Vitamin D status in children with cystic fibrosis. Associations with inflammation and bacterial colonization

Ann Am Thorac Soc. 2014 Feb;11(2):205-10. doi: 10.1513/AnnalsATS.201306-171BC.


Rationale: Patients with cystic fibrosis (CF) have high rates of vitamin D insufficiency. The relation between vitamin D status and inflammation in patients with CF is poorly understood.

Objectives: To determine the prevalence of vitamin D deficiency and insufficiency in a young CF population and to examine correlations between vitamin D status, disease severity, and inflammatory markers.

Methods: This was a retrospective chart review of patients with CF under the age of 12 years. Serum laboratory parameters, growth indices, pancreatic status, CFTR genetics, medications, microbiology, and presence of CF-related comorbidities were collected for patients who had fat-soluble vitamin levels measured between January 1, 2009 and December 31, 2011. Vitamin D deficiency was defined as a serum 25(OH)D less than 20 ng/ml and insufficiency as serum 25(OH)D 20 to 29.9 ng/ml. Associations between serum vitamin D concentration and clinical/inflammatory markers were assessed using Chi-square and t tests.

Measurements and main results: Data were collected for 148 children. The mean serum 25(OH)D concentration was 32.4 ng/ml (SD, 8.9). Seven percent (10 of 148) were vitamin D deficient, and 36% (53 of 148) were vitamin D insufficient. Among the pancreatic-sufficient patients, 50% (14 of 28) were vitamin D insufficient/deficient, whereas among pancreatic-insufficient patients, 41% (49 of 120) were vitamin D insufficient/deficient. Pseudomonas aeruginosa was a more common pathogen in the patients who were vitamin D insufficient/deficient (18 of 63 vs. 11 of 85, P = 0.018). There was no difference between vitamin D-sufficient versus -insufficient groups in terms of other bacterial colonization or inflammatory markers.

Conclusions: Overall, vitamin D insufficiency is common among young children with CF. Vitamin D insufficiency is prevalent even in children who are pancreatic sufficient. In this population, vitamin D insufficiency is associated with a history of Pseudomonas colonization but not with classic markers of systemic inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • C-Reactive Protein / immunology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cystic Fibrosis / epidemiology*
  • Cystic Fibrosis / immunology
  • Exocrine Pancreatic Insufficiency / epidemiology*
  • Female
  • Humans
  • Immunoglobulin E / immunology
  • Immunoglobulin G / immunology
  • Infant
  • Inflammation / immunology
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Prevalence
  • Pseudomonas Infections / epidemiology*
  • Pseudomonas aeruginosa*
  • Respiratory Tract Infections / epidemiology*
  • Retrospective Studies
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / epidemiology*


  • Immunoglobulin G
  • Vitamin D
  • Immunoglobulin E
  • C-Reactive Protein
  • 25-hydroxyvitamin D