)D concentration of 31.8 ng/mL.
Key findings include:
- The majority (52.6%) of the subjects developed CFRD during the study period.
- Vitamin D deficiency (defined as 25(OH)D < 20 ng/mL) was present in 25.3% of the subjects.
- Close to two thirds (64.1%) of the subjects with vitamin D deficiency developed CFRD during the study.
- Vitamin D deficiency increased the risk of developing CFRD during the course of the study.
- The time to the onset of CFRD stratified by vitamin D status was also significant (25(OH)D < 20 ng/mL vs. 25(OH)D ≥ 20 ng/mL).
"Our findings support the hypothesis that adults with CF and vitamin D deficiency are at a higher risk of developing CFRD and are at risk for earlier CFRD onset," wrote the authors. "We found that a serum 25(OH)D concentration above 20 ng/mL may decrease the risk of progression to CFRD."
The researchers add that however, it is not clear whether providing vitamin D supplements will actually decrease the progression to CFRD. So, there is a need for future randomized prospective studies for evaluating whether vitamin D supplementation with vitamin D in adults and/or children can decrease the progression to CFRD.
The study titled, "Vitamin D Status and Risk of Cystic Fibrosis-Related Diabetes: A Retrospective Single Center Cohort Study," is published in the journal Nutrients.