Vitamin D, vitamin D binding protein, and longitudinal outcomes in COPD

Louise J P Persson; Marianne Aanerud; Pieter S Hiemstra; Annika E Michelsen; Thor Ueland; Jon A Hardie; Pål Aukrust; Per S Bakke; Tomas M L Eagan

doi:10.1371/journal.pone.0121622

Vitamin D, vitamin D binding protein, and longitudinal outcomes in COPD

PLoS One. 2015 Mar 24;10(3):e0121622. doi: 10.1371/journal.pone.0121622. eCollection 2015.

Authors

Louise J P Persson¹, Marianne Aanerud², Pieter S Hiemstra³, Annika E Michelsen⁴, Thor Ueland⁵, Jon A Hardie⁶, Pål Aukrust⁷, Per S Bakke⁶, Tomas M L Eagan⁸

Affiliations

¹ Dept. of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
² Dept. of Medicine, Haukeland University Hospital, Bergen, Norway.
³ Dept. of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
⁵ Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁶ Dept. of Clinical Science, University of Bergen, Bergen, Norway.
⁷ Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁸ Dept. of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Dept. of Clinical Science, University of Bergen, Bergen, Norway.

Abstract

Background: Associations between Vitamin D3 [25(OH)D], vitamin D binding protein (VDBP) and chronic obstructive pulmonary disease (COPD) are previously reported. We aimed to further investigate these associations on longitudinal outcomes.

Methods: 426 COPD patients from western Norway, GOLD stage II-IV, aged 40-76, were followed every six-month from 2006 through 2009 with spirometry, bioelectrical impedance measurements and registration of exacerbation frequency. Serum 25(OH)D and VDBP levels were determined at study-entry by high-performance liquid chromatography coupled with mass spectrometry and enzyme immunoassays respectively. Yearly change in lung function and body composition was assessed by generalized estimating equations (GEE), yearly exacerbation rate by negative binomial regression models, and 5 years all-cause mortality by Cox proportional-hazard regression.

Results: 1/3 of the patients had vitamin D deficiency (<20ng/mL) and a greater decline in both FEV1 and FVC, compared to patients with normal levels; for FEV1 this difference only reached statistical significance in the 28 patients with the lowest levels (<10ng/mL, p = 0.01). Neither 25(OH)D nor VDBP levels predicted exacerbation rate, change in fat free mass index or risk of death.

Conclusion: Severe vitamin D deficiency may affect decline in lung function parameters in COPD. Neither 25(OH)D nor VDBP levels did otherwise predict markers of disease progression.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Body Mass Index
Cohort Studies
Disease Progression
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prognosis
Pulmonary Disease, Chronic Obstructive / blood*
Pulmonary Disease, Chronic Obstructive / diagnosis*
Pulmonary Disease, Chronic Obstructive / mortality
Pulmonary Disease, Chronic Obstructive / pathology
Respiratory Function Tests
Risk
Vitamin D / blood*
Vitamin D-Binding Protein / blood*

Substances

Vitamin D-Binding Protein
Vitamin D

Grants and funding

Funding for the Vitamin D measurements was provided from an unrestricted grant from the Bergen Medical Research Foundation received by TMLE. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.