Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 11 , ISSUE 2 ( April-June, 2022 ) > List of Articles

Original Article

The Association between Serum Vitamin D Deficiency and Chronic Obstructive Pulmonary Disease Exacerbation

Farnoosh Ebrahimzadeh, Milad Bahrami, Fariba Rezaeetalab, Fatemeh Taheri Asl, Mobina Sadat Mirvahabi, Zeinolabedin Kafa, Farzaneh Akbari

Keywords : Chronic obstructive pulmonary disease, exacerbation, hypoxemia, Vitamin D

Citation Information : Ebrahimzadeh F, Bahrami M, Rezaeetalab F, Asl FT, Mirvahabi MS, Kafa Z, Akbari F. The Association between Serum Vitamin D Deficiency and Chronic Obstructive Pulmonary Disease Exacerbation. Indian J Respir Care 2022; 11 (2):140-144.

DOI: 10.4103/ijrc.ijrc_157_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by irreversible airway obstruction and impaired pulmonary function. Acute exacerbation is responsible for the majority of COPD mortality and morbidity. This study aimed to evaluate the association between serum Vitamin D deficiency and COPD exacerbation. Materials and Methods: This cross-sectional study was conducted on 80 COPD patients who were hospitalized for severe acute exacerbation in Imam Reza Hospital, Mashhad, Iran, in 2016Â-2017. Subjects were excluded if they were taking corticosteroid, calcium, phosphorus, or Vitamin D supplements. Immunocompromised patients and cases with underlying cardiovascular, liver, or renal diseases, metabolic syndrome, cancers, electrolyte imbalance, and any diseases related to Vitamin D metabolism and absorption were also excluded. A blood sample of 3 ml was taken from each participant to measure 25-hydroxyvitamin D (25OHD) level, up to 24 h after hospitalization. The severity of the disease was assessed by forced expiratory volume in 1 s obtained from spirometry tests, and hypoxemia level using O2 saturation. Results: The lower levels of mean serum 25OHD were significantly associated with the increased number of exacerbations (P = 0.01). Hypoxemia levels and the mean serum 25OHD level were found to have a significant association as well (P = 0.01). However, no significant relationship was observed between the mean serum 25OHD level and the duration of hospitalization (P = 0.1). Conclusions: Serum Vitamin D deficiency was associated with increased COPD exacerbation and poor clinical outcomes. Therefore, Vitamin D supplementation should be considered to reduce the risk of COPD exacerbation.


