Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
Respir Med. 2021 Jun;182:106395. doi: 10.1016/j.rmed.2021.106395. Epub 2021 Apr 20.
A reliable evidence from a comprehensive large-scale study supporting associations between serum vitamin D (25-hydroxyvitamin D) level (SVDL) and lung function decline (LFD) in healthy individuals has been unavailable. Using a well-established health screening database, we assessed the associations between SVDL and LFDs, measured as the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio.
Serial SVDL and lung function data were analyzed using linear mixed models, which were performed in smokers and non-smokers, separately. Vitamin D-deficient individuals (VDDs) were defined when their SVDLs were consistently lower than 20 ng/mL at all measurements.
A total of 1371 individuals were analyzed. The mean FEV1 decline rates of VDDs and vitamin D-normal individuals (VDNs) in smokers were -33.35 mL/year (95% CI: 39.44 to -27.26 mL/year) and -15.61 mL/year (95% CI: 27.29 to -4.21 mL/year) respectively, over a mean of 6.29 years of observation with statistical significance (P < 0.001). However, there was no significant differences observed between decline rates of FEV1 in non-smokers. Similarly, FVC decline rates of VDDs were significantly greater than those of VDNs only in smokers (P < 0.001). However, FEV1/FVC ratio decline rates showed no significant difference between VDDs and VDNs regardless of their smoking status.
Consistently low SVDLs predicted more rapid FEV1 and FVC declines in smokers. However, FEV1/FVC decline rate was not associated with SVDL. SVDL may be used to identify healthy smoking individuals at high risk for accelerated LFD.
目前缺乏可靠的综合大规模研究证据支持健康个体血清维生素 D(25-羟维生素 D)水平(SVDL)与肺功能下降(LFD)之间的关联。本研究使用成熟的健康筛查数据库评估了 SVDL 与 LFD(以用力肺活量(FVC)、1 秒用力呼气量(FEV1)和 FEV1/FVC 比值衡量)之间的关联。
采用线性混合模型分别在吸烟者和非吸烟者中分析了 SVDL 和肺功能的系列数据。当 SVDL 在所有测量中均持续低于 20ng/mL 时,定义为维生素 D 缺乏个体(VDD)。
共分析了 1371 人。吸烟者中 VDD 和维生素 D 正常个体(VDN)的 FEV1 年下降率分别为-33.35mL/年(95%CI:39.44 至-27.26mL/年)和-15.61mL/年(95%CI:27.29 至-4.21mL/年),在平均 6.29 年的观察中具有统计学意义(P<0.001)。然而,在非吸烟者中未观察到 FEV1 下降率的显著差异。同样,仅在吸烟者中,VDD 的 FVC 年下降率明显大于 VDN(P<0.001)。然而,无论其吸烟状况如何,VDD 和 VDN 的 FEV1/FVC 下降率均无显著差异。
持续低 SVDL 预测吸烟者的 FEV1 和 FVC 下降更快。然而,FEV1/FVC 下降率与 SVDL 无关。SVDL 可用于识别有加速 LFD 风险的健康吸烟个体。