Allergy and Immunology Division, Bryn Mawr Hospital, Bryn Mawr, PA USA.
Pulmonary, Allergy and Critical Care Division, University of Pennsylvania School of Medicine, Philadelphia, PA USA.
Allergy Asthma Clin Immunol. 2014 Sep 5;10(1):48. doi: 10.1186/1710-1492-10-48. eCollection 2014.
Asthma in the elderly is poorly understood and vitamin D deficiency and insufficiency are very common in older individuals. We studied the role of vitamin D in elderly asthmatics.
Asthmatics subjects, age 65 and older, were followed every 4 weeks for 12 weeks in the late fall and winter. During the study period they took 2,000 I.U. vitamin D3 daily. Serum 25-Hydroxyvitamin D and calcium were measured at baseline and study end.
Twenty nine percent of subjects were deficient and 50% insufficient in serum vitamin D at baseline. Serum vitamin D increased from 24.3±9.2 ng/ml (60.7±23 nmol/L) to 34±7.1 ng/ml (84.9±17.7 nmol/L) at the end of the study (p<0.001), whereas calcium was unchanged. We found no significant association between vitamin D and subjects' demographics. Vitamin D was similar in men and women. There was no association between serum vitamin D and inhaled steroid dose. Vitamin D was significantly lower in subjects with uncontrolled asthma (Asthma Control Test, ACT≤19) compared to the ones with well controlled symptoms (p<0.05). In subjects with uncontrolled asthma at baseline, ACT scores increased significantly at the end of the study (p<0.04), but not at 4 and 8 weeks. Spirometric values remained unchanged throughout the study.
Elderly asthmatics very commonly have vitamin D deficiency or insufficiency. Serum vitamin D levels were lower in subjects with uncontrolled asthma. In these subjects, vitamin D supplementation for 12 weeks led to improved ACT scores. Larger, randomized, placebo controlled studies are required to further evaluate whether vitamin D supplementation may improve asthma symptoms in this population.
ClinicalTrials.gov NCT01730976.
老年人哮喘的了解甚少，而老年人中维生素 D 缺乏和不足非常普遍。我们研究了维生素 D 在老年哮喘患者中的作用。
在秋季和冬季末期，每 4 周对年龄在 65 岁及以上的哮喘患者进行为期 12 周的随访。在此研究期间，他们每天服用 2,000 IU 维生素 D3。在基线和研究结束时测量血清 25-羟维生素 D 和钙。
29%的患者在基线时血清维生素 D 缺乏，50%血清维生素 D 不足。血清维生素 D 从 24.3±9.2ng/ml（60.7±23nmol/L）增加到研究结束时的 34±7.1ng/ml（84.9±17.7nmol/L）（p<0.001），而钙没有变化。我们发现维生素 D 与患者的人口统计学特征之间没有显著相关性。男性和女性的维生素 D 相似。血清维生素 D 与吸入性类固醇剂量之间没有关联。与症状控制良好的患者（哮喘控制测试，ACT≥20）相比，未控制哮喘患者（ACT≤19）的血清维生素 D 明显降低（p<0.05）。在基线时未控制哮喘的患者中，ACT 评分在研究结束时显著增加（p<0.04），但在 4 周和 8 周时没有增加。整个研究过程中，肺量计值保持不变。
老年哮喘患者非常普遍存在维生素 D 缺乏或不足。未控制哮喘患者的血清维生素 D 水平较低。在这些患者中，12 周的维生素 D 补充治疗可使 ACT 评分提高。需要进行更大规模的、随机的、安慰剂对照的研究，以进一步评估维生素 D 补充是否可改善该人群的哮喘症状。
ClinicalTrials.gov NCT01730976。
