***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The aim of this study was to assess the efficacy , tolerability and safety of risedronate in adults with CF . METHODS Patients with a lumbar spine ( LS ) , total hip ( TH ) or femoral neck ( FN ) bone mineral density ( BMD ) Z-score of -1 or less were r and omised to receive risedronate 35 mg weekly or placebo , and calcium (1g)+vitamin D(3 ) ( 800IU ) . RESULTS At baseline , BMD Z-scores in the risedronate ( n=17 ) and placebo ( n=19 ) groups were similar . By 24 months , 7/17 risedronate patients vs 0/19 placebo patients stopped the study medication due to bone pain . After 24 months treatment , the mean difference ( 95 % CI ) in change in LS , TH and FN BMD between the risedronate vs placebo groups was 4.3 % ( 0.4 , 8.2 ) p=0.03 ; 4.0 % ( -0.5 , 8.6 ) p=0.08 ; and 2.4 % ( -3.5 , 8.2 ) p=0.41 . CONCLUSIONS After two years treatment there was a significant increase in LS BMD with weekly risedronate compared to placebo Background : Vitamin D insufficiency is common in cystic fibrosis ( CF ) and vitamin D repletion may have an important role in improving clinical outcomes in CF . This r and omized , placebo-controlled , pilot study examined the feasibility and impact of a single , large dose of cholecalciferol on vitamin D status and clinical outcomes in subjects with CF . Methods : Thirty adults with were r and omized in a double-blinded , pilot study to receive 250,000 IU cholecalciferol or placebo within 48 h of hospital admission for a pulmonary exacerbation .  Concentrations of 25-hydroxyvitamin D ( 25(OH)D ) , clinical outcomes and potential adverse events were assessed up to one year after r and omization . Mixed effects linear regression models were used to evaluate the difference in mean serum concentrations and log-rank analyses were used to evaluate survival . Results : Data from all subjects was analyzed . Serum 25(OH)D concentrations increased from a mean of 30.6 ± 3.2 ng/mL to 58.1 ± 3.5 ng/mL ( p < 0.001 ) at one week and 36.7 ± 2.6 ng/mL by 12 weeks ( p = 0.06 ) in the vitamin D group ; in contrast , serum 25(OH)D concentrations remained unchanged in the placebo group . Unadjusted , one-year survival and hospital-free days were increased in the vitamin D group ( p = 0.029 , p = 0.036 ; respectively ) . There was also a trend toward increased IV antibiotic therapy-free days in the vitamin D group ( p = 0.073 ) . There were no signs of hypervitaminosis D or adverse events . Serum PTH and calcium concentrations were similar across both groups . Conclusions : In this pilot study , a single , oral bolus of cholecalciferol  increased serum 25(OH)D concentrations and was associated with a trend toward improved clinical outcomes in CF subjects hospitalized for a pulmonary exacerbation . Further investigation is needed into the clinical impact of improved vitamin D status in patients with CF Background / Objectives : The hallmark of cystic fibrosis ( CF ) is chronic lung inflammation . The severity of lung disease is closely correlated with immunoglobulin G ( IgG ) levels . Beyond its contribution to the bone health , the importance of vitamin D has not been fully recognized owing to the lack of human studies providing evidence of its benefit . In the context of the recently described immunomodulatory functions of vitamin D , we aim ed to assess the relationship between vitamin D and IgG levels . Subjects/ Methods : Eight hundred and ninety-six CF patients were included ( 0.53–65.9 years ) from seven centers in Denmark , Norway and Sweden . Serum 25-hydroxyvitamin D ( 25OHD ) and total IgG were measured , spirometry was carried out and vitamin D intake data were gathered using a 7-day dietary food record . Multiple linear regression analyses were performed for IgG and forced expiratory volume in 1λs ( FEV1 ) as dependent variables , and serum 25OHD , daily food and supplemented vitamin D sources of intake as independent variables . The model was