HTML PDF Share
  1. Soriano JB, Kendrick PJ, Paulson KR, Gupta V, Abrams EM, Adedoyin RA, et al. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: A systematic analysis for the global burden of disease study 2017. Lancet Respir Med 2020;8:585-96.
  2. Huang X, Zhu Z, Guo X, Kong X. The roles of microRNAs in the pathogenesis of chronic obstructive pulmonary disease. Int Immunopharmacol 2019;67:335-47.
  3. Rao W, Wang S, Duleba M, Niroula S, Goller K, Xie J, et al. Regenerative metaplastic clones in COPD lung drive inflammation and fibrosis. Cell
  4. e18.
  5. Khan DM, Ullah A, Randhawa FA, Iqtadar S, Butt NF, Waheed K. Role of vitamin D in reducing number of acute exacerbations in Chronic Obstructive Pulmonary Disease (COPD) patients. Pak J Med Sci
  6. Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D'Souza GA, Gupta D, et al. A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Indian J Chest Dis Allied Sci 2006;48:23-9.
  7. Cai X, Zhao Y, Deng X, Fang F. Effect of a two-way quality feedback nursing model on patients with chronic obstructive pulmonary disease. Ann Palliat Med 2020;9:3182-6.
  8. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's Principles of Internal Medicine. 19th ed. New York USA: Mcgraw-Hill; 2015.
  9. Pauwels RA, Rabe KF. Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet 2004;364:613-20.
  10. Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom 2018;3:e4.
  11. Rubinsztajn R, Chazan R. An analysis of the causes of mortality and co-morbidities in hospitalised patients with chronic obstructive pulmonary disease. Adv Respir Med 2011;79:343-6.
  12. Fauci AS. Harrison's Principles of Internal Medicine. New York: McGraw-Hill, Medical Publishing Division; 2008.
  13. Jahnz-Różyk K, Targowski T, From S, Faluta T, Borowiec Ł. Costs of chronic obstructive pulmonary disease in patients receiving specialist outpatient care in Poland. Adv Respir Med 2011;79:337-42.
  14. Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One 2010;5:e11088.
  15. Dinlen N, Zenciroglu A, Beken S, Dursun A, Dilli D, Okumus N. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns. J Matern Fetal Neonatal Med 2016;29:928-32.
  16. Rafiq R, Aleva FE, Schrumpf JA, Heijdra YF, Taube C, Daniels JM, et al. Prevention of exacerbations in patients with COPD and vitamin D deficiency through vitamin D supplementation (PRECOVID): A study protocol. BMC Pulm Med 2015;15:106.
  17. Malinovschi A, Masoero M, Bellocchia M, Ciuffreda A, Solidoro P, Mattei A, et al. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. Respir Res
  18. Finklea JD, Grossmann RE, Tangpricha V. Vitamin D and chronic lung disease: A review of molecular mechanisms and clinical studies. Adv Nutr 2011;2:244-53.
  19. Malani PN. Harrison's principles of internal medicine. JAMA
  20. Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol
  21. Jolliffe DA, Greenberg L, Hooper RL, Mathyssen C, Rafiq R, de Jongh RT, et al. Vitamin D to prevent exacerbations of COPD: Systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 2019;74:337-45.
  22. Kokturk N, Baha A, Oh YM, Young Ju J, Jones PW. Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? A compherensive review for pulmonologists. Clin Respir J 2018;12:382-97.
  23. American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults. Recommendations abstracted from the American geriatrics society consensus statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 2014;62:147-52.
  24. Wedzicha JA Ers Co-Chair, Miravitlles M, Hurst JR, Calverley PM, Albert RK, Anzueto A, et al. Management of COPD exacerbations: A European Respiratory Society/American Thoracic Society guideline. Eur Respir J 2017;49:1600791.
  25. 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 Obstruct Pulmon Dis 2016;11:2597-607.
  26. Bellocchia M, Boita M, Patrucco F, Ferrero C, Verri G, Libertucci D, et al. Vitamin D deficiency and COPD exacerbations: Effect of vitamin D supplementation. Eur Respir J 2015;46 Suppl 59:PA3961.
  27. Sanjari M, Soltani A, Habibi Khorasani A, Zareinejad M. The effect of vitamin D on COPD exacerbation: A double blind randomized placebo-controlled parallel clinical trial. J Diabetes Metab Disord
  28. Burkes RM, Ceppe AS, Doerschuk CM, Couper D, Hoffman EA, Comellas AP, et al. Associations among 25-hydroxyvitamin D levels, lung function, and exacerbation outcomes in COPD: An analysis of the SPIROMICS cohort. Chest 2020;157:856-65.
  29. Jung JY, Kim YS, Kim SK, Kim HY, Oh YM, Lee SM, et al. Relationship of vitamin D status with lung function and exercise capacity in COPD. Respirology 2015;20:782-9.
  30. Mekov E, Slavova Y, Tsakova A, Genova M, Kostadinov D, Minchev D, et al. Vitamin D deficiency and insufficiency in hospitalized COPD patients. PLoS One 2015;10:e0129080.
  31. Au DH, Bryson CL, Chien JW, Sun H, Udris EM, Evans LE, et al. The effects of smoking cessation on the risk of chronic obstructive pulmonary disease exacerbations. J Gen Intern Med 2009;24:457-63.
  32. Martineau AR, James WY, Hooper RL, Barnes NC, Jolliffe DA, Greiller CL, 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.
  33. Gawron G, Trzaska-Sobczak M, Sozańska E, Śnieżek P, Barczyk A. Vitamin D status of severe COPD patients with chronic respiratory failure. Adv Respir Med 2018;86:78-85.
  34. Baneen U, Naseem S. Correlation of severity of chronic obstructive pulmonary disease with serum vitamin-D level. J Family Med Prim Care 2019;8:2268-77.
  35. Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 2007;103:620-5.
  36. Molla AM, Al Badawi M, Hammoud MS, Molla AM, Shukkur M, Thalib L, et al. Vitamin D status of mothers and their neonates in Kuwait. Pediatr Int 2005;47:649-52.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.