Pulmonary, University of California San Francisco, San Francisco, California, USA
Pulmonary, University of California San Francisco, San Francisco, California, USA.
BMJ Open Respir Res. 2020 Dec;7(1). doi: 10.1136/bmjresp-2020-000798.
Obstructive lung disease is a significant cause of morbidity and healthcare burden within the USA. A growing body of evidence has suggested that vitamin D levels can influence the course or incidence of obstructive lung disease. However, there is an insufficient previous investigation of this association.
We used the National Health and Nutrition Examination Survey (NHANES) cycles 2007-2008 and 2009-2010 spirometry results of individuals aged 40 years and older to assess the association between serum 25-hydroxyvitamin D levels and obstructive lung disease, as defined by the American Thoracic Society using the lower limit of normal. We used stage multivariate survey-logistic regression.
The final model included age, gender, body mass index, pack-years smoking history, season, income-to-poverty ratio and race/ethnicity. In the primary analysis using vitamin D as a continuous variable, there was no association between vitamin D levels and obstructive lung disease. We noted a trend between 'other Hispanic' self-identified race and serum vitamin D levels wherein higher levels were associated with higher odds of obstructive lung disease in this ethnicity, but not among other racial or ethnic groups (OR (95% CI)=1.40 (0.98 to 1.99), p=0.06). In a secondary analysis, when vitamin D was measured as a categorical variable, there was a significant association between the highest levels of serum vitamin D levels and lesser odds of obstructive lung disease (OR (95% CI)=0.77 [0.61 to 0.98], p0.04).
Higher serum vitamin D levels among adults are associated with decreased odds of obstructive lung disease in the general population. Results among non-Mexican Hispanic participants highlight the need for further research in minority populations. More work is needed to address the course and incidence of lung disease in the USA.
阻塞性肺疾病是美国发病率和医疗保健负担的重要原因。越来越多的证据表明,维生素 D 水平可能影响阻塞性肺疾病的病程或发病率。然而,之前对此关联的研究还不够充分。
我们使用了国家健康和营养调查(NHANES)2007-2008 年和 2009-2010 年的肺活量测定结果,评估了血清 25-羟维生素 D 水平与阻塞性肺疾病之间的关系,美国胸科学会使用正常下限定义了阻塞性肺疾病。我们使用了多阶段调查逻辑回归。
最终模型包括年龄、性别、体重指数、吸烟史包年数、季节、收入贫困比例和种族/族裔。在使用维生素 D 作为连续变量的主要分析中,维生素 D 水平与阻塞性肺疾病之间没有关联。我们注意到“其他西班牙裔”自我认同的种族与血清维生素 D 水平之间存在一种趋势,即较高的水平与这种族中阻塞性肺疾病的更高几率相关,但在其他种族或族裔中则不然(比值比(95%置信区间)=1.40(0.98 至 1.99),p=0.06)。在二次分析中,当维生素 D 作为分类变量测量时,血清维生素 D 水平最高与阻塞性肺疾病的几率较低之间存在显著关联(比值比(95%置信区间)=0.77(0.61 至 0.98),p<0.04)。
成年人血清维生素 D 水平较高与普通人群中阻塞性肺疾病的几率降低有关。非墨西哥裔西班牙裔参与者的结果突出表明,需要在少数族裔人群中进一步开展研究。需要做更多的工作来解决美国的肺部疾病病程和发病率问题。