controlled for age , gender , genotype , CF-related diabetes , season , infection/colonization status , long-term oral corticosteroid treatment , long-term treatment with macrolide antibiotics , pancreatic insufficient phenotype and body mass index z-score . Results : Serum total IgG levels were negatively associated with serum 25OHD ( adjusted R 2=0.376 ; beta=−0.02 ; P<0.001 ) , supplemented vitamin D intake per kg bodyweight ( adjusted R 2=0.375 ; beta=−0.82 ; P<0.001 ) and total vitamin D intake per kg bodyweight ( adjusted R 2=0.398 ; beta=−0.60 ; P=0.002 ) . Serum 25OHD was positively associated with FEV1 ( adjusted R 2=0.308 ; beta=0.0007 ; P=0.025 ) . Conclusions : Increasing vitamin D intake may positively modulate inflammation in CF . This study supports the proposed role of vitamin D in the immune system during infection and substantiates prospect i ve studies ABSTRACT Objective : To examine the association between 25-hydroxyvitamin D ( 25[OH]D ) levels and the risk of multiple sclerosis ( MS ) in blood sample s collected prospect ively and during gestation . Methods : In this nested case-control study , 2 population -based biobanks with 291,500 sample s from 164,000 persons collected since 1975 in the northern half of Sweden were used . We identified  prospect ively collected blood sample s from MS cases ( n = 192 , controls matched 2:1 ) and gestational sample s from pregnant mothers where the offspring had later developed MS ( n = 37 , control mothers matched 5:1 ) .  25(OH)D levels were measured using an ELISA , and the risk of MS was analyzed using matched logistic regression . Results : Levels of 25(OH)D ≥75 ( vs < 75 ) nmol/L in prospect ively collected blood sample s were associated with a decreased risk of MS ( odds ratio [ OR ] 0.39 , 95 % confidence interval [ CI ] 0.16–0.98 ) . No decrease in MS risk was found in the offspring exposed to gestational 25(OH)D levels ≥75 ( vs < 75 ) nmol/L ( OR 1.8 , 95 % CI 0.53–5.8 ) . The prevalence of 25(OH)D levels ≥75 nmol/L in female controls decreased gradually during 1976–2005 ( p trend = 0.005 ) . Conclusion : This study supports the presence of an association between high 25(OH)D levels during the years preceding disease onset and a decreased risk of MS . In the very limited material with sample s drawn in early pregnancy , where month-of-birth effects were controlled for , we found no association between gestational 25(OH)D levels and MS risk in the offspring . Decreasing 25(OH)D levels in the population may contribute to explain the increasing MS incidence that is suggested from epidemiologic studies BACKGROUND Osteoporosis is a common complication of cystic fibrosis . OBJECTIVE To determine the prevalence of osteopenia and osteoporosis in adults with cystic fibrosis and to look for factors associated with low bone mineral density ( BMD ) values . METHODS During this prospect i ve 2-year study , we collected clinical data ( history , body mass index , and treatments ) and laboratory data ( nutritional and hormonal status , markers for inflammation and bone turnover , and calcium and phosphate levels ) . Lung function tests and a 6-meter walking test were performed .  BMD was measured at the spine , total hip , and femoral neck . RESULTS We included 55 patients ( 31 women ) with a mean age of 31.9 years ; 14 were homozygous and 25 heterozygous for the deltaF508 mutation and 20 ( 36 % ) had a history of fractures .  