The influence of disease severity and lifestyle factors on the peak annual 25(OH)D value of COPD patients

Kentson, Magnus; Leanderson, Per; Jacobson, Petra; Persson, Hans Lennart

doi:10.2147/copd.s156121

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…No previous Scandinavian [ 11 , 13 , 37 ] nor more recent international [ 22 , 33 ] study on patients with COPD have found a significant association between gender and vitamin D status. In contrast to our findings Black et al found a significantly higher level of 25(OH)D in men compared to women, 78.3 nmol/L versus 71.7 nmol/L, in a cohort from the Third National Health and nutrition Examination Survey (NHANES III) [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Vitamin D Status and Determinants of Vitamin D Insufficiency in Patients with Chronic Obstructive Pulmonary Disease

et al. 2023

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Low vitamin D levels are common in Chronic Obstructive Pulmonary Disease (COPD) and have been associated with various adverse COPD-related outcomes. Recent data on vitamin D status in representative COPD cohorts in Scandinavia is lacking. This study aimed to assess vitamin D status and determinants of vitamin D insufficiency in patients with COPD who were attending a specialist secondary care COPD clinic in Southwestern Sweden. All patients who visited the COPD clinic for their first medical visit during two periods, 2017–2018 and 2021, were included in this observational study. Measurements of 25-Hydroxyvitamin D (25(OH)D), clinical data and documentation of supplements containing vitamin D were collected retrospectively from patients’ medical records. Multivariable logistic regression analysis was performed to identify determinants of the primary outcome, vitamin D insufficiency (25(OH)D < 50 nmol/L). A total of 667 patients were included, and 33% had vitamin D insufficiency. The median 25(OH)D was 62 nmol/L (43.5–83.1 nmol/L). Vitamin D insufficiency was related to the male gender, current smoking habits, a lack of supplements containing vitamin D and the winter season for blood sampling. In conclusion, vitamin D insufficiency is common in patients with COPD. Men had significantly lower levels of vitamin D but took vitamin D-containing supplements less frequently compared to women. Our findings can help clinicians to identify patients who are at risk of vitamin D insufficiency and allow correction with supplementation where appropriate.

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Section: Discussionmentioning

confidence: 99%

Gender Differences in Vitamin D Status and Determinants of Vitamin D Insufficiency in Patients with Chronic Obstructive Pulmonary Disease

et al. 2023

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“…Differences in lifestyle, physical exercise and thereby also sunlight exposure presumably display key factors in the associations between 25-OHD levels and disease severity in COPD. As generally listlessness increases with pronounced pulmonary impairment, it is assumed that also light exposure decreases with disease progression, which in turn predisposes for vitamin D deficiency (7,19,50). In line with this, while the GOLD stage and weekly hours of sunlight exposure were not generally associated (Kruskal-Wallis test, P=0.051), patients in GOLD stage IV reported significantly lower weekly hours of sunlight exposure than those in GOLD stage I in direct comparison (Mann-Whitney test, P=0.022).…”

Section: Discussionmentioning

confidence: 99%

Association of serum vitamin D levels with disease severity, systemic inflammation, prior lung function loss and exacerbations in a cohort of patients with chronic obstructive pulmonary disease (COPD)

Jorde¹,

Stegemann-Koniszewski²,

Papra³

et al. 2021

J Thorac Dis

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Background: Vitamin D deficiency has been associated with chronic disorders including chronic obstructive pulmonary disease (COPD) but the relationships with inflammation, exacerbations and disease progression remain unclear. Methods: In this monocentric cross-sectional observational study we analyzed the disease status, systemic inflammation, prior exacerbation frequency and loss in lung function in relation to serum 25-hydroxyvitamin D (25-OHD) levels in a cohort of 94 patients with COPD. Serum 25-OHD, C-reactive protein, interleukin-6 and tumor necrosis factor-α were quantified. Exacerbation frequencies and sunlight exposure were assessed. These parameters were analyzed in correlation to the current forced expiratory volume in 1 s (FEV 1 ), the individual average 3-year FEV 1 decline and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage. Results:We observed fair correlation between serum 25-OHD and the current FEV 1 (r=0.38, P<0.001). Furthermore, mean serum 25-OHD was significantly altered between patients of GOLD stages I-IV (P=0.013). There was weak negative correlation of 25-OHD and the average annual change of the FEV 1 (r=−0.26, P<0.05). Furthermore, we observed fair negative correlation between 25-OHD and C-reactive protein (r=−0.32, P<0.01) as well as weak negative correlation with interleukin-6 (r=−0.23, P<0.05). While the exacerbation frequency significantly differed between GOLD stages (P=0.04), there was no direct association between exacerbations and 25-OHD levels. Conclusion:Our data confirm frequent vitamin D deficiency in COPD and point out correlations between 25-OHD levels, systemic inflammation, disease severity and progression.

