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Posted on 06.24.02

Vitamin D and Calcium in Children with Cystic Fibrosis
By Starr L. Nicely, BS, Sue Tolleson-Rinehart, PhD, and David A. Ontjes MD

Cystic fibrosis (CF) is a metabolic disorder that occurs at birth. One effect of CF is that vitamin D is absorbed poorly. Because vitamin D is needed to absorb calcium from the diet, children with CF often have low levels of calcium and, occasionally, reduced bone mineral density. Low bone mineral density in turn can lead to a condition called osteoporosis, in which weakened and fragile bones are easily broken.

UNC CERTs investigator Dr. David A. Ontjes studied the effect of taking vitamin D on the amount of calcium the body takes in. Dr. Ontjes gave calcium and calcitriol, a vitamin D supplement, to a group of children with CF. At the same time, he gave calcium and a sugar pill to another group of children with CF.

The children who took calcitriol absorbed more calcium from a test meal than did the children receiving the sugar pills. They also retained calcium in their bones better over the short term. These results suggest that calcitriol does indeed help patients with CF take in and use calcium. The investigators now are examining the longer-term effects of calcitriol on bone density in children with CF.

Dr. Ontjes's project has shown that taking a very simple step—just giving vitamin D supplements to children with CF at an earlier age—can prevent the serious and common problem of low bone density. Many doctors are not aware that giving children with CF vitamin D is a good way to prevent low bone density, and ultimately osteoporosis, in this group.

"New labeling for the use of vitamin D, and new programs that teach doctors about this simple treatment, may lead to earlier use of Vitamin D in CF patients," Dr. Ontjes said.

This work shows that a very simple and low-cost treatment can improve the health outcomes, and the future health, of children with CF.

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