Research Article
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Year 2022, , 471 - 477, 15.03.2022
https://doi.org/10.32322/jhsm.1050722

Abstract

References

  • Lopez A, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006; 27: 397-412.
  • Vestbo J, Edwards LD, Scanlon PD, et al. Changes in forced expiratory volume in 1 second over time in COPD. New Engl J Med 2011; 365: 1184-92.
  • Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. New Engl J Med 2010; 363: 1128-38.
  • Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187: 347-65.
  • Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet (London, England) 2007; 370: 765-73.
  • Janssens W, Bouillon R, Claes B, et al. Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Thorax 2010; 65: 215-20.
  • Persson LJP, Aanerud M, Hiemstra PS, Hardie JA, Bakke PS, Eagan TML. Chronic obstructive pulmonary disease is associated with low levels of vitamin D. PloS one 2012; 7.
  • Romme EA, Rutten EP, Smeenk FW, Spruit MA, Menheere PP, Wouters EF. Vitamin D status is associated with bone mineral density and functional exercise capacity in patients with chronic obstructive pulmonary disease. Ann Med 2013; 45: 91-6.
  • Zhu M, Wang T, Wang C, Ji Y. The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis. Int J Chron Obstructive Pulmonary Dis 2016; 11: 2597.
  • Janssens W, Mathieu C, Boonen S, Decramer M. Vitamin D deficiency and chronic obstructive pulmonary disease: a vicious circle. Vitamins Hormones 2011; 86: 379-99.
  • Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol 2008; 181: 7090-9.
  • Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006; 311: 1770-3.
  • Janssens W, Lehouck A, Carremans C, Bouillon R, Mathieu C, Decramer M. Vitamin D beyond bones in chronic obstructive pulmonary disease: time to act. Am J Respir Crit Care Med 2009; 179: 630-6.
  • Zasloff M. Fighting infections with vitamin D. Nature medicine 2006; 12: 388-90.
  • Kunisaki KM, Niewoehner DE, Connett JE. Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. Am J Respir Crit Care Med 2012; 185: 286-90.
  • Singh D, Agusti A, Anzueto A, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J 2019; 53.
  • Holick MF. Vitamin D deficiency. New Engl J Med 2007; 357: 266-81.
  • Ferrari R, Caram LM, Tanni SE, Godoy I, de Paiva SAR. The relationship between Vitamin D status and exacerbation in COPD patients–a literature review. Respir Med 2018; 139: 34-8.
  • Sanket S, Madireddi J, Stanley W, Sura P, Prabhu M. Relation between vitamin D deficiency and severity of chronic obstructive pulmonary disease-A case control study. JCDR 2016; 10: OC16.
  • Malinovschi A, Masoero M, Bellocchia M, et al. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. Respir Res 2014; 15: 131.
  • Mekov E, Slavova Y, Tsakova A, et al. Vitamin D deficiency and insufficiency in hospitalized COPD patients. PLoS One 2015; 10.
  • Quint JK, Donaldson GC, Wassef N, Hurst JR, Thomas M, Wedzicha JA. 25-hydroxyvitamin D deficiency, exacerbation frequency and human rhinovirus exacerbations in chronic obstructive pulmonary disease. BMC Pulmonary Med 2012; 12: 28.
  • Puhan MA, Siebeling L, Frei A, Zoller M, Bischoff-Ferrari H, Ter Riet G. No association of 25-hydroxyvitamin D with exacerbations in primary care patients with COPD. Chest 2014; 145: 37-43.
  • Martineau AR, James WY, Hooper RL, et al. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med 2015; 3: 120-30.
  • Persson LJ, Aanerud M, Hiemstra PS, et al. Vitamin D, vitamin D binding protein, and longitudinal outcomes in COPD. PloS one 2015; 10.
  • Wei R, Christakos S. Mechanisms underlying the regulation of innate and adaptive immunity by vitamin D. Nutrients 2015; 7: 8251-60.
  • Gombart AF. The vitamin D–antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 2009; 4: 1151-65.
  • Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients 2015; 7: 4240-70.
  • Donaldson GC, Wilkinson TM, Hurst JR, Perera WR, Wedzicha JA. Exacerbations and time spent outdoors in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005; 171: 446-52.
  • Donaldson G, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847-52.
  • Soler-Cataluna J, Martínez-García MÁ, Sánchez PR, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005; 60: 925-31.
  • Ginde AA, Mansbach JM, Camargo CA. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009; 169: 384-90.
  • Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest 2005; 128: 3792-8.
  • Timms P, Mannan N, Hitman G, et al. Circulating MMP9, vitamin D and variation in the TIMP‐1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? Qjm 2002; 95: 787-96.
  • Schlaich C, Minne H, Bruckner T, et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporosis International 1998; 8: 261-7.