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“…Deficiency, defined as serum-25(OH)D <50 nmol/ L, is associated with insufficient outdoor activities and dietary intake, and reflects COPD severity as previously shown. 33 To measure FEV 1 and FVC and to calculate the ratio of these volumes, dynamic spirometry was performed before and after bronchodilatation (spirometry was repeated ≥15 min after inhalation of salbutamol 0.6 mg) using Hedenström as a reference. 34,35 COPD was staged by airway obstruction, that is, FEV 1 % predicted 80-100%=GOLD stage I, 50-79% =stage II, 30-49%=stage III, and <30%=stage IV.…”

Section: Matched Controlsmentioning

confidence: 99%

Skeletal Myosteatosis is Associated with Systemic Inflammation and a Loss of Muscle Bioenergetics in Stable COPD

Persson¹,

Sioutas²,

Kentson³

et al. 2022

JIR

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Background: Common features among patients with more advanced chronic obstructive pulmonary disease (COPD) are systemic inflammation and a loss of both muscle mass and normal muscle composition. In the present study, we investigated COPD subjects to better understand how thigh muscle fat infiltration (MFI) and energy metabolism relate to each other and to clinical features of COPD with emphasis on systemic inflammation. Methods: Thirty-two Caucasians with stable COPD were investigated using questionnaires, lung function tests, blood analysis and magnetic resonance imaging (MRI) for analysis of body-and thigh muscle composition. Bioenergetics in the resting thigh muscle, expressed as the PCr/Pi ratio, were analysed using 31 phosphorus magnetic resonance spectroscopy ( 31 P-MRS). Results: Based on the combination of the MFI adjusted for sex (MFI a ) and the thigh fat-tissue free muscle volume, expressed as the deviation from the expected muscle volume of a matched virtual control group (FFMV vcg ), all COPD subjects displayed abnormally composed thigh muscles. Clinical features of increased COPD severity, including a decrease of blood oxygenation (r = −0.44, p < 0.05) and FEV 1 /FVC ratio, reflecting airway obstruction (r = −0.53, p < 0.01) and an increase of COPD symptoms (r = 0.37, p < 0.05) and breathing frequency at rest (r = 0.41, p < 0.05), were all associated with a raise of the PCr/Pi ratio in the thigh muscle. Increased MFI a of the thigh muscle correlated positively with markers of systemic inflammation (white blood cell count, r = 0.41, p < 0.05; fibrinogen, r = 0.44, p < 0.05), and negatively with weekly physical activity (r = −0.40, p < 0.05) and the PCr/Pi ratio in the resting thigh muscle (r = −0.41, p < 0.05). Conclusion:The present study implies a link between systemic inflammation, excessive MFI and a loss of bioenergetics in subjects with stable COPD.

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The influence of disease severity and lifestyle factors on the peak annual 25(OH)D value of COPD patients

Cited by 7 publications

References 28 publications

Gender Differences in Vitamin D Status and Determinants of Vitamin D Insufficiency in Patients with Chronic Obstructive Pulmonary Disease

Gender Differences in Vitamin D Status and Determinants of Vitamin D Insufficiency in Patients with Chronic Obstructive Pulmonary Disease

Association of serum vitamin D levels with disease severity, systemic inflammation, prior lung function loss and exacerbations in a cohort of patients with chronic obstructive pulmonary disease (COPD)

Skeletal Myosteatosis is Associated with Systemic Inflammation and a Loss of Muscle Bioenergetics in Stable COPD

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