Supplemental vitamin D and physical performance in COPD: a pilot randomized trial

Bjerk, Sonja; Edgington, Bradley; Rector, Thomas S.; Kunisaki, Ken M.

doi:10.2147/copd.s40885

Cited by 24 publications

(18 citation statements)

References 35 publications

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“…Given that serum 25(OH)D deficiency was mainly observed in severe COPD patients, the protective effects of 25(OH)D in severe COPD patients was compared with that in mild COPD patients. While our results are not consistent with the study conducted by Bjerk et al 40 our conclusion was not influenced. First, a limited number of patients (n=36) were included in that study.…”

Section: Discussioncontrasting

confidence: 99%

“… 9 , 38 Only the study conducted by Bjerk et al reported that there was no obvious benefit for severe COPD patients with vitamin D supplement based on two questionnaire scores (Short Physical Performance Battery and St George’s Respiratory Questionnaire). 40 Generally, vitamin D intake was a safe approach without severe side effects for COPD patients based on most studies.…”

Section: Resultsmentioning

confidence: 99%

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Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis

Zhu

Xiao

Zheng

2015

COPD

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PurposeTo explore the association between host serum 25-hydroxyvitamin D (25(OH)D) and the susceptibility and severity of COPD.MethodsPrevious studies on the association between host 25(OH)D and the susceptibility and severity of COPD were collected on the basis of a systematic literature search of PubMed and Web of Science up to June 2015. Continuous variable data were presented as standard mean difference (SMD) or weighted mean difference with 95% confidence interval (CI). The dichotomous variable data were analyzed as relative ratio (RR) or odds ratio with 95% CI for cohort and case-control studies. A systematic review was conducted to understand the curative and side effects of vitamin D intake.ResultsA total of 18 studies including eight cohort, five case-control, and five randomized studies met the inclusion criteria. The serum level of 25(OH)D in COPD patients was comparable with controls with a pooled SMD of 0.191 (95% CI: −0.126 to 0.508, P=0.237) based on pooled analyses of cohort studies. However, the serum level of 25(OH)D in COPD patients was lower with a pooled SMD of 0.961 (95% CI: 0.476–1.446, P<0.001) compared with controls based on pooled analyses of case-control studies. The deficiency rates of 25(OH)D were comparable between controls and COPD patients with a pooled RR of 0.955 (95% CI: 0.754–1.211, P=0.705) based on analyses of cohort studies, and the same results were observed based on pooled analyses of case-control studies. Interestingly, the deficiency rate of 25(OH)D was significantly lower in moderate or severe COPD patients with a pooled RR of 0.723 (95% CI: 0.632–0.828, P<0.001) compared with that in mild COPD patients. The same results were obtained from the pooled analysis between moderate and severe COPD patients. The four randomized studies showed that vitamin D intake provided benefit for COPD patients.ConclusionLow serum levels of 25(OH)D were not associated with COPD susceptibility, but the high deficiency rate of 25(OH)D was associated with COPD severity. Vitamin D supplementation may prevent COPD exacerbation.

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Section: Discussioncontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis

Zhu

Xiao

Zheng

2015

COPD

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“…Two studies have been performed assessing the effect of vitamin D supplementation on physical performance in patients with COPD. A pilot RCT did not show effects of vitamin D supplementation on physical performance, but was limited by the small number of 36 participants and short follow-up of 6 weeks [ 32 ]. Also, the study was not specifically aimed at patients with vitamin D deficiency.…”

Section: Introductionmentioning

confidence: 99%

Prevention of exacerbations in patients with COPD and vitamin D deficiency through vitamin D supplementation (PRECOVID): a study protocol

