Relation between Vitamin D Deficiency and Severity of Chronic Obstructive Pulmonary Disease-A Case Control Study
Published: January 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.7097
Shah Sanket, Jagadesh Madireddi, Weena Stanley, Pradeep Sura, Mukhyaprana Prabhu
1. Post Graduate, Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
2. Post Graduate, Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
3. Associate Professor, Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
4. Post Graduate, Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
5. Professor and Head of Unit, Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Correspondence
Dr. Jagadesh Madireddi,
Post Graduate, Department of Medicine, Kasturba Medical College, Manipal-576 104, Karnataka, India.
E-mail: jagadesh.madireddi21@gmail.com
Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder characterized by irreversible and progressive limitation of expiratory airflow. COPD is now considered as a systemic disease with several extra-pulmonary manifestations which include osteoporosis, muscle weakness, arrhythmia, stroke, cancer etc. The role of vitamin D in skeletal integrity is well established. Role of it in several other diseases like autoimmune, infectious, respiratory and cardiovascular diseases has been increasingly recognised. Data on vitamin D status in COPD in Indian population was limited while those comparing vitamin D with stage, pack year and body mass index were lacking.
Aim: To assess Vitamin D in subjects with COPD and matched controls and also to study the variability in serum vitamin D levels with COPD disease characteristics. Materials and Methods: A total of 162 patients aged 18-65 years from south India presenting to kasturba hospital were included in the study. Serum 25- hydroxy-vitamin D were measured in 81 COPD patients (combined COPD stage A-D) and compared with 81 age and gender matched controls. Level < 20 ng/ml defined deficiency. Risk estimate with Odds ratio and association of COPD characteristics with Vitamin D was assessed using logistic regression analysis.
Results: COPD patients had an increased risk for vitamin D deficiency compared to controls after adjustment for age and gender(OR =2.687 (1.40,5.13)). Variables associated with lower 25(OH) D levels in COPD patients were higher pack year (p=0.001), current smoking status (p=0.026), Low BMI (p=0.02), and GOLD stage III- IV (p=0.001).
Conclusion: COPD was associated with an increased risk of vitamin D deficiency, and there was a significant association between vitamin D levels and Combined COPD stage severity. Also, a higher pack year and a low BMI are associated with lower levels of vitamin D.
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