title: Relationship Between Fat-Soluble Vitamin Supplementation and Blood Concentrations in Adolescent and Adult Patients With Cystic Fibrosis.
abstract: Background: Pancreatic insufficiency is common in patients with cystic fibrosis (CF) and leads to malabsorption of fat-soluble vitamins. Multivitamins, including vitamins A, D, E, and K, are routinely prescribed to patients with CF to prevent vitamin deficiencies. Our objective was to examine the relationship between fat-soluble vitamin supplements and their impact on blood concentrations. Methods: This was a retrospective chart review of patients with CF who were treated at Emory Clinic and Emory University Hospital during 2008-2012. The amount of fat-soluble vitamin supplementation, serum markers of fat-soluble vitamin concentrations, CF transmembrane conductance regulator genotype, and other demographic information were recorded from electronic medical records. Mixed-effects models were used to investigate the trends over time of fat-soluble vitamin supplements and serum vitamin concentrations. Results: In total, 177 charts were eligible. Mean (SD) age was 26.1 (10.2) years. Ninety-two percent of patients had pancreatic insufficiency and 52% had the homozygous ΔF508 mutation. Recorded fat-soluble vitamin supplementation increased in the past 5 years (P < .001 for all). Serum 25-hydroxyvitamin D increased slightly (3% increase; P < .01); however, there were no changes in the blood concentrations of vitamins A, E, and K (P = .26-.96). Conclusions: Despite a near doubling of recorded fat-soluble vitamin supplementation over the past 5 years, there was no parallel increase in blood concentrations of these vitamins. Potential reasons include suboptimal dosages, low adherence, or ongoing issues with malabsorption.
authors.affiliation: Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Samitivej Srinakarin Hospital, Bangkok Hospital Group, Bangkok, Thailand.
authors.forename: Oranan
authors.initials: O
authors.lastname: Siwamogsatham
authors.affiliation: Department of Epidemiology, Emory University School of Public Health, Atlanta, Georgia.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: Department of Biostatistics and Bioinformatics, Emory University School of Public Health, Atlanta, Georgia.
authors.forename: Jose N
authors.initials: JN
authors.lastname: Binongo
authors.affiliation: Department of Epidemiology, James T. Laney School of Graduate Studies, Emory University, Atlanta, Georgia Department of Surgery, Emory at Grady Hospital Systems, Atlanta, Georgia.
authors.forename: Ritam
authors.initials: R
authors.lastname: Chowdhury
authors.affiliation: Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Alvarez
authors.affiliation: Department of Environmental Health, Emory University School of Public Health, Atlanta, Georgia.
authors.forename: Shawna J
authors.initials: SJ
authors.lastname: Feinman
authors.affiliation: Emory Adult Cystic Fibrosis Program, Emory Healthcare, Atlanta, Georgia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Enders
authors.affiliation: Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Emory Adult Cystic Fibrosis Program, Emory Healthcare, Atlanta, Georgia Section of Endocrinology, Atlanta VA Medical Center, Decatur, Georgia vin.tangpricha@emory.edu.
authors.forename: Vin
authors.initials: V
authors.lastname: Tangpricha
keywords: avitaminosis; cystic fibrosis; vitamin A; vitamin D; vitamin E; vitamin K
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