Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.
File(s)Jolliffe JSBMB 2017.pdf (1.46 MB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV1), % predicted forced vital capacity (FVC), the ratio of FEV1 to FVC (FEV1:FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration <50nmol/L). Lower vitamin D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (P<0.001), sampling in Winter or Spring (P for trend=0.006) and lack of a recent sunny holiday (P=0.002). Vitamin D deficiency associated with reduced % predicted FEV1 (P for trend=0.060) and % predicted FVC (P for trend=0.003), but it did not associate with FEV1:FVC, ICS dose, QoL, QS, or the percentage of eosinophils or neutrophils in induced sputum. After correction for multiple comparisons testing, genetic variation in the vitamin D pathway was not found to associate with serum 25(OH)D concentration or clinical correlates of COPD severity. Vitamin D deficiency was common in this group of COPD patients in the UK, and it associated independently with reduced % predicted FEV1 and FVC. However, genetic variation in the vitamin D pathway was not associated with vitamin D status or severity of COPD.
Date Issued
2017-02-01
Date Acceptance
2017-02-01
Citation
Journal of Steroid Biochemistry and Molecular Biology, 2017, 175, pp.138-145
ISSN
1879-1220
Publisher
Elsevier
Start Page
138
End Page
145
Journal / Book Title
Journal of Steroid Biochemistry and Molecular Biology
Volume
175
Copyright Statement
© 2017 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
PII: S0960-0760(17)30019-5
Subjects
COPD
FEV1
FVC
Single nucleotide polymorphism
Spirometry
Vitamin D
Adult
Aged
Aged, 80 and over
Body Mass Index
Continental Population Groups
Cross-Sectional Studies
Cytochrome P-450 Enzyme System
DNA-Binding Proteins
Eosinophils
Female
Gene Expression Regulation
Humans
London
Low Density Lipoprotein Receptor-Related Protein-2
Male
Middle Aged
Neutrophils
Oxidoreductases Acting on CH-CH Group Donors
Prevalence
Pulmonary Disease, Chronic Obstructive
Receptors, Calcitriol
Receptors, Cell Surface
Respiratory Function Tests
Severity of Illness Index
Transcription Factors
Vitamin D Deficiency
0601 Biochemistry And Cell Biology
Endocrinology & Metabolism
Publication Status
Published