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Vitamin D deficiency is associated with impaired disease control in asthma-COPD overlap syndrome patients.

Odler B, Ivancsó I, Somogyi V, Benke K, Tamási L, Gálffy G, Szalay B, Müller V - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: As asthma-COPD overlap syndrome (ACOS) is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown.Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OH)D]) in different OLDs, including ACOS patients, and its correlation with clinical parameters.A positive correlation was found between 25(OH)D level and forced expiratory volume in 1 second (r=0.4433; P<0.0001), forced vital capacity (FVC) (r=0.3741; P=0.0004), forced expiratory flow between 25% and 75% of FVC (r=0.4179; P<0.0001), and peak expiratory flow (r=0.4846; P<0.0001) in OLD patient groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.

ABSTRACT

Introduction: The association between vitamin D and clinical parameters in obstructive lung diseases (OLDs), including COPD and bronchial asthma, was previously investigated. As asthma-COPD overlap syndrome (ACOS) is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown.

Aim: Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OH)D]) in different OLDs, including ACOS patients, and its correlation with clinical parameters.

Methods: A total of 106 men and women (control, n=21; asthma, n=44; COPD, n=21; and ACOS, n=20) were involved in the study. All patients underwent detailed clinical examinations; disease control and severity was assessed by disease-specific questionnaires (COPD assessment test, asthma control test, and modified Medical Research Council); furthermore, 25(OH)D levels were measured in all patients.

Results: The 25(OH)D level was significantly lower in ACOS and COPD groups compared to asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL). A positive correlation was found between 25(OH)D level and forced expiratory volume in 1 second (r=0.4433; P<0.0001), forced vital capacity (FVC) (r=0.3741; P=0.0004), forced expiratory flow between 25% and 75% of FVC (r=0.4179; P<0.0001), and peak expiratory flow (r=0.4846; P<0.0001) in OLD patient groups. Asthma control test total scores and the 25(OH)D level showed a positive correlation in the ACOS (r=0.4761; P=0.0339) but not in the asthma group. Higher COPD assessment test total scores correlated with decreased 25(OH)D in ACOS (r=-0.4446; P=0.0495); however, this was not observed in the COPD group.

Conclusion: Vitamin D deficiency is present in ACOS patients and circulating 25(OH)D level may affect disease control and severity.

No MeSH data available.


Related in: MedlinePlus

25(OH)D levels in different patient groups and in OLD patients using different ICS doses.Notes: (A) 25(OH)D levels measured in healthy individuals, asthma, ACOS, and COPD patients. (B) 25(OH)D levels in OLD patients using different doses of ICS. No significant differences were found between the study groups. *P<0.05 vs control. #P<0.05 vs asthma.Abbreviations: ACOS, asthma–COPD overlap syndrome; COPD, chronic obstructive pulmonary disease; 25(OH)D, 25-hydroxyvitamin D; ICS, inhaled corticosteroid; OLD, obstructive lung disease.
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f1-copd-10-2017: 25(OH)D levels in different patient groups and in OLD patients using different ICS doses.Notes: (A) 25(OH)D levels measured in healthy individuals, asthma, ACOS, and COPD patients. (B) 25(OH)D levels in OLD patients using different doses of ICS. No significant differences were found between the study groups. *P<0.05 vs control. #P<0.05 vs asthma.Abbreviations: ACOS, asthma–COPD overlap syndrome; COPD, chronic obstructive pulmonary disease; 25(OH)D, 25-hydroxyvitamin D; ICS, inhaled corticosteroid; OLD, obstructive lung disease.

Mentions: Sixty percentage (15/20) of ACOS, 76% (16/21) of COPD, and 36% (16/44) of asthmatic patients had vitamin D deficiency defined as <20 ng/mL. As shown in Figure 1, the mean serum 25(OH)D level was significantly lower in ACOS and COPD groups compared to the asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL – mean ± standard error of mean; 15.85 [5.55–33.40] ng/mL and 10.80 [4.00–33.80] ng/mL vs 23.45 [8.43–63.10] ng/mL – median [range]). There was no significant difference between COPD and ACOS groups; likewise, no difference between the control group and asthma and ACOS groups was noted. Furthermore, serum 25(OH)D was not influenced by the daily inhaled ICS dose (Figure 1B). The statistical power of the comparable study groups was >0.8, indicating that the number of the patients was adequate to conclude real differences for 25(OH)D levels.


