Section of Respiratory Medicine, Hvidovre University Hospital, Kettegaard Allé 30, 2650, Hvidovre, Denmark,
Lung. 2014 Aug;192(4):493-7. doi: 10.1007/s00408-014-9582-9. Epub 2014 Apr 20.
It has been suggested that identifying phenotypes in chronic obstructive pulmonary disease (COPD) might improve treatment outcome and the accuracy of prediction of prognosis. In observational studies vitamin D deficiency has been associated with decreased pulmonary function, presence of emphysema and osteoporosis, upper respiratory tract infections, and systemic inflammation. This could indicate a relationship between vitamin D status and COPD phenotypes. The aim of this study was to assess the association between vitamin D levels and COPD phenotypes. In addition, seasonality of vitamin D levels was examined.
A total of 91 patients from a Danish subpopulation of the "Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points" cohort took part in a biomarker substudy. Vitamin D concentration was measured from blood samples taken at two visits, approximately 6 months apart. The participants were 40-75-year-old patients with COPD and had a smoking history of >10 pack-years.
Fifty-six patients had 25-hydroxyvitamin D measured from blood samples from both visits. In the final model of the multivariate analyses, the factors that were associated with vitamin D deficiency at the first visit were age (OR: 0.89, p = 0.02) and summer season (OR: 3.3, p = 0.03). Factors associated with vitamin D level also at the first visit were age (B: 0.9, p = 0.02) and 6 min walking distance (B: 0.05, p = 0.01).
Vitamin D was not associated with COPD phenotypes and season did not seem to be a determinant of vitamin D levels in patients with moderate to severe COPD.
有研究表明，在慢性阻塞性肺疾病（COPD）中识别表型可能会改善治疗效果，并提高预后预测的准确性。在观察性研究中，维生素 D 缺乏与肺功能下降、肺气肿和骨质疏松症、上呼吸道感染和全身炎症有关。这可能表明维生素 D 状态与 COPD 表型之间存在关联。本研究旨在评估维生素 D 水平与 COPD 表型之间的关系。此外，还检查了维生素 D 水平的季节性。
共有 91 名来自丹麦“评估 COPD 纵向以确定预测替代终点”队列的患者参加了生物标志物子研究。在两次就诊时（大约相隔 6 个月）从血液样本中测量维生素 D 浓度。参与者为 40-75 岁有 COPD 病史且吸烟史>10 包年的患者。
56 名患者的两次就诊均进行了 25-羟维生素 D 测量。在多变量分析的最终模型中，第一次就诊时维生素 D 缺乏的相关因素是年龄（OR：0.89，p = 0.02）和夏季（OR：3.3，p = 0.03）。与第一次就诊时维生素 D 水平相关的因素还包括年龄（B：0.9，p = 0.02）和 6 分钟步行距离（B：0.05，p = 0.01）。
维生素 D 与 COPD 表型无关，季节似乎不是中重度 COPD 患者维生素 D 水平的决定因素。
