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Fat-soluble vitamin deficiency in children and adolescents with cystic fibrosis
  1. Malay Rana1,2,
  2. Denise Wong-See3,
  3. Tamarah Katz4,
  4. Kevin Gaskin5,
  5. Bruce Whitehead6,
  6. Adam Jaffe7,8,
  7. John Coakley9,
  8. Alistair Lochhead1
  1. 1Southern IML Pathology, Wollongong, New South Wales, Australia
  2. 2Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  3. 3Department of Nutrition and Dietetics, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
  4. 4Department of Nutrition and Dietetics, Sydney Children's Hospital, Sydney, New South Wales, Australia
  5. 5Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  6. 6Department of Paediatric Respiratory and Sleep Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
  7. 7Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
  8. 8School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
  9. 9Department of Clinical Biochemistry, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  1. Correspondence to Dr Malay Rana, Southern IML Pathology, 45 Denison St Wollongong, NSW 2500, Australia; Malay.Rana{at}southernpath.com.au

Abstract

Aims Determine the prevalence of fat-soluble vitamin deficiency in children with cystic fibrosis (CF) aged ≤18 years in New South Wales (NSW), Australia, from 2007 to 2010.

Methods A retrospective analysis of fat-soluble vitamin levels in children aged ≤18 years who lived in NSW and attended any of the three paediatric CF centres from 2007 to 2010. An audit of demographic and clinical data during the first vitamin level measurement of the study period was performed.

Results Deficiency of one or more fat-soluble vitamins was present in 240/530 children (45%) on their first vitamin level test in the study period. The prevalence of vitamins D and E deficiency fell from 22.11% in 2007 to 15.54% in 2010, and 20.22% to 13.89%, respectively. The prevalence of vitamin A deficiency increased from 11.17% to 13.13%. Low vitamin K was present in 29% in 2007, and prevalence of prolonged prothrombin time increased from 19.21% to 22.62%. Fat-soluble vitamin deficiency is present in 10%–35% of children with pancreatic insufficiency, but only a very small proportion of children who are pancreatic-sufficient.

Conclusions This is one of few studies of fat-soluble vitamin deficiency in children with CF in Australia. Fat-soluble vitamin testing is essential to identify deficiency in pancreatic-insufficient children who may be non-compliant to supplementation or require a higher supplement dose, and pancreatic-sufficient children who may be progressing to insufficiency. Testing of vitamin K-dependent factors needs consideration. Further studies are needed to monitor rates of vitamin deficiency in the CF community.

  • VITAMIN D
  • CHEMICAL PATHOLOGY
  • BIOCHEMISTRY
  • AIRWAYS DISEASE
  • PAEDIATRIC CHEMISTRY

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