BMD values indicated osteopenia in 32 ( 58.2 % ) patients and osteoporosis in 11 ( 20 % ) patients at one or more measurement sites . At all three sites , BMD values correlated with the body mass index , forced vital capacity as % predicted , and forced expiratory volume in 1 s as % predicted ; at the femoral neck and total hip , BMD values correlated with the 6-meter walking test result and grip strength . CONCLUSION BMD was low in 78.2 % of adults with cystic fibrosis . Three factors reflecting lung disease severity were associated with low BMD values , namely , respiratory function , physical function ( walking test and grip strength ) , and nutritional status Aims /hypothesisMany cystic fibrosis patients are vitamin D-insufficient . Cystic fibrosis-related diabetes is a major complication of cystic fibrosis . The literature suggests that vitamin D might possess certain glucose-lowering properties . We aim ed to assess the relationship between vitamin D and cystic fibrosis-related glucose intolerance . Methods We enrolled 898 cystic fibrosis patients from Sweden , Norway and Denmark .  Vitamin D intake was assessed using a seven-day food record .  Serum 25-hydroxyvitamin D ( s25OHD ) and HbA1c were measured , and an OGTT was carried out . Multiple linear and logistic regressions were used for HbA1c and cystic fibrosis-related diabetes/OGTT result as outcome variables , respectively . Each model was controlled for country , and for known cystic fibrosis-related diabetes risk factors : age , sex , genotype , liver dysfunction , long-term corticosteroid treatment , and lung and pancreatic function . Results Degree of vitamin D insufficiency ( OR 1.36 ; p = 0.032 ) and s25OHD < 30 nmol/l ( OR 1.79 ; p = 0.042 ) were significant risk factors for cystic fibrosis-related diabetes . Accordingly , HbA1c value was positively associated with s25OHD < 30 nmol/l and < 50 nmol/l , as well as with degree of vitamin D insufficiency ( adjusted R2 = 20.5 % and p < 0.05 in all ) . In subgroup analyses , s25OHD < 30 nmol/l determined the HbA1c value in paediatric patients ( adjusted R2 = 20.2 % ; p = 0.017 ) , but not in adults . Conclusions /interpretationVitamin D status is associated with HbA1c and diabetes in cystic fibrosis , particularly in children . The study justifies prospect i ve studies on the proposed role of vitamin D deficiency in the pathophysiology of diabetes mellitus Patients with cystic fibrosis ( CF ) suffer from chronic lung infection and inflammation leading to respiratory failure . Vitamin D deficiency is common in patients with CF , and correction of vitamin D deficiency may improve innate immunity and reduce inflammation in patients with CF . We conducted a double-blinded , placebo-controlled , r and omized clinical trial of high-dose vitamin D to assess the impact of vitamin D therapy on antimicrobial peptide concentrations and markers of inflammation . We r and omized 30 adults with CF hospitalized with a pulmonary exacerbation to 250 000 IU of cholecalciferol or placebo  , and evaluated changes in plasma concentrations of inflammatory markers and the antimicrobial peptide LL-37 at baseline and 12 weeks post intervention . In the vitamin D group , there was a 50.4 % reduction in tumor necrosis factor-α ( TNF-α ) at 12 weeks ( P<0.01 ) , and there was a trend for a 64.5 % reduction in interleukin-6 ( IL-6 ) ( P=0.09 ) . There were no significant changes in IL-1β , IL-8 , IL-10 , IL-18BP and NGAL ( neutrophil gelatinase-associated lipocalin ) . We conclude that a large bolus dose of vitamin D is associated with reductions in two inflammatory cytokines , IL-6 and TNF-α . This study supports the concept that vitamin D may help regulate inflammation in CF , and that further research is needed to eluci date the potential mechanisms involved and the impact on clinical outcomes UNLABELLED We assessed the role of low aBMD and impaired architecture-assessed by an HR-pQCT system-in a case-control study of postmenopausal women with fractures . Vertebral and nonvertebral fractures are associated with low volumetric BMD and architectural alterations of trabecular and cortical bone , independent of aBMD assessed by DXA . INTRODUCTION Alterations of bone architecture and low BMD both contribute to ske 
    Output:
    
A systematic review based on meta-analyses reports that oral and intravenous bisphosphonates both improve bone mineral density in CF patients , but no data are available concerning the reduction of low-trauma fractures .