Vitamin D deficiency and lung function decline in healthy individuals: A large longitudinal observation study

Ahn, Kyung Min; Kim, Sun Sin; Lee, Suh Young; Lee, So Hee; Park, Heung-Woo

doi:10.1016/j.rmed.2021.106395

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…Several prospective cohort studies suggest an association between vitamin D deficiency and diminished lung function or an increased risk of acute exacerbation in COPD ( 18 , 38 , 39 ). Furthermore, multiple randomized controlled trials (RCTs) have demonstrated that vitamin D supplementation can decrease the incidence of moderate or severe COPD exacerbations in patients with lower baseline concentrations of 25(OH)D ( 13 , 40 ).…”

Section: Discussionmentioning

confidence: 99%

Nonlinear correlation and mediation effects between serum 25-hydroxyvitamin D levels and all-cause mortality in COPD patients

Jiang,

et al. 2024

Front. Nutr.

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BackgroundNumerous studies have shown that low levels of vitamin D are linked to a higher risk of inflammatory diseases and their progression. However, how vitamin D levels affect mortality in chronic obstructive pulmonary disease (COPD) patients is still unclear. Thus, this study aimed to explore the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and the risk of death from all causes in U.S. adults with COPD.MethodsThis study analyzed 1,876 adults with COPD from the National Health and Nutrition Examination Survey (2005–2018). Mortality data up to December 31, 2019, were obtained from the National Death Index (NDI) records. Participants were categorized into three groups according to their 25(OH)D levels: Q1 (<50.0 nmol/L) for deficiency; Q2 (50.0–74.9 nmol/L) for insufficiency; and Q3 (≥75.0 nmol/L) for adequacy. A weighted Cox regression model assessed the link between 25(OH)D levels and mortality. Kaplan–Meier survival curves, subgroup, and sensitivity analyses were conducted. Additionally, the relationship between 25(OH)D and the hazard ratio (HR) was detailed through restricted cubic spline analysis. Mediation analysis revealed how 25(OH)D mediates the relationship between Dietary Inflammatory Index and mortality.ResultsThere were 395