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Vitamin D deficiency as a risk factor for cystic fibrosis-related diabetes in the Scandinavian Cystic Fibrosis Nutritional Study
Stockholm CF Centre, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Stockholm CF Centre, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
National Centre for Cystic Fibrosis, University Hospital Ullevaal, Oslo, Norway.
Cystic Fibrosis Centre, Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
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2011 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 54, no 12, 3007-3015 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2011. Vol. 54, no 12, 3007-3015 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-164837DOI: 10.1007/s00125-011-2287-1ISI: 000297740000006PubMedID: 21901282OAI: oai:DiVA.org:uu-164837DiVA: diva2:470411
Available from: 2011-12-29 Created: 2011-12-29 Last updated: 2012-03-12Bibliographically approved

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Hollsing, Annika
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