Monitoring of Vitamin D Levels in Patients with Cystic Fibrosis in Republic of Macedonia

Vitamin D is necessary for maintaining the bone health, but vitamin D deficiency is being recognized in patients with CF. Aim: To assess the plasmatic levels of 25OHD in patients with CF who regular visit the CF center at the University Pediatric Clinic in Skopje, Macedonia despite the daily supplementation of 1000 IU vitamin D and to measure the effectiveness of higher dose oral vitamin D supplementation(2000 IE).

Methods: Serum concentrations of 25OHD were measured in 80 CF patients from CF center at the University Pediatric Clinic in Skopje, R.Macedonia. 25OHD levels were determined by RIA method. The measurements were held both before changing vitamin D dosage and after at least one year of follow-up. CF patients used to receive 1000IU vitamin D daily. The protocol was revised to include 2000IU vitamin D daily dose.

Results: Vitamin D deficiency was observed at baseline in 26, 25% of CF patients, from them 85 % were pancreatic insufficient. The mean serum concentration of vitamin D at baseline was 22, 7 ng/ml compared to 25, 7 ng/ml at the end of follow-up (p<0, 1). There was no significant difference between the protocols in vitamin D levels. The number of CF patients with deficiency using 2000 IU decline on half, but still mean values remains low (10, 4ng/ml versus 10,9ng/ml).

Conclusion: Despite supplementation with recommended doses of vitamin D, the study confirms levels of 25OHD bellow 30ng/ml in many CF patients. Our conclusion is that these patients have need of higher doses of vitamin D per day and frequent monitoring of 25OHD levels.