title: Fat-soluble vitamins in cystic fibrosis and pancreatic insufficiency: efficacy of a nutrition intervention.
abstract: OBJECTIVE
  The aim of the study was to assess the impact of LYM-X-SORB (LXS), an organized lipid matrix that has been shown to be absorbable without pancreatic enzyme therapy on fat-soluble vitamin status in children with cystic fibrosis (CF) and pancreatic insufficiency (PI).
  
  
  METHODS
  Children with CF and PI were randomized to daily LXS or an isocaloric placebo comparison supplement for 12 months. Serum vitamins A (retinol), D (25-hydroxyvitamin D[25D]), E (α-tocopherol, α-tocopherol:cholesterol ratio), and K (percentage of undercarboxylated osteocalcin [%ucOC] and plasma proteins induced by vitamin K absence factor II [PIVKA II]) were assessed at baseline and 12 months. Dietary intake was determined using 3-day weighed food records and supplemental vitamin intake by a comprehensive questionnaire.
  
  
  RESULTS
  A total of 58 subjects (32 boys, age 10.3 ± 2.9 years [mean ± standard deviation]) with complete serum vitamin, dietary and supplemental vitamin data were analyzed. After adjusting for dietary and supplemental vitamin intake, serum retinol increased 3.0 ± 1.4 μg/dL (coefficient ± standard error) (adjusted R2 = 0.02, P = 0.03) and vitamin K status improved as demonstrated by a decreased percentage of undercarboxylated osteocalcin of -6.0% ± 1.6% by 12 months (adjusted R2 = 0.15, P < 0.001). These changes occurred in both the LXS and placebo comparison groups. No changes in serum 25D or α-tocopherol were detected. Both nutrition interventions increased caloric intake a mean of 83 ± 666 kcal/day by 12 months.
  
  
  CONCLUSIONS
  Vitamins A and K status improved, whereas vitamins D and E status was unchanged during 12 months of LXS and isocaloric placebo comparison supplement in children with CF and PI.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bertolaso
authors.forename: Veronique
authors.initials: V
authors.lastname: Groleau
authors.forename: Joan I
authors.initials: JI
authors.lastname: Schall
authors.forename: Asim
authors.initials: A
authors.lastname: Maqbool
authors.forename: Maria
authors.initials: M
authors.lastname: Mascarenhas
authors.forename: Norma E
authors.initials: NE
authors.lastname: Latham
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Dougherty
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Stallings
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015930:Diet Records; D019587:Dietary Supplements; D010188:Exocrine Pancreatic Insufficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008055:Lipids / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014812:Vitamin K / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D008055:Lipids; D014801:Vitamin A; D014812:Vitamin K; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D024502:alpha-Tocopherol