Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
Respirology. 2015 Jul;20(5):782-9. doi: 10.1111/resp.12538. Epub 2015 Apr 13.
The relationship between blood vitamin D level and clinical parameters in patients with chronic obstructive pulmonary disease (COPD) has been reported with conflicting results. We explored the effects of vitamin D on clinical characteristics of patients with COPD in Korea.
The study population comprised 193 patients with COPD from Korean Obstructive Lung Disease Cohort. The plasma level of 25-OH vitamin D3 (25-OH-VitD3) was measured every year along with various clinical parameters such as lung function, 6-min walking (6MW) distance, quality of life, exacerbations and emphysema index. Generalized estimating equations and linear mixed model were used for statistical analysis.
Of the 193 patients, 12 (6.2%), 28 (14.5%) and 153 (79.3%) were categorized into normal, insufficiency and deficiency groups. Clustered analysis showed that the plasma 25-OH-VitD3 level was associated with the post-bronchodilator ratio of force expiratory volume in 1 s/forced vital capacity (FEV1 /FVC) (estimated = 0.001; P = 0.022). The vitamin D deficiency group showed lower FEV1 (estimated = -0.129, P = 0.043), FEV1 % predicted (estimated = -4.994, P = 0.029) and FEV1 /FVC ratio (estimated = -0.048, P = 0.001) than did the non-deficiency group. The 6MW distance tended to be shorter in deficiency group (estimated = -17.26, P = 0.069) than in non-deficiency group. Quality of life, exacerbation and emphysema index were not associated with plasma 25-OH-VitD3 level.
We demonstrated a high prevalence of vitamin D deficiency in Korean patients with COPD and a significant relationship between vitamin D deficiency and airflow limitation. The exercise capacity tended to be decreased in the vitamin D deficiency group.
已有研究报告称，慢性阻塞性肺疾病（COPD）患者的血液维生素 D 水平与临床参数之间存在关联，但结果相互矛盾。本研究旨在探讨维生素 D 对韩国 COPD 患者临床特征的影响。
本研究纳入了韩国阻塞性肺疾病队列中的 193 例 COPD 患者。每年检测患者的血浆 25-羟维生素 D3（25-OH-VitD3）水平，并记录其肺功能、6 分钟步行（6MW）距离、生活质量、急性加重和肺气肿指数等临床参数。采用广义估计方程和线性混合模型进行统计学分析。
193 例患者中，正常、不足和缺乏维生素 D 者分别占 12.0%（28 例）、14.5%（28 例）和 79.3%（153 例）。聚类分析显示，血浆 25-OH-VitD3 水平与用力呼气量（FEV1）占预计值百分比（FEV1/FVC）呈正相关（估计值=0.001，P=0.022）。维生素 D 缺乏组的 FEV1（估计值=-0.129，P=0.043）、FEV1 预计值百分比（估计值=-4.994，P=0.029）和 FEV1/FVC 比值（估计值=-0.048，P=0.001）均低于非缺乏组。维生素 D 缺乏组的 6MW 距离较非缺乏组短（估计值=-17.26，P=0.069）。生活质量、急性加重和肺气肿指数与血浆 25-OH-VitD3 水平均无相关性。
本研究表明，韩国 COPD 患者普遍存在维生素 D 缺乏，且维生素 D 缺乏与气流受限显著相关。维生素 D 缺乏组的运动能力可能下降。
