Vitamin D, vitamin D binding protein, lung function and structure in COPD

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• 作者：Isaac Berg ; Corrine Hanson ; Harlan Sayles ; Debra Romberger ; Amy Nelson ; Jane Meza ; Bruce Miller ; Emiel F.M. Wouters ; William MacNee ; E.P.A. Rutten ; Elisabeth A.P.M. Romme ; J?rgen Vestbo ; Lisa Edwards ; Stephen Rennard
• 关键词：Emphysema ; 25(OH)D ; FEV1 ; Free vitamin D
• 刊名：Respiratory Medicine
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：107
• 期：10
• 页码：1578-1588
• 全文大小：1565 K

文摘

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Summary

Rationale

Vitamin D and vitamin D binding protein (DBP) have been associated with COPD and FEV1. There are limited data regarding emphysema and vitamin D and DBP.

Objective

This is a pilot study of a portion of the subjects in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study designed to examine the relationship between vitamin D status, DBP, FEV1 and emphysema in COPD patients.

Methods

We measured serum 25(OH)D and DBP in 498 ECLIPSE subjects. Subjects were distributed amongst smoker controls, non-smoker controls, and GOLD stages 2, 3 and 4. Within each GOLD stage, the subjects were equally divided amongst high and low emphysema burden. The associations between 25(OH)D, DBP, and free vitamin D with FEV1, CT-defined emphysema, biomarkers and clinical data including CT-measured bone attenuation were assessed.

Measurements

25(OH)D and DBP were measured using tandem mass spectroscopy and competitive enzyme-linked immunosorbent assay, respectively,

Main result

25(OH)D was correlated with FEV1 (p?=?0.01) and with severity of emphysema (p?<?0.01). 25(OH)D was also associated with six-minute walk (p?=?0.02), bronchodilator response (p?=?0.04), and Clara cell secretory protein (CC-16) (p?=?0.01). 25(OH)D levels were not associated with CT-measured bone attenuation, however DBP was associated with bone attenuation in subjects with emphysema. DBP was not associated with FEV1 or emphysema. 25(OH)D and DBP were inversely associated (p?=?0.01).

Conclusion

This is the first study to demonstrate a relationship between emphysema and vitamin D. We also provide further evidence for a relationship between vitamin D and FEV1.