Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
Clin Nutr ESPEN. 2021 Dec;46:527-531. doi: 10.1016/j.clnesp.2021.08.009. Epub 2021 Aug 28.
Previous studies have emphasized the effects of vitamin D on the lung function of cystic fibrosis (CF) adult patients. The main aim of the present study sought to determine the association between circulating 25-hydroxyvitamin D (25-OH D) concentration and clinical outcomes in non-cystic fibrosis (non-CF) bronchiectasis subjects. Secondary, we assessed the possible relationship between body composition and respiratory dysfunction in these patients.
Sixty-two non-CF bronchiectasis patients (24 male/38 female), aged 18-72, were recruited in this cross-sectional study. Anthropometric indices, lung function tests, and bronchiectasis severity valuations were determined. Body composition, including Mid-arm muscle circumference (MAMC, cm) was calculated using triceps skinfold (TSF,mm) and mid-arm circumference (MAC,cm) under the reference formula. Then serum 25-hydroxyvitamin D concentration and C-reactive protein level were measured. The correlation between vitamin D level and pulmonary function and disease exacerbation tests was primarily assessed. Additionally, we evaluated the correlation between body composition and lung function tests.
Circulating 25-hydroxyvitamin D status positively was correlated with lung function tests, including FEV (r = 0.30, p value = 0.035) and FVC (r = 0.36, p value = 0.011), and also be associated with the extent of pulmonary involvement (r = -0.34, p value = 0.03). There was a significant negative correlation between percentage body fat and respiratory function, FEV/FVC ratio (r = -0.43, p value < 0.001). In contrast, there was a strong correlation between skeletal muscle mass and pulmonary function tests (r = 0.26, p value = 0.04).
There is a positive association between low 25-hydroxyvitamin D status and lung dysfunction in participants with non-CF bronchiectasis. The pulmonary dysfunction also correlated with more percentage body fat and low skeletal muscle mass in these patients. Therefore, the evaluation of body composition and serum vitamin D are suggested in the disease management of the patients with non-CF bronchiectasis. However, these associations should be interpreted with caution due to the likelihood of reverse causation. More high-quality prospective studies are warranted to confirm our observations and determine the mechanisms underlying these findings.
先前的研究强调了维生素 D 对囊性纤维化 (CF) 成年患者肺功能的影响。本研究的主要目的是确定循环 25-羟维生素 D (25-OH D) 浓度与非 CF 支气管扩张症患者临床结局之间的关联。其次，我们评估了这些患者的身体成分与呼吸功能障碍之间的可能关系。
本横断面研究纳入了 62 名非 CF 支气管扩张症患者（24 名男性/38 名女性），年龄 18-72 岁。测定了人体测量指数、肺功能检查和支气管扩张症严重程度评估。使用肱三头肌皮褶厚度（TSF，mm）和上臂中部周长（MAC，cm）按参考公式计算身体成分，包括上臂中部肌肉周长（MAMC，cm）。然后测量血清 25-羟维生素 D 浓度和 C-反应蛋白水平。主要评估了维生素 D 水平与肺功能和疾病恶化试验之间的相关性。此外，我们评估了身体成分与肺功能检查之间的相关性。
循环 25-羟维生素 D 状态与肺功能检查呈正相关，包括 FEV（r=0.30，p 值=0.035）和 FVC（r=0.36，p 值=0.011），并与肺部受累程度相关（r=-0.34，p 值=0.03）。身体脂肪百分比与呼吸功能、FEV/FVC 比值呈显著负相关（r=-0.43，p 值<0.001）。相反，骨骼肌质量与肺功能检查呈强相关（r=0.26，p 值=0.04）。
在非 CF 支气管扩张症患者中，低 25-羟维生素 D 状态与肺功能障碍呈正相关。这些患者的肺功能障碍也与更高的身体脂肪百分比和较低的骨骼肌质量相关。因此，建议在非 CF 支气管扩张症患者的疾病管理中评估身体成分和血清维生素 D。但是，由于可能存在反向因果关系，这些关联应谨慎解释。需要更多高质量的前瞻性研究来证实我们的观察结果并确定这些发现的机制。
