Vitamin D Deficiency Is Associated with Rapid Decline in Exercise Capacity in Male Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Vitamin D is suggested to play a role in airway and systemic inflammation in chronic obstructive pulmonary disease (COPD). Low serum 25-hydroxyvitamin D (25-OHD) levels have been suggested to be associated with lower lung function and poorer exercise capacity in COPD. Objectives: The main purpose of this study was to investigate the effects of vitamin D deficiency on the change in exercise capacity in male COPD patients. Methods: A total of 156 male subjects were selected from the Korean Obstructive Lung Disease cohort. Vitamin D deficiency was subdivided into three subgroups: mild, moderate, and severe deficiency groups. Rapid decline was defined as an annual rate of change in exercise capacity ≥17 m. Exercise capacity was assessed by 6-minute walk distance (6MWD). Results: Significant differences were observed in the serum levels of 25-OHD, the number of patients with vitamin D sufficiency, and moderate-to-severe deficiency between rapid decliners (n = 40) and non-rapid decliners (n = 116). No differences were found between the groups for age, smoking status, lung function, and 6MWD. Multivariate analysis showed that vitamin D deficiency was independently related to rapid decline in exercise capacity (p = 0.028). A statistically significant difference was observed among the subgroups of vitamin D deficiency in terms of the change in exercise capacity (p < 0.001). The annual decline in exercise capacity was prominent in the severe deficiency group (23.1 m/year). Conclusion: This study shows that vitamin D deficiency is associated with rapid decline in exercise capacity in male patients with COPD.

Vitamin D and disease severity in bronchiectasis

“…Recently, several studies have emphasised the role of Vitamin D in modulating the activity of various defense mechanisms and its involvement in host defense, inflammation, immunity, and repair processes [10,11], suggesting a link between Vitamin D deficiency and lung diseases, a higher susceptibility to respiratory tract infections and therefore to exacerbations of chronic respiratory diseases [12][13][14][15][16][17][18][19][20][21][22][23][24][25]. A previous study, performed by Chalmers et al in Scotland in 2013, showed that about 50% of patients affected by bronchiectasis had Vitamin D deficiency and that it correlates with markers of disease severity, such as chronic bacteria colonisation, number of exacerbations https://doi.org/10.1016/j.rmed.2019.01.009 Received 14 August 2018; Received in revised form 8 January 2019; Accepted 20 January 2019 T and lung function decline [26].…”

Severe vitamin D deficiency is associated with emphysema progression in male patients with COPD

“…Several studies have already demonstrated that vitamin D deficiency is common in patients with COPD and is associated with lung function and exercise capacity [9,19,20]. However, there are no reports on the relationship between vitamin D deficiency and emphysema progression in COPD.…”

A Comprehensive Review on Vitamin D as a Novel Therapeutic Agent in Chronic Obstructive Pulmonary Disease

“…Quality of life, muscle strength, and exercise tolerance are other disease variables with fewer observational studies. Still, all of these variables have a negative correlation with serum vitamin D levels [8,26,27].…”