Role of Vitamin D in reducing number of acute exacerbations in Chronic Obstructive Pulmonary Disease (COPD) patients

Abstract

Background and Objective:Chronic obstructive pulmonary disease (COPD) is characterized by chronic incompletely reversible poor airflow and air trapping and usually this debilitating disorder limits the outside activities of the patients depriving them of sunlight which is a rich source of Vitamin D. The objective of this study was to determine the effect of vitamin D supplementation in reducing number of acute exacerbation in COPD patients.Methods:This randomized control trial was conducted at East Medical Ward Mayo Hospital Lahore from January to December 2015 as exacerbations of COPD are season dependent. Diagnosis was confirmed by performing Pulmonary Function Tests (PFTs). Basic demographical information was obtained and baseline PFTs of the patient was done. Only Group A patients was treated with oral vitamin D intake of 2000 IU daily for 6 months. Vitamin D level was measured at 0, 2, 4, and 6 months and exacerbation of COPD, FEV1 and FVC was measured weekly. Both the groups were given standard treatment for exacerbation of COPD. Spirometry was repeated at each visit. Blood samples were collected every 2 months for vitamin D. Supplementation was stopped if vitamin D level exceeded 100ng/ml.Results:The mean age of the patients was 46.28±8.83 years, the male to female ratio was 1.8:1. The mean 25(OH) level at baseline was 24.08±2.58 and at 6th month was 29.60±8.74. The mean FVC at baseline was 77.83±5.49 and at 6th month was 91.34±5.52. The exacerbation at baseline was present in all 120(100%) patients and at 6th month was reduced to 4(3.3%).Conclusion:Vitamin D supplementation has significant effect in reducing number of acute exacerbation in COPD patients when it is given for prolonged period.

Low Vitamin D Status Is Associated with Inflammation in Patients with Chronic Obstructive Pulmonary Disease

“…Recently, numerous researchers indicated that 1,25(OH) 2 D 3 , the active form of vitamin D, recovered elastaneinduced reduction of forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) and alveolar destruction in a mouse model of COPD (15). A population-based study found that vitamin D supplementation obviously alleviated acute exacerbation in COPD patients (16). Otherwise, experiment in vitro also found that vitamin D receptor (VDR) knock-out mice showed increased lung inflammation and accelerated lung function decline in a COPD mouse model (17).…”

Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency

“…In terms of respiratory diseases, there is wide evidence of benefit from cholecalciferol supplementation in chronic obstructive pulmonary disease (COPD), with two RCTs demonstrating statistically significant benefits in favor of cholecalciferol in several relevant clinical end-points, such as reduced rate of exacerbations and improvement of FEV1 (forced expiratory volume in the first second) [ 37 , 38 ], as well as another RCT showing improvements in inspiratory muscle strength and maximum oxygen consumption [ 39 ]. Also noteworthy in this clinical context is the ViDiCO RCT of Martineau AR et al, performed on 240 COPD patients and published in Lancet Respiratory Medicine in 2015, in which it was observed that cholecalciferol supplementation produced a statistically significant reduction in the risk of moderate or severe exacerbation in COPD patients with baseline levels of 25(OH)D below 20 ng/mL at the start of the clinical trial [ 40 ].…”

A Comprehensive Review on Vitamin D as a Novel Therapeutic Agent in Chronic Obstructive Pulmonary Disease

“…In comparison, Hornix et al performed a subgroup analysis on people with very low baseline 25(OH)D levels from Lehouck's study population, which showed positive results in improving inspiratory muscle strength [ 30 ]. Later on, many RCTs proved this vitamin to be protective of the frequency of acute exacerbations of COPD [ 31 , 33 , 34 ].…”