Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Department of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland.
Adv Exp Med Biol. 2018;1070:27-36. doi: 10.1007/5584_2018_157.
Aging and menopause are closely related to hormonal and metabolic changes. Vitamin D is a crucial factor modulating several metabolic processes. The aim of this study was to evaluate biomarkers of bone metabolism in peri- and postmenopausal women with obstructive lung diseases. Sixty two female patients, 27 with asthma and 35 with COPD, aged over 45 years (median age 58 and 64 years, respectively) were enrolled into the study. The evaluation included lung function, bone mineral density, serum concentration of vitamin D, and bone metabolism markers. The study groups differed significantly in terms of forced expiratory volume in 1 s (FEV); median values of 1.79 L vs. 1.16 L (p = 0.0001) and 71.2% vs. 53.0% predicted (p = 0.0072) and in vitamin D concentration (12.3 ng/ml vs. 17.6 ng/ml). Total bone mineral density (BMD) was lower in the COPD group (p = 0.0115). Serum vitamin D inversely correlated with the number of pack-years in asthma patients (r = -0.45, p = 0.0192). There was no correlation between serum vitamin D and disease duration or severity, and the Asthma Control Test (ACT) and the modified Medical Research Council (mMRC) dyspnea scores. The serum bone metabolism markers C-terminal cross-linked telopeptide of collagen type I (BCROSS), N-terminal propeptides of procollagen type-1 (tP1NP), and N-mid osteocalcin (OCN) inversely correlated with age in the COPD, but not asthma, patients (r = -0.38, p = 0.0264; r = -0.37, p = 0.0270; and r = -0.42, p = 0.0125, respectively). We conclude that peri- and postmenopausal women with obstructive lung diseases had a decreased serum concentration of vitamin D. Furthermore, vitamin D and body mineral density were appreciably lower in women with COPD than those with asthma.
衰老和绝经与激素和代谢变化密切相关。维生素 D 是调节多种代谢过程的关键因素。本研究旨在评估患有阻塞性肺疾病的绝经前和绝经后妇女的骨代谢生物标志物。共纳入 62 名女性患者,其中 27 名患有哮喘,35 名患有 COPD,年龄均在 45 岁以上(中位年龄分别为 58 岁和 64 岁)。评估包括肺功能、骨矿物质密度、血清维生素 D 浓度和骨代谢标志物。两组在 1 秒用力呼气量(FEV)方面有显著差异;中位数分别为 1.79 L 和 1.16 L(p = 0.0001)和 71.2% 和 53.0%预计值(p = 0.0072),维生素 D 浓度也有差异(12.3 ng/ml 和 17.6 ng/ml)。COPD 组的总骨矿物质密度(BMD)较低(p = 0.0115)。血清维生素 D 与哮喘患者的吸烟包年数呈负相关(r = -0.45,p = 0.0192)。血清维生素 D 与疾病持续时间或严重程度以及哮喘控制测试(ACT)和改良的医学研究委员会(mMRC)呼吸困难评分之间无相关性。COPD 患者的血清骨代谢标志物 I 型胶原交联 C 端肽(BCROSS)、I 型前胶原 N 端前肽(tP1NP)和 N 端中骨钙素(OCN)与年龄呈负相关,但在哮喘患者中无相关性(r = -0.38,p = 0.0264;r = -0.37,p = 0.0270;r = -0.42,p = 0.0125)。我们得出结论,患有阻塞性肺疾病的绝经前和绝经后妇女的血清维生素 D 浓度降低。此外,COPD 女性的维生素 D 和体矿物质密度明显低于哮喘患者。