Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 405 30, Sweden.
Department of Lung Medicine, Angered Hospital, SV Hospital Group, Angered, 424 22, Sweden.
Int J Chron Obstruct Pulmon Dis. 2024 Jun 11;19:1291-1302. doi: 10.2147/COPD.S458102. eCollection 2024.
Alterations in body weight and composition are common in patients with chronic obstructive pulmonary disease (COPD) and are independent predictors for morbidity and mortality. Low vitamin D status is also more prevalent in patients with COPD compared to controls and has been related to lower lung function, muscle atrophy and impaired musculoskeletal function. This study aimed to evaluate the association between vitamin D levels and status with body composition (BC), as well as with its changes over time.
Patients with COPD and controls without COPD, participating in the Individualized COPD Evaluation in relation to Ageing (ICE-Age) study, a prospective observational study, were included. Plasma 25-hydroxyvitamin D (25(OH)D) was measured at baseline and BC was measured by dual-energy X-ray absorptiometry scan, at baseline and after two years of follow-up. Multiple linear regression analyses were performed to assess the relationships between 25(OH)D (nmol/l) and longitudinal changes in BMI, fat-free mass index (FFMI), fat mas index (FMI) and bone mineral density (BMD).
A total of 192 patients with COPD (57% males, mean ± SD age, 62 ± 7, FEV1, 49 ± 16% predicted) and 199 controls (45% males, mean ± SD age 61 ± 7) were included in this study. Vitamin D levels were significantly lower in patients with COPD (64 ± 26 nmol/L, 95% CI 60-68 nmol/L versus 75 ± 25 nmol/L, 95% CI 72-79 nmol/L) compared to controls. Both patients and controls presented a significant decline in FFMI and T-score hip, but vitamin D level or status did not determine differences in BC or changes in BC over time in either COPD or controls.
Vitamin D status was not associated with BC or longitudinal changes in BC. However, vitamin D insufficiency and low BMD were more prevalent in patients with COPD compared to controls.
在慢性阻塞性肺疾病（COPD）患者中，体重和成分的改变很常见，并且是发病率和死亡率的独立预测因素。与对照组相比，维生素 D 状态较低的患者也更常见，并且与较低的肺功能、肌肉萎缩和受损的肌肉骨骼功能有关。本研究旨在评估维生素 D 水平和状态与身体成分（BC）之间的关系，以及与随时间的变化。
纳入了参与个体化 COPD 评估与年龄相关（ICE-Age）前瞻性观察研究的 COPD 患者和无 COPD 的对照组患者。在基线时测量血浆 25-羟维生素 D（25（OH）D），并在基线和两年随访时通过双能 X 射线吸收法扫描测量 BC。进行多元线性回归分析，以评估 25（OH）D（nmol/L）与 BMI、无脂肪质量指数（FFMI）、脂肪质量指数（FMI）和骨密度（BMD）的纵向变化之间的关系。
共纳入 192 例 COPD 患者（57%为男性，平均年龄 ± SD 为 62 ± 7 岁，FEV1 为 49 ± 16%预计值）和 199 例对照组（45%为男性，平均年龄 ± SD 为 61 ± 7）。与对照组相比，COPD 患者的维生素 D 水平显著降低（64 ± 26 nmol/L，95%CI 60-68 nmol/L 与 75 ± 25 nmol/L，95%CI 72-79 nmol/L）。患者和对照组的 FFMI 和髋部 T 评分均有显著下降，但维生素 D 水平或状态并未决定 COPD 或对照组中 BC 或 BC 随时间的变化。
维生素 D 状态与 BC 或 BC 的纵向变化无关。然而，与对照组相比，维生素 D 不足和低骨密度在 COPD 患者中更为常见。
