Detalhes bibliográficos
Ano de defesa: |
2021 |
Autor(a) principal: |
Ongaratto, Renata
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Orientador(a): |
Pinto, Leonardo Araújo
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Banca de defesa: |
Não Informado pela instituição |
Tipo de documento: |
Tese
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Tipo de acesso: |
Acesso aberto |
Idioma: |
por |
Instituição de defesa: |
Pontifícia Universidade Católica do Rio Grande do Sul
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Programa de Pós-Graduação: |
Programa de Pós-Graduação em Medicina/Pediatria e Saúde da Criança
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Departamento: |
Escola de Medicina
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País: |
Brasil
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Palavras-chave em Português: |
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Palavras-chave em Inglês: |
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Área do conhecimento CNPq: |
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Link de acesso: |
http://tede2.pucrs.br/tede2/handle/tede/9934
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Resumo: |
Background: Pulmonary exacerbations are associated with a worse evolution of cystic fibrosis (CF) and their control is of great importance in the treatment of disease. Extra skeletal properties of vitamin D have been pointed out, but the effect of its supplementation on markers of CF-related pulmonary disease is unclear. Methods: A randomized crossover trial conducted at a CF center in southern Brazil was used to evaluate the effect of an extra-dose supplementation regimen of vitamin D (5,000 IU/day <5 years and 10,000 IU/day ≥5 years) on pulmonary exacerbations in CF patients. Subjects were randomly allocated to receive vitamin D followed by standard treatment, or standard treatment followed by vitamin D for three months. Each treatment period was separated by a 9-month washout. The primary outcome was the number of pulmonary exacerbations during the intervention period. Additionally, a period of six months after the use of the extra dose of vitamin D was evaluated. The change in serum concentration of 25(OH)D after the end of supplementation was evaluated as a secondary outcome. Results: Thirty-four patients participated in the study (median age 5.16 years). Sixteen patients received vitamin D first, and 18 received standard treatment first. There was a borderline statistical difference (p=0.10) in pulmonary exacerbations during the use of the extra dose of vitamin D. No effect of vitamin D on pulmonary exacerbations was observed in a period of six months after the end of supplementation. More than half of the patients had suboptimal levels of 25(OH)D pre-supplementation, and only 58% achieved desirable vitamin levels. Conclusion: Our findings indicate a possible effect of vitamin D in reducing CF pulmonary exacerbations and reinforce the high prevalence of hypovitaminosis D in these patients, despite routine vitamin supplementation. Large studies, multicenter studies and/or metanalyses are necessary. Brazilian Clinical Trials Registry (ReBEC): RBR-439vzm |