All ETDs from UAB

Advisory Committee Chair

Nancy Wooldridge

Advisory Committee Members

Amanda Brown

Wyn Hoover

David T Redden

Document Type

Thesis

Date of Award

2011

Degree Name by School

Master of Science (MS) School of Health Professions

Abstract

COMPARISON OF VITAMIN D SUPPLEMENTATION REGIMENS IN PEDIATRIC PATIENTS WITH CYSTIC FIBROSIS JULIANNA BAILEY CLINICAL NUTRITION ABSTRACT The objective of this randomized prospective study was to determine the most efficacious form of vitamin D supplementation for pediatric patients with Cystic Fibrosis (CF). We hypothesized that 50,000 IU monthly cholecalciferol would be as effective in raising serum 25-hyrdroxyvitamin D [25(OH)D] concentrations as routine daily supplementation of 1000-2000 IU cholecalciferol in pediatric patients with CF, birth to 20 years of age, over a period of 3 months. Data collected at baseline included serum 25(OH)D concentration, gender, genotype, race, age, FEV1, height, weight, BMI, previous vitamin D supplementation, sunlight exposure, and vitamin D intake from food and beverage, oral nutritional supplements, and CF fat soluble vitamins. A survey that included a food frequency questionnaire and questions on time spent in the sunlight during the weekdays and weekends was used to obtain data on vitamin D intake and sunlight exposure. Three month follow-up data collected included serum 25(OH)D concentration, FEV1, height, weight, BMI, and calcium creatinine ratio. Thirty-four participants were enrolled, and age ranged from four to 20 years of age. Twenty-nine participants were Caucasian (85%), two were African American (6%), two were Hispanic (6%), and one was classified other (3%). The mean serum 25(OH)D was 23.5 ± 4.6 ng/mL at baseline. Six participants (38%) in group A and six participants in group B (33.3%) achieved vitamin D sufficiency, considered serum 25(OH)D levels of ≥ 30 ng/mL. However, t-tests revealed no significant difference between the treatment groups regarding serum 25(OH)D at three months. A significant increase in serum 25(OH)D was observed for the sample as a whole, including both groups (p-value = 0.0004). No significant trends were observed for BMI status or FEV1 over the course of the treatment period. Calcium creatinine ratio was not significantly different between groups and the mean ratio for both groups was within normal limits. These results suggest that treatments were equivalent. However, both methods were minimally effective in correcting vitamin D insufficiency, with only 35% of participants achieving sufficient 25(OH)D concentrations. Future research should be conducted using higher dosages of cholecalciferol to determine the best vitamin D supplementation method for pediatric patients with CF and vitamin D insufficiency.

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