236 Vitamin status in infants with cystic fibrosis during the first year of life

Abstract

Objectives Nutritional guidelines for cystic fibrosis recommend vitamin supplements [1]. Newborn screening has resulted in better nutrition at diagnosis. We assessed vitamin A, D, E status in the first year of life and vitamin supplements. Methods We identified 55 newborn infants with CF at our regional CF centre, over a 3 year period (2011–13). Vitamin A, D, E levels were measured at 3 & 12 months, according to local guidelines. We examined the association between vitamin levels and pancreatic status, vitamin supplements, meconium ileus, milk formulation, nutrition status. TableSerum vitamin levelsSerum levelNumber (%) of subjectsVit A (0.7–1.5 mmol/L)Vit D (50/75–150 nmol/L)Vit E (12–24 mmol/L)3 mo (n = 35)12 mo (n = 35)3 mo (n = 35)12 mo (n = 35)3 mo (n = 34)12 mo (n = 35)Low1 (2.8%)1 (2.8%)3 (8.6%)9 (25.7%)2 (5.9%)3 (8.6%)Normal31 (88.6%)22 (62.9%)32 (91.4%)26 (74.3%)7 (20.6%)16 (45.7%)High3 (8.6%)12 (34.3%)0025 (73.5%)16 (45.7%) Results See the table. Vitamins were commenced by age 1 month in pancreatic insufficient infants. There was no relationship between vitamin status and bowel resection, milk formulation and nutrition status. Vitamin A supplementation was appropriate at 3 months, but by 12 months, a third of infants had high levels. Vitamin D status was normal at 3 months, but by 12 months a quarter of infants were deficient. Vitamin E levels were high in most infants at 3 months, and by 12 months, high vitamin E levels correlated with the amount of supplements. Conclusion Our audit of vitamin assays during the first year of life in CF infants indicates the need to review our guidelines, particularly to achieve adequate vitamin D status and avoid excess vitamin E levels.