Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis.

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Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis.

Author(s): Biyuan Zhu ¹ , Biqing Zhu ² , Chaolie Xiao ³ , Zhiwen Zheng ¹

Publication date (Electronic): 2015

Journal: International journal of chronic obstructive pulmonary disease

Publisher: Informa UK Limited

Keywords: 25(OH)D, COPD, susceptibility

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Abstract

To explore the association between host serum 25-hydroxyvitamin D (25(OH)D) and the susceptibility and severity of COPD.

Most cited references 36

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Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.

R A Pauwels, A Buist, P. Calverley … (2001)

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Chronic obstructive pulmonary disease

Marc DeCramer, Wim Janssens, Marc Miravitlles (2012)

Summary Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects or comorbities. The main cause is smoking tobacco, but other factors have been identified. Several pathobiological processes interact on a complex background of genetic determinants, lung growth, and environmental stimuli. The disease is further aggravated by exacerbations, particularly in patients with severe disease, up to 78% of which are due to bacterial infections, viral infections, or both. Comorbidities include ischaemic heart disease, diabetes, and lung cancer. Bronchodilators constitute the mainstay of treatment: β2 agonists and long-acting anticholinergic agents are frequently used (the former often with inhaled corticosteroids). Besides improving symptoms, these treatments are also thought to lead to some degree of disease modification. Future research should be directed towards the development of agents that notably affect the course of disease.

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High doses of vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial.

Claudia Carremans, Wim Janssens, Jan Verhaegen … (2012)

Low serum 25-hydroxyvitamin D (25-[OH]D) levels have been associated with lower FEV(1), impaired immunologic control, and increased airway inflammation. Because many patients with chronic obstructive pulmonary disease (COPD) have vitamin D deficiency, effects of vitamin D supplementation may extend beyond preventing osteoporosis. To explore whether supplementation with high doses of vitamin D could reduce the incidence of COPD exacerbations. Randomized, single-center, double-blind, placebo-controlled trial. (ClinicalTrials.gov registration number: NCT00666367) University Hospitals Leuven, Leuven, Belgium. 182 patients with moderate to very severe COPD and a history of recent exacerbations. 100,000 IU of vitamin D supplementation or placebo every 4 weeks for 1 year. The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, FEV(1), quality of life, and death. Mean serum 25-(OH)D levels increased significantly in the vitamin D group compared with the placebo group (mean between-group difference, 30 ng/mL [95% CI, 27 to 33 ng/mL]; P < 0.001). The median time to first exacerbation did not significantly differ between the groups (hazard ratio, 1.1 [CI, 0.82 to 1.56]; P = 0.41), nor did exacerbation rates, FEV(1), hospitalization, quality of life, and death. However, a post hoc analysis in 30 participants with severe vitamin D deficiency (serum 25-[OH]D levels <10 ng/mL) at baseline showed a significant reduction in exacerbations in the vitamin D group (rate ratio, 0.57 [CI, 0.33 to 0.98]; P = 0.042). This was a single-center study with a small sample size. High-dose vitamin D supplementation in a sample of patients with COPD did not reduce the incidence of exacerbations. In participants with severe vitamin D deficiency at baseline, supplementation may reduce exacerbations. Applied Biomedical Research Program, Agency for Innovation by Science and Technology (IWT-TBM).

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Author and article information

Journal

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Title: International journal of chronic obstructive pulmonary disease

Publisher: Informa UK Limited

ISSN (Electronic): 1178-2005

ISSN (Print): 1176-9106

Publication date (Electronic): 2015

Volume: 10

Affiliations

[1 ] The Fifth Internal Medicine Department, Guangzhou University of Chinese Medicine, Dongguan City, People's Republic of China.

[2 ] Department of Laboratory Medicine, Guangzhou University of Chinese Medicine, Dongguan City, People's Republic of China.

[3 ] Department of Intensive Care Unit, Dongguan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Dongguan City, People's Republic of China.