PurposeTo explore the association between host serum 25-hydroxyvitamin D (25(OH)D) and the susceptibility and severity of COPD.MethodsPrevious studies on the association between host 25(OH)D and the susceptibility and severity of COPD were collected on the basis of a systematic literature search of PubMed and Web of Science up to June 2015. Continuous variable data were presented as standard mean difference (SMD) or weighted mean difference with 95% confidence interval (CI). The dichotomous variable data were analyzed as relative ratio (RR) or odds ratio with 95% CI for cohort and case-control studies. A systematic review was conducted to understand the curative and side effects of vitamin D intake.ResultsA total of 18 studies including eight cohort, five case-control, and five randomized studies met the inclusion criteria. The serum level of 25(OH)D in COPD patients was comparable with controls with a pooled SMD of 0.191 (95% CI: −0.126 to 0.508, P=0.237) based on pooled analyses of cohort studies. However, the serum level of 25(OH)D in COPD patients was lower with a pooled SMD of 0.961 (95% CI: 0.476–1.446, P<0.001) compared with controls based on pooled analyses of case-control studies. The deficiency rates of 25(OH)D were comparable between controls and COPD patients with a pooled RR of 0.955 (95% CI: 0.754–1.211, P=0.705) based on analyses of cohort studies, and the same results were observed based on pooled analyses of case-control studies. Interestingly, the deficiency rate of 25(OH)D was significantly lower in moderate or severe COPD patients with a pooled RR of 0.723 (95% CI: 0.632–0.828, P<0.001) compared with that in mild COPD patients. The same results were obtained from the pooled analysis between moderate and severe COPD patients. The four randomized studies showed that vitamin D intake provided benefit for COPD patients.ConclusionLow serum levels of 25(OH)D were not associated with COPD susceptibility, but the high deficiency rate of 25(OH)D was associated with COPD severity. Vitamin D supplementation may prevent COPD exacerbation.

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Aim  Frailty is common and is reported to be associated with adverse outcomes in patients with chronic diseases in Western countries. However, the prevalence of frailty remains unclear in individuals with chronic kidney disease (CKD) in China. We examined the prevalence of frailty and factors associated with frailty in patients with CKD. Methods  This was a cross-sectional analysis of 177 adult patients (mean age 54 ± 15 years, 52% men) with CKD from the open cohort entitled Physical Evaluation and Adverse outcomes for patients with chronic Kidney disease IN Guangdong (PEAKING). Frailty at baseline were assessed by FRAIL scale which included five items: fatigue, resistance, ambulation, illnesses, and loss of weight. Potential risk factors of frailty including age, sex, body mass index, and daily step counts recorded by ActiGraph GT3X + accelerometer were analyzed by multivariate logistic regression analysis. Results The prevalence of prefrailty and frailty was 50.0% and 11.9% in patients with stages 4–5 CKD, 29.6% and 9.3% in stage 3, and 32.1% and 0 in stages 1–2. In the multivariate logistic regression analysis, an increase of 100 steps per day (OR = 0.95, 95% CI 0.91–0.99, P = 0.01) and an increase of 5 units eGFR (OR = 0.82, 95% CI 0.68–0.99, P = 0.045) were inversely associated with being frail; higher BMI was associated with a higher likelihood of being frail (OR = 1.52, 95% CI 1.11–2.06, P = 0.008) and prefrail (OR = 1.25, 95% CI 1.10–1.42, P = 0.001). Conclusion  Frailty and prefrailty were common in patients with advanced CKD. A lower number of steps per day, lower eGFR, and a higher BMI were associated with frailty in this population.

BACKGROUND AND AIMS Favorable skeletal muscles have been associated with higher physical activity (PA) in the general population. However, little is known regarding this relationship in a population of Chinese chronic kidney disease (CKD) patients. The aim of this study is to investigate the relationship between PA and skeletal muscle in Chinese non-dialysis CKD patients. METHOD This was a cross-sectional analysis of the PEAKING cohort—an open cohort aimed to explore the effect of PA on health-related outcomes in the Chinese non-dialysis CKD population from 2017. The PA of patients was assessed by wearing an accelerometer (ActiGraph) for 9 consecutive days. The levels of PA were classified into four categories (no PA, low, moderate and high level of PA) according to the 2008 U.S. Physical Activity Guidelines. The information of skeletal muscles was evaluated by Biospace Inbody 770 within 180 days after the enrollment. Multivariate linear analysis was conducted to investigate the association between PA and skeletal muscle, adjusted for age, sex, CKD stages, smoking and drinking status, drug use and complications. RESULTS A total of 104 non-dialysis CKD patients (median age 49.6 years, 48% female, 49% with CKD stage 3 or above) were enrolled in this study. None of the included CKD patients had no or low-level PA while 42 (40%) patients had moderate and 62 (60%) had high-level PA. Multivariate linear regression showed that there was no significant association between skeletal muscle and level of PA (B = 0.07, 95% CI −0.58, 2.01; P = 0.279). CONCLUSION Higher-level PA was not significantly associated with more skeletal muscle mass. Further work examining the relationship between skeletal muscle and level of PA needs to be done in a larger sample of non-dialysis CKD patients.