Association between vitamin D levels and frequency of disease exacerbations and hospitalizations in patients with COPD

Year 2022, , 471 - 477, 15.03.2022
https://doi.org/10.32322/jhsm.1050722

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a debilitating disorder that restricts the physical activity of patients who are deprived of sunlight, which is a source of vitamin D. The purpose of this study was to assess the relationship between vitamin D and the frequency of exacerbation and hospitalization among patients with COPD.
Material and Method: In the main analysis, 303 patients with COPD (stage GOLD A to D) were included in a retrospective cohort study in Turkey. Serum levels of vitamin D (25-hydroxyvitamin D) were measured in 303 patients with COPD and were associated with pulmonary function, AECOPD frequency and hospitalization in the previous year. Results: For COPD patients, the mean reference level of 25 hydroxyvitamin D in serum was 12.5 ng/dL. In comparison to patients with a serious 25-hydroxyvitamin D deficiency (< 10 ng/dL, n=119 [39,3%]), patients with a moderate deficiency (10-19.99 ng/dL, n=100 [33%]), inadequate levels (20-29.99 ng/dL, n=49 [16,2%]) presented a different risk of exacerbation (incidence rate ratio, 2.3 [95% CI, 1.9-2.6], 1.6 [95% CI, 1.2-2.0], and 0.8 [95% CI, 0.3-1.2] respectively). In patients with desirable levels (> 30 ng/dL, n=34 [11,2%]), the risk was lower but not significant (incidence ratio, 0.7 [95% CI, 0.2-1.2]. In COPD patients, 25-hydroxyvitamin D rates are low correlated with 1-s forced expiratory volume (FEV1) (r=0.187, p=0.0013).
Conclusion: 25-hydroxyvitamin D deficiency is a frequent occurrence in COPD and is correlated with the frequency of exacerbation and hospitalization in COPD patients.

