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Observational Study
. 2014 Dec 13;15(1):131.
doi: 10.1186/s12931-014-0131-0.

Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients

Andrei Malinovschi  1 , Monica Masoero  2 , Michela Bellocchia  3 , Antonio Ciuffreda  4 , Paolo Solidoro  5 , Alessio Mattei  6 , Lorena Mercante  7 , Enrico Heffler  8 , Giovanni Rolla  9 , Caterina Bucca  10
Affiliations
Observational Study

Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients

Andrei Malinovschi et al. Respir Res. .

Abstract

Background: Acute exacerbations of COPD (AECOPD) are common and strongly influence disease severity and relative healthcare costs. Vitamin D deficiency is frequent among COPD patients and its contributory role in disease exacerbations is widely debated. Our aim was to assess the relationship of serum vitamin D levels with COPD severity and AECOPD.

Methods: Serum vitamin D (25-hydroxyvitamin D) levels were measured in 97 COPD patients and related to lung function, comorbidities, FEV1 decline, AECOPD and hospital admission during the previous year.

Results: Most patients (96%) had vitamin D deficiency, which was severe in 35 (36%). No significant relationship was found between vitamin D and FEV1 or annual FEV1 decline. No difference between patients with and without severe vitamin D deficiency was found in age, gender, BMI, smoking history, lung function, and comorbidities, apart from osteoporosis (60.9% in severe deficiency vs 22.7%, p = 0.001). In multiple logistic regression models, severe deficiency was independently associated with AECOPD [adjusted odds ratios (aOR) of 30.5 (95% CI 5.55, 168), p < 0.001] and hospitalization [aOR 3.83 (95% CI 1.29, 11.4), p = 0.02]. The odds ratio of being a frequent exacerbator if having severe vitamin D deficiency was 18.1 (95% CI 4.98, 65.8) (p < 0.001), while that of hospitalization was 4.57 (95% CI 1.83, 11.4) (p = 0.001).

Conclusions: In COPD patients severe vitamin D deficiency was related to more frequent disease exacerbations and hospitalization during the year previous to the measurement of vitamin D. This association was independent of patients' characteristics and comorbidities.

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Figures

Figure 1
Figure 1
Lung function parameters: FEV 1 (%predicted) (A), VC (% predicted) (B), MEF 50 (% predicted) (C), FEV 1 /VC (×100) (D) in relation to vitamin D levels (log-scale).
Figure 2
Figure 2
Levels of vitamin D (log-scale) in COPD subjects divided according to the number of exacerbations the year previous to the measurements of vitamin D levels (A) and the proportion of subjects with severe vitamin D deficiency (<10 ng/mL) in COPD subjects divided according to the number of exacerbations the year previous to the measurements of vitamin D levels (B).
Figure 3
Figure 3
Levels of vitamin D (A) or prevalence of severe vitamin D deficiency (B) in COPD subjects divided according to being hospitalized the year previous to the measurements of vitamin D levels.
See this image and copyright information in PMC

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