Vitamin D deficiency is associated with pulmonary exacerbations in children with cystic fibrosis.

RATIONALE: Recent literature suggests vitamin D has an effect on lung function and on the lung's ability to fight infection, both important in the cystic fibrosis (CF) population as predictors of morbidity and mortality. OBJECTIVES: Our study assessed associations between vitamin D and % predicted lung function, pulmonary exacerbations, and first Pseudomonas aeruginosa infection in children with CF. We hypothesized that children with CF who have 25-hydroxy vitamin D (25-OHD) levels less than 30 µg/L would have lower % predicted lung function and more pulmonary exacerbations than those with 25-OHD greater than or equal to 30 µg/L. METHODS: This retrospective longitudinal study of 130 children aged 6 to 18 years between 2000 and 2012 examined 25-OHD levels classed in three vitamin D groups: sufficient (≥30 µg/L), insufficient (20-29 µg/L), and deficient (<20 µg/L). Longitudinal models followed individuals' changing vitamin D groups over time to compare numbers of pulmonary exacerbations (defined by hospitalization), incidence of first P. aeruginosa infection, and % predicted lung function. Cross-sectional comparisons between vitamin D groups were performed at ages 8, 12, and 16 years. MEASUREMENTS AND MAIN RESULTS: The prevalence of vitamin D deficiency and insufficiency increased slowly through adolescence. The rate of exacerbations for the deficient vitamin D group, aged 15 to 18 years, was 13.1 per 10 patient-years, significantly higher than 4.3 per 10 patient-years for the insufficient and sufficient vitamin D groups (P < 0.05), which were not significantly different There were no differences between vitamin D groups in pulmonary function or incidence of first P. aeruginosa infection, which was about 2 per 10 patient-years. CONCLUSIONS: Higher 25-OHD levels in children with CF were associated with lower rates of pulmonary exacerbations and, in adolescents, higher FEV1.

Overweight among high school children: how does Wisconsin rank?

BACKGROUND: The rate of childhood overweight is increasing among our nation's youth. This epidemic has led to an increase of comorbidities such as high blood pressure and diabetes being treated in the pediatric population. This paper analyzes self-reported heights and weights to determine trends in the prevalence of overweight among US students in grades 9-12. METHODS: Data from the Youth Risk Behavior Surveillance System from 1999 to 2003 were used to determine the prevalence of overweight--which is defined as a BMI < 85th percentile for age and gender--in 41 participating states. (Data from the "at risk of overweight" group [defined as BMI > or = 85 percentile and < 95 percentile] and the "overweight" group [defined as BMI > or = 95 percentile] were combined and labeled as "overweight" [BMI > or = 85 percentile] to make communication of results more clear.) RESULTS: The prevalence of overweight adolescents in Wisconsin increased slightly during the past 4 years, from 22.6% in 1999 to 24.1% in 2003, with adolescent males 50% more likely than females to be overweight. In 2003, Wisconsin's rate of overweight was the 14th lowest among 41 states reporting to the Centers for Disease Control and Prevention. (Colorado is lowest at 15.7% and Mississippi is highest at 31.4%.) When examining races separately, Wisconsin's ranking decreases slightly, but remains in the top half of all states reporting. CONCLUSIONS: The prevalence of childhood overweight in Wisconsin appears to be rising, following the national trend. The prevalence of overweight among high school students is lowest in the Rocky Mountain states. Understanding reasons for these differences may shed light on strategies to decrease overweight in Wisconsin.