References

  • Lopez A, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006; 27: 397-412.
  • Vestbo J, Edwards LD, Scanlon PD, et al. Changes in forced expiratory volume in 1 second over time in COPD. New Engl J Med 2011; 365: 1184-92.
  • Hurst JR, Vestbo J, Anzueto A, Locantore N, Müllerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. New Engl J Med 2010; 363: 1128-38.
  • Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187: 347-65.
  • Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet (London, England) 2007; 370: 765-73.
  • Janssens W, Bouillon R, Claes B, et al. Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Thorax 2010; 65: 215-20.
  • Persson LJP, Aanerud M, Hiemstra PS, Hardie JA, Bakke PS, Eagan TML. Chronic obstructive pulmonary disease is associated with low levels of vitamin D. PloS one 2012; 7.
  • Romme EA, Rutten EP, Smeenk FW, Spruit MA, Menheere PP, Wouters EF. Vitamin D status is associated with bone mineral density and functional exercise capacity in patients with chronic obstructive pulmonary disease. Ann Med 2013; 45: 91-6.
  • Zhu M, Wang T, Wang C, Ji Y. The association between vitamin D and COPD risk, severity, and exacerbation: an updated systematic review and meta-analysis. Int J Chron Obstructive Pulmonary Dis 2016; 11: 2597.
  • Janssens W, Mathieu C, Boonen S, Decramer M. Vitamin D deficiency and chronic obstructive pulmonary disease: a vicious circle. Vitamins Hormones 2011; 86: 379-99.
  • Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol 2008; 181: 7090-9.
  • Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006; 311: 1770-3.
  • Janssens W, Lehouck A, Carremans C, Bouillon R, Mathieu C, Decramer M. Vitamin D beyond bones in chronic obstructive pulmonary disease: time to act. Am J Respir Crit Care Med 2009; 179: 630-6.
  • Zasloff M. Fighting infections with vitamin D. Nature medicine 2006; 12: 388-90.
  • Kunisaki KM, Niewoehner DE, Connett JE. Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. Am J Respir Crit Care Med 2012; 185: 286-90.
  • Singh D, Agusti A, Anzueto A, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J 2019; 53.
  • Holick MF. Vitamin D deficiency. New Engl J Med 2007; 357: 266-81.
  • Ferrari R, Caram LM, Tanni SE, Godoy I, de Paiva SAR. The relationship between Vitamin D status and exacerbation in COPD patients–a literature review. Respir Med 2018; 139: 34-8.
  • Sanket S, Madireddi J, Stanley W, Sura P, Prabhu M. Relation between vitamin D deficiency and severity of chronic obstructive pulmonary disease-A case control study. JCDR 2016; 10: OC16.
  • Malinovschi A, Masoero M, Bellocchia M, et al. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. Respir Res 2014; 15: 131.
  • Mekov E, Slavova Y, Tsakova A, et al. Vitamin D deficiency and insufficiency in hospitalized COPD patients. PLoS One 2015; 10.
  • Quint JK, Donaldson GC, Wassef N, Hurst JR, Thomas M, Wedzicha JA. 25-hydroxyvitamin D deficiency, exacerbation frequency and human rhinovirus exacerbations in chronic obstructive pulmonary disease. BMC Pulmonary Med 2012; 12: 28.
  • Puhan MA, Siebeling L, Frei A, Zoller M, Bischoff-Ferrari H, Ter Riet G. No association of 25-hydroxyvitamin D with exacerbations in primary care patients with COPD. Chest 2014; 145: 37-43.
  • Martineau AR, James WY, Hooper RL, et al. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med 2015; 3: 120-30.
  • Persson LJ, Aanerud M, Hiemstra PS, et al. Vitamin D, vitamin D binding protein, and longitudinal outcomes in COPD. PloS one 2015; 10.
  • Wei R, Christakos S. Mechanisms underlying the regulation of innate and adaptive immunity by vitamin D. Nutrients 2015; 7: 8251-60.
  • Gombart AF. The vitamin D–antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 2009; 4: 1151-65.
  • Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients 2015; 7: 4240-70.
  • Donaldson GC, Wilkinson TM, Hurst JR, Perera WR, Wedzicha JA. Exacerbations and time spent outdoors in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005; 171: 446-52.
  • Donaldson G, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847-52.
  • Soler-Cataluna J, Martínez-García MÁ, Sánchez PR, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005; 60: 925-31.
  • Ginde AA, Mansbach JM, Camargo CA. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009; 169: 384-90.
  • Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest 2005; 128: 3792-8.
  • Timms P, Mannan N, Hitman G, et al. Circulating MMP9, vitamin D and variation in the TIMP‐1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? Qjm 2002; 95: 787-96.
  • Schlaich C, Minne H, Bruckner T, et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporosis International 1998; 8: 261-7.
There are 35 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Sertan Bulut 0000-0003-1267-3440

Harun Karamanlı 0000-0001-5453-1526

Mustafa Engin Şahin 0000-0002-2707-8196

Deniz Çelik 0000-0003-4634-205X

Çiğdem Biber 0000-0003-4485-1977

Publication Date March 15, 2022
Published in Issue Year 2022

Cite

AMA Bulut S, Karamanlı H, Şahin ME, Çelik D, Biber Ç. Association between vitamin D levels and frequency of disease exacerbations and hospitalizations in patients with COPD. J Health Sci Med /JHSM /jhsm. March 2022;5(2):471-477. doi:10.32322/jhsm.1050722

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