et al. 2015

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BackgroundVitamin D is well known for its function in calcium homeostasis and bone mineralisation, but is increasingly studied for its potential immunomodulatory properties. Vitamin D deficiency is a common problem in patients with COPD. Previous studies have not demonstrated a beneficial effect of vitamin D on exacerbation rate in COPD patients. However, subgroup analyses suggested protective effects in vitamin D deficient patients. Our objective is to assess the effect of vitamin D supplementation on exacerbation rate specifically in vitamin D deficient COPD patients.Methods/DesignWe will perform a randomised, multi-center, double-blind, placebo-controlled intervention study. The study population consists of 240 COPD patients aged 40 years and older with vitamin D deficiency (25-hydroxyvitamin D concentration < 50 nmol/L). Participants will be recruited after an exacerbation and will be randomly allocated in a 1:1 ratio to receive vitamin D3 16800 IU or placebo orally once a week during 1 year. Participants will receive a diary card to register the incidence of exacerbations and changes in medication during the study period. Visits will be performed at baseline, at 6 months and at 12 months after randomisation. Participants will undergo spirometry, measurement of total lung capacity and assessment of maximal respiratory mouth pressure. Several physical performance and hand grip strength tests will be performed, questionnaires on quality of life and physical activity will be filled in, a nasal secretion sample and swab will be obtained and blood samples will be taken. The primary outcome will be exacerbation rate.DiscussionThis study will be the first RCT aimed at the effects of vitamin D supplementation on exacerbation rate in vitamin D deficient COPD patients. Also, in contrast to earlier studies that used infrequent dosing regimens, our trial will study effects of a weekly dose of vitamin D supplementation. Secondly, the immunomodulatory effects of vitamin D on host immune response of COPD patients and underlying mechanisms will be studied. Finally, the effects on physical functioning will be examined.Trial registrationThis trial is registered in ClinicalTrials.gov, ID number NCT02122627. Date of Registration April 2014.

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“…[25] Vitamin D supplementation has also been suggested for improving physical performance, but a recent randomised trial did not show any benefits in this regard. [26] Although vitamin D deficiency may contribute to morbidity in COPD patients, a lack of vitamin D does not appear to contribute to excess mortality. [27] …”

Section: Asthma and Vitamin D Levelsmentioning

confidence: 99%

Vitamin D in respiratory diseases

Mahomed

2017

S Afr Res J

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REVIEWVitamin D has traditionally been known for its role in bone homeostasis with its effects on calcium and phosphate absorption and secretion. However, new evidence is emerging of its effects on a number of other cells, especially the immune system. This article reviews the role of vitamin D as it pertains to the respiratory tract and respiratory diseases. Respir J 2017;23 (1) Vitamin D belongs to a group of fat-soluble secosteroids and is required for intestinal absorption of calcium (Ca 2+ ) and phosphate (PO 4 3-). In humans, vitamin D is present as ergocalciferol (vitamin D 2 ) or cholecalciferol (vitamin D 3 ), and both forms can be ingested from the diet and/or supplements. The body can also synthesise vitamin D from cholesterol when sun exposure is adequate, hence it has been nicknamed the 'sunshine vitamin' . [1] Recently, interest has grown in the role of vitamin D in many non-skeletal medical conditions, including respiratory infection and lung function. [2] Emerging evidence indicates that vitamin D-mediated innate immunity is important in host defences against respiratory tract pathogens. [3] Observational studies suggest that vitamin D deficiency increases the risk of respiratory infections, incident wheezing illness in children and adults, and can cause asthma exacerbations. Vitamin D also modulates regulatory T-cell function and interleukin-10 (IL-10) production, which may increase the therapeutic response to glucocorticoids in steroid-resistant asthma. S Afr HistoryIn 1914, American researchers McCollum and Davis discovered a substance in cod liver oil which was later called 'vitamin A' . In 1922, McCollum tested modified cod liver oil in which the vitamin A had been denatured. The modified oil cured rickets in sick dogs, so McCollum concluded the factor in cod liver oil that cured rickets was distinct from vitamin A. He called it vitamin D because it was the fourth vitamin to be named. [4] In 1923, American biochemist Harry Steenbock demonstrated that the irradiation of foodstuffs, especially milk, led to a cure for rickets. In 1932, an academic collaboration between Bourdillon, Rosenheim, King and Callow led to the isolation and characterisation of vitamin D and later in the 1930s, Windaus further clarified the chemical structure of vitamin D. By 1972, Holick had discovered that vitamin D was metabolised to two active forms, i.e. calcidiol and calcitriol. [5,6] Recommended dietary allowance of vitamin DThe US Institute of Medicine (IOM) recommended dietary allowance of vitamin D is 400 international units (IU) per day for children younger than 1 year of age, 600 IU per day for children at least 1 year of age and adults up to 70 years, and 800 IU per day for older adults.The US IOM concluded that serum 25-hydroxyvitamin D (25(OH)D) of 20 ng/mL or more would cover the requirements of 97.5% of the population. [7] The US Endocrine Society's Clinical Practice Guidelines suggest that 400 -1 000 IU/day may be needed for children aged <1 year, 600 -1 000 IU/day for children aged ≥1 year, and 1 500 ...

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Supplemental vitamin D and physical performance in COPD: a pilot randomized trial

Cited by 24 publications

References 35 publications

Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis

Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis

Prevention of exacerbations in patients with COPD and vitamin D deficiency through vitamin D supplementation (PRECOVID): a study protocol

Vitamin D in respiratory diseases

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