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Wood, Phoebe, Illingworth, Sarah and Dunnage, Megan (2025) The effect of vitamin D status on markers of inflammation and lung function in adults with cystic fibrosis. Clinical Nutrition ESPEN, 68. p. 873. ISSN 2405-4577
Background:
People with cystic fibrosis (pwCF) are at a higher risk of vitamin D deficiency when compared with the general population. This has been linked to decreased lung function and dysregulation of inflammation; but research shows mixed results for improved clinical benefits for inflammation within vitamin D-sufficient pwCF (1,2).
Aims:
The primary aim was to investigate the link between vitamin D status and markers of inflammation and lung function in pwCF. The secondary aim was to determine if vitamin D sufficiency was protective against respiratory multi-resistant micro-organisms infections (MRRI).
Methods: Ethical approval was granted by London Metropolitan University for this retrospective observational study of adult pwCF under St Bartholomew's Hospital. Data regarding nutritional status, vitamin D status, lung function, inflammatory markers and presence of MRRI were gathered. 198 out of 258 participants were included. A Spearman's Rank-Order assessed the relationship between 25-hydroxyvitamin D (25(OH)D), FEV1%, c-reactive protein (CRP) and white cell count (WCC). A Fisher’s exact test was carried out in patients with or without ≥3 colonisations and their vitamin D status.
Results:
A sub-group analysis showed correlation between vitamin D status and CRP status (rs= -0.143, p=0.04). Mean vitamin D level was highest when WCC was within range (4-11x109/L) and lowest when below range (<4-11x109/L) (69.4 nmol/L vs 59.2 nmol/L). No association was observed between vitamin D status and FEV1% or WCC. No significance was observed between patients with or without ≥3 MRRI (p = 0.05), however those with ≥3 MRRI were disproportionately affected by vitamin D deficiency than those without.
Conclusions:
There was a significant negative correlation with vitamin D status and CRP, however a causal relationship cannot be made due to the observational methods in this study. There could be benefits to managing chronic inflammation seen in pwCF by continuing to aim for a 25(OH)D concentration >75 nmol/L (3).
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