Lokesh KS, Chaya SK, Jayaraj BS, Praveena AS, Krishna M, Madhivanan P, Mahesh PA. Vitamin D deficiency is associated with chronic obstructive pulmonary disease and exacerbation of COPD.
Clin Respir J 2021;
15:389-399. [PMID:
33217151 PMCID:
PMC8043964 DOI:
10.1111/crj.13310]
[Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/14/2020] [Accepted: 11/13/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION
Low Vitamin D levels have been associated with Chronic Obstructive Pulmonary Disease (COPD) and acute exacerbations.
OBJECTIVES
There is a paucity of data on Vitamin D and COPD, its severity and exacerbations in populations that are exposed to sunlight regularly with high levels of physical activity most of their lives.
METHODS
Serum levels of 25-OH-Vitamin-D were assessed in 100 COPD subjects and 100 age- and gender-matched controls from the rural community-based MUDHRA cohort in South India. Levels of <20 ng/mL were defined as Vitamin D deficiency. Smoking habits, occupation, Charlson co-morbidity index, Standard of living index(SLI), body mass index(BMI), 6-minute walking distance were examined for associations with logistic regression between controls and COPD subjects. Unconditional logistic regression was used to examine the association with exacerbation of COPD.
RESULTS
Vitamin D deficiency was observed in 64.5% (95%CI 57.7-70.8) of the subjects in spite of regular exposure to sunlight. Subjects with COPD had higher risk of Vitamin D deficiency (Adjusted OR: 5.05; 95%CI 1.4-17.8) as compared to controls. Amongst subjects with COPD, Vitamin D deficient subjects were three times more likely to have exacerbations in the previous year (Adjusted OR:3.51; 95%CI 1.27-9.67) as compared to COPD subjects without Vitamin D deficiency. Levels of Vitamin D <20.81 ng/mL and <18.45 ng/mL had the highest levels of combined sensitivity and specificity for COPD and acute exacerbation of COPD (AECOPD) respectively.
CONCLUSION
In a rural population exposed to sunlight many hours a day throughout their lives, low Vitamin D levels were associated with COPD and exacerbations of COPD.
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