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Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study.

Abstract

RATIONALE

Low blood levels of 25-hydroxyvitamin D (25[OH]D) have been associated with a higher risk of respiratory infections in general populations and higher risk of exacerbations of lung disease in people with asthma. We hypothesized that low blood levels of 25(OH)D in patients with chronic obstructive pulmonary disease (COPD) would be associated with an increased risk of acute exacerbations of COPD (AECOPD).

OBJECTIVES

To determine if baseline 25(OH)D levels relate to subsequent AECOPD in a cohort of patients at high risk for AECOPD.

METHODS

Plasma 25(OH)D was measured at baseline in 973 participants on entry to a 1-year study designed to determine if daily azithromycin decreased the incidence of AECOPD. Relationships between baseline 25(OH)D and AECOPD over 1 year were analyzed with time to first AECOPD as the primary outcome and exacerbation rate as the secondary outcome.

MEASUREMENTS AND MAIN RESULTS

In this largely white (85%) sample of North American patients with severe COPD (mean FEV(1) 1.12L; 40% of predicted), mean 25(OH)D was 25.7 ± 12.8 ng/ml. A total of 33.1% of participants were vitamin D insufficient (≥20 ng/ml but <30 ng/ml); 32% were vitamin D deficient (<20 ng/ml); and 8.4% had severe vitamin D deficiency (<10 ng/ml). Baseline 25(OH)D levels had no relationship to time to first AECOPD or AECOPD rates.

CONCLUSIONS

In patients with severe COPD, baseline 25(OH)D levels are not predictive of subsequent AECOPD. Clinical trial registered with www.clinicaltrials.gov (NCT00119860).

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  • Authors+Show Affiliations

    ,

    Pulmonary Section, Minneapolis Veterans Affairs Medical Center, Minnesota 55417, USA. kunis001@umn.edu

    , ,

    Source

    MeSH

    Acute Disease
    Aged
    Anti-Bacterial Agents
    Azithromycin
    Biomarkers
    Female
    Humans
    Male
    Middle Aged
    Proportional Hazards Models
    Prospective Studies
    Pulmonary Disease, Chronic Obstructive
    Recurrence
    Risk
    Vitamin D
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22077070

    Citation

    Kunisaki, Ken M., et al. "Vitamin D Levels and Risk of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: a Prospective Cohort Study." American Journal of Respiratory and Critical Care Medicine, vol. 185, no. 3, 2012, pp. 286-90.
    Kunisaki KM, Niewoehner DE, Connett JE, et al. Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. Am J Respir Crit Care Med. 2012;185(3):286-90.
    Kunisaki, K. M., Niewoehner, D. E., & Connett, J. E. (2012). Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. American Journal of Respiratory and Critical Care Medicine, 185(3), pp. 286-90. doi:10.1164/rccm.201109-1644OC.
    Kunisaki KM, et al. Vitamin D Levels and Risk of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: a Prospective Cohort Study. Am J Respir Crit Care Med. 2012 Feb 1;185(3):286-90. PubMed PMID: 22077070.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. AU - Kunisaki,Ken M, AU - Niewoehner,Dennis E, AU - Connett,John E, AU - ,, Y1 - 2011/11/10/ PY - 2011/11/15/entrez PY - 2011/11/15/pubmed PY - 2012/4/18/medline SP - 286 EP - 90 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 185 IS - 3 N2 - RATIONALE: Low blood levels of 25-hydroxyvitamin D (25[OH]D) have been associated with a higher risk of respiratory infections in general populations and higher risk of exacerbations of lung disease in people with asthma. We hypothesized that low blood levels of 25(OH)D in patients with chronic obstructive pulmonary disease (COPD) would be associated with an increased risk of acute exacerbations of COPD (AECOPD). OBJECTIVES: To determine if baseline 25(OH)D levels relate to subsequent AECOPD in a cohort of patients at high risk for AECOPD. METHODS: Plasma 25(OH)D was measured at baseline in 973 participants on entry to a 1-year study designed to determine if daily azithromycin decreased the incidence of AECOPD. Relationships between baseline 25(OH)D and AECOPD over 1 year were analyzed with time to first AECOPD as the primary outcome and exacerbation rate as the secondary outcome. MEASUREMENTS AND MAIN RESULTS: In this largely white (85%) sample of North American patients with severe COPD (mean FEV(1) 1.12L; 40% of predicted), mean 25(OH)D was 25.7 ± 12.8 ng/ml. A total of 33.1% of participants were vitamin D insufficient (≥20 ng/ml but <30 ng/ml); 32% were vitamin D deficient (<20 ng/ml); and 8.4% had severe vitamin D deficiency (<10 ng/ml). Baseline 25(OH)D levels had no relationship to time to first AECOPD or AECOPD rates. CONCLUSIONS: In patients with severe COPD, baseline 25(OH)D levels are not predictive of subsequent AECOPD. Clinical trial registered with www.clinicaltrials.gov (NCT00119860). SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/22077070/Vitamin_D_levels_and_risk_of_acute_exacerbations_of_chronic_obstructive_pulmonary_disease:_a_prospective_cohort_study_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.201109-1644OC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -