Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, , Herlev, Denmark.
Thorax. 2014 Jan;69(1):24-31. doi: 10.1136/thoraxjnl-2013-203682. Epub 2013 Aug 1.
25-hydroxyvitamin D (25(OH)D) may be associated with lung function through modulation of pulmonary protease-antiprotease imbalance, airway inflammation, lung remodelling and oxidative stress. We examined the association of plasma 25(OH)D levels with lung function, lung function decline and risk of chronic obstructive pulmonary disease (COPD).
Plasma 25(OH)D was measured in 10 116 participants in the Copenhagen City Heart Study and in 8391 participants in the Copenhagen General Population Study. In the former study, up to three measurements of lung function spanning 20 years allowed analyses of lung function decline.
In both cohorts, forced vital capacity in % of predicted was 7% lower and forced expiratory volume in 1 s in % of predicted was 7-10% lower for lowest versus highest decile of 25(OH)D (ptrend≤1×10(-28)). In prospective analyses, participants in the lower versus higher 25(OH)D quintiles had a faster decline in forced expiratory volume in 1 s % predicted (pinteraction=1×10(-7)) and forced vital capacity % predicted (pinteraction=8×10(-8)). In cross-sectional analyses, multivariable adjusted ORs for COPD were 2.30 (95% CI 1.55 to 3.41) and 3.06 (1.97 to 4.76) for lowest versus highest quintile in the Copenhagen City Heart Study using Global Initiative for Chronic Obstructive Lung Disease (GOLD) and lower limit of normal criteria. The corresponding ORs were 1.82 (1.13 to 2.92) and 2.23 (1.35 to 3.69) in the Copenhagen General Population Study. In prospective analyses, corresponding multivariable adjusted HRs for developing COPD were 1.58 (1.05 to 2.40) and 2.00 (1.19 to 3.36).
We observed a novel association of lower plasma 25(OH)D levels with faster decline in lung function and with a higher risk of COPD in prospective analyses.
25-羟维生素 D（25(OH)D）可能通过调节肺蛋白酶-抗蛋白酶失衡、气道炎症、肺重塑和氧化应激，与肺功能相关。我们研究了血浆 25(OH)D 水平与肺功能、肺功能下降和慢性阻塞性肺疾病（COPD）风险之间的关联。
在哥本哈根城市心脏研究中，对 10116 名参与者和哥本哈根普通人群研究中的 8391 名参与者进行了血浆 25(OH)D 测量。在前一项研究中，长达 20 年的三次肺功能测量允许对肺功能下降进行分析。
在两个队列中，最低与最高 25(OH)D 十位数相比，预测值的用力肺活量降低了 7%，1 秒用力呼气量降低了 7-10%（趋势检验≤1×10(-28)）。在前瞻性分析中，较低与较高 25(OH)D 五分位数的参与者 1 秒用力呼气量预测值的下降速度更快（交互作用检验=1×10(-7)）和用力肺活量预测值的下降速度更快（交互作用检验=8×10(-8)）。在横断面分析中，哥本哈根城市心脏研究中，使用全球慢性阻塞性肺疾病倡议（GOLD）和正常下限标准，最低与最高五分位数的 COPD 多变量调整比值比（OR）分别为 2.30（95%CI 1.55 至 3.41）和 3.06（1.97 至 4.76）。在哥本哈根普通人群研究中，相应的 OR 分别为 1.82（1.13 至 2.92）和 2.23（1.35 至 3.69）。在前瞻性分析中，发展为 COPD 的多变量调整 HR 相应为 1.58（1.05 至 2.40）和 2.00（1.19 至 3.36）。
在前瞻性分析中，我们观察到较低的血浆 25(OH)D 水平与肺功能下降更快和 COPD 风险增加之间存在新的关联。
