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Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study

Pincikova, T.; Nilsson, K.; Moen, I. E.; Fluge, G.; Hollsing, A.; Knudsen, P. K.; Lindblad, A.; Mared, Lena LU ; Pressler, T. and Hjelte, L. (2011) In Diabetologia 54(12). p.3007-3015
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cystic fibrosis, Diabetes, Food record, HbA(1c), Vitamin D
in
Diabetologia
volume
54
issue
12
pages
3007 - 3015
publisher
Springer Verlag
external identifiers
  • wos:000297740000006
  • scopus:82455198590
ISSN
1432-0428
DOI
10.1007/s00125-011-2287-1
language
English
LU publication?
yes
id
8302de9a-1079-4608-93bb-3ab6b685698b (old id 2291919)
date added to LUP
2012-01-11 15:55:44
date last changed
2017-11-12 03:08:43
@article{8302de9a-1079-4608-93bb-3ab6b685698b,
  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&lt;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&lt;30 nmol/l and&lt;50 nmol/l, as well as with degree of vitamin D insufficiency (adjusted R-2=20.5% and p&lt;0.05 in all). In subgroup analyses, s25OHD&lt;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.},
  author       = {Pincikova, T. and Nilsson, K. and Moen, I. E. and Fluge, G. and Hollsing, A. and Knudsen, P. K. and Lindblad, A. and Mared, Lena and Pressler, T. and Hjelte, L.},
  issn         = {1432-0428},
  keyword      = {Cystic fibrosis,Diabetes,Food record,HbA(1c),Vitamin D},
  language     = {eng},
  number       = {12},
  pages        = {3007--3015},
  publisher    = {Springer Verlag},
  series       = {Diabetologia},
  title        = {Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study},
  url          = {http://dx.doi.org/10.1007/s00125-011-2287-1},
  volume       = {54},
  year         = {2011},
}