Vitamin D deficiency is associated with impaired disease control in asthma-COPD overlap syndrome patients.

Odler B, Ivancsó I, Somogyi V, Benke K, Tamási L, Gálffy G, Szalay B, Müller V - Int J Chron Obstruct Pulmon Dis (2015)

25(OH)D levels in different patient groups and in OLD patients using different ICS doses.Notes: (A) 25(OH)D levels measured in healthy individuals, asthma, ACOS, and COPD patients. (B) 25(OH)D levels in OLD patients using different doses of ICS. No significant differences were found between the study groups. *P<0.05 vs control. #P<0.05 vs asthma.Abbreviations: ACOS, asthma–COPD overlap syndrome; COPD, chronic obstructive pulmonary disease; 25(OH)D, 25-hydroxyvitamin D; ICS, inhaled corticosteroid; OLD, obstructive lung disease.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590340&req=5

f1-copd-10-2017: 25(OH)D levels in different patient groups and in OLD patients using different ICS doses.Notes: (A) 25(OH)D levels measured in healthy individuals, asthma, ACOS, and COPD patients. (B) 25(OH)D levels in OLD patients using different doses of ICS. No significant differences were found between the study groups. *P<0.05 vs control. #P<0.05 vs asthma.Abbreviations: ACOS, asthma–COPD overlap syndrome; COPD, chronic obstructive pulmonary disease; 25(OH)D, 25-hydroxyvitamin D; ICS, inhaled corticosteroid; OLD, obstructive lung disease.
Mentions: Sixty percentage (15/20) of ACOS, 76% (16/21) of COPD, and 36% (16/44) of asthmatic patients had vitamin D deficiency defined as <20 ng/mL. As shown in Figure 1, the mean serum 25(OH)D level was significantly lower in ACOS and COPD groups compared to the asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL – mean ± standard error of mean; 15.85 [5.55–33.40] ng/mL and 10.80 [4.00–33.80] ng/mL vs 23.45 [8.43–63.10] ng/mL – median [range]). There was no significant difference between COPD and ACOS groups; likewise, no difference between the control group and asthma and ACOS groups was noted. Furthermore, serum 25(OH)D was not influenced by the daily inhaled ICS dose (Figure 1B). The statistical power of the comparable study groups was >0.8, indicating that the number of the patients was adequate to conclude real differences for 25(OH)D levels.

Bottom Line: As asthma-COPD overlap syndrome (ACOS) is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown.Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OH)D]) in different OLDs, including ACOS patients, and its correlation with clinical parameters.A positive correlation was found between 25(OH)D level and forced expiratory volume in 1 second (r=0.4433; P<0.0001), forced vital capacity (FVC) (r=0.3741; P=0.0004), forced expiratory flow between 25% and 75% of FVC (r=0.4179; P<0.0001), and peak expiratory flow (r=0.4846; P<0.0001) in OLD patient groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.

ABSTRACT

Introduction: The association between vitamin D and clinical parameters in obstructive lung diseases (OLDs), including COPD and bronchial asthma, was previously investigated. As asthma-COPD overlap syndrome (ACOS) is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown.

Aim: Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OH)D]) in different OLDs, including ACOS patients, and its correlation with clinical parameters.

Methods: A total of 106 men and women (control, n=21; asthma, n=44; COPD, n=21; and ACOS, n=20) were involved in the study. All patients underwent detailed clinical examinations; disease control and severity was assessed by disease-specific questionnaires (COPD assessment test, asthma control test, and modified Medical Research Council); furthermore, 25(OH)D levels were measured in all patients.

Results: The 25(OH)D level was significantly lower in ACOS and COPD groups compared to asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL). A positive correlation was found between 25(OH)D level and forced expiratory volume in 1 second (r=0.4433; P<0.0001), forced vital capacity (FVC) (r=0.3741; P=0.0004), forced expiratory flow between 25% and 75% of FVC (r=0.4179; P<0.0001), and peak expiratory flow (r=0.4846; P<0.0001) in OLD patient groups. Asthma control test total scores and the 25(OH)D level showed a positive correlation in the ACOS (r=0.4761; P=0.0339) but not in the asthma group. Higher COPD assessment test total scores correlated with decreased 25(OH)D in ACOS (r=-0.4446; P=0.0495); however, this was not observed in the COPD group.

Conclusion: Vitamin D deficiency is present in ACOS patients and circulating 25(OH)D level may affect disease control and severity.

No MeSH data available.


Related in: MedlinePlus