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Randomized Controlled Trial
. 2013;8(1):e53670.
doi: 10.1371/journal.pone.0053670. Epub 2013 Jan 14.

Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality--results from a 10-year prospective cohort study

Dennis Back Holmgaard  1 , Lone Hagens Mygind, Ingrid Louise Titlestad, Hanne Madsen, Palle Bach Nielsen Fruekilde, Svend Stenvang Pedersen, C Pedersen
Affiliations
Randomized Controlled Trial

Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality--results from a 10-year prospective cohort study

Dennis Back Holmgaard et al. PLoS One. 2013.

Abstract

Background: Recent studies have found vitamin D (25-OHD) deficiency and insufficiency to be common among patients with COPD. Serum level of 25-OHD seems to correlate to pulmonary function, COPD disease staging, and increased susceptibility to respiratory infections. We wanted to investigate whether vitamin D deficiency or insufficiency was associated with mortality rate in patients suffering from advanced COPD.

Methods: 25-OHD serum levels were measured in 462 patients suffering from moderate to very severe COPD. Patients were stratified into three groups according to serum levels of 25-OHD. Outcome measure was mortality in a 10 year follow-up period. Kaplan-Meier curves (KM) were plotted and mortality hazard ratios (HR) were calculated using Cox Proportional Hazard regression (Cox PH).

Results: Serum 25-OHD deficiency and insufficiency were prevalent. We were unable to demonstrate any association between baseline serum levels of 25-OHD and mortality rate. We found an association between mortality and age [HR 1.05 (CI 95%: 1.03-1.06)], Charlson score [HR 1.49 (CI 95%: 1.06-2.09)], increasing neutrophil count [HR 1.05 (CI 95%: 1.02-1.09)], severe [HR 1.41 (CI 95%: 1.06-1.86)]/very severe COPD [HR 2.19 (CI 95%: 1.58-3.02)] and a smoking history of more than 40 pack years [HR 1.27 (CI 95%: 1.02-1.70)].

Conclusions: Serum level of 25-OHD does not seem to be associated with mortality rate, suggesting no or only a minor role of 25-OHD in disease progression in patients with moderate to very severe COPD.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Three-year survival according to conventional levels of serum 25-OHD deficiency and insufficiency.
Differences between groups were examined using a log-rank test. Result is displayed as a p value in the lower left corner.
Figure 2
Figure 2. Three-year survival according to levels of serum 25-OHD distributed on tertiles.
Differences between groups were examined using a log-rank. Result is displayed as a p value in the lower left corner.
Figure 3
Figure 3. Seasonal differences in median serum 25-OHD levels.
Significance levels were determined using Wilcoxon Rank sum test.
Figure 4
Figure 4. 25-Hydroxyvitamin serum levels plotted as a function of Fev1 (% pred).
Spearman coefficient was determined and the value noted in the lower left of the figure. Table below displays median 25-OHD levels distributed on COPD severity. Significance was tested using Kruskal Wallis equality-of-populations rank test.
See this image and copyright information in PMC

References

    1. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS (2001) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 163: 1256–1276. - PubMed
    1. Lash TL, Johansen MB, Christensen S, Baron JA, Rothman KJ, et al. (2011) Hospitalization rates and survival associated with COPD: a nationwide Danish cohort study. Lung 189: 27–35. - PubMed
    1. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367: 1747–1757. - PubMed
    1. Pauwels RA, Rabe KF (2004) Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet 364: 613–620. - PubMed
    1. Sandford AJ, Chagani T, Weir TD, Connett JE, Anthonisen NR, et al. (2001) Susceptibility genes for rapid decline of lung function in the lung health study. Am J Respir Crit Care Med 163: 469–473. - PubMed

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