Effect of an antioxidant-rich multivitamin supplement in cystic fibrosis

Background: Despite supplementation with standard multivitamins and pancreatic enzymes, deficiencies of vitamins D and K and antioxidants are common in cystic fibrosis (CF). Methods: In this non-randomized, open-label study, AquADEKs (R) softgels were given daily over 12 weeks to 14 CF subjects (mean age 15 years, range 10-23) without a preceding wash-out period. Both pancreatic sufficient and insufficient subjects were enrolled. Plasma vitamin and antioxidant levels, urine 8-isoprostane levels, anthropometric measures, and pulmonary function were determined at baseline, 6 and 12 weeks. Results: Daily supplementation significantly increased plasma beta(beta)-carotene, coenzyme Q10, and gamma-tocopherol concentrations, decreased proteins induced in vitamin K absence (PIVKA-II) levels, but did not normalize vitamin D and K status in all subjects. Vitamin A levels did not exceed the normal range for any subject during the entire study period. Modest improvements in weight percentile and pulmonary function were observed. Change in plasma beta-carotene concentrations weakly correlated with changes in weight and body mass index percentiles. Conclusions: In this study, AquADEKs (R) increased systemic antioxidant levels, while maintaining vitamin A levels in the normal range, and improved but did not completely normalize vitamin D and K status. Increased beta-carotene levels were associated with improved growth parameters. These results warrant further clinical evaluation in CF. (C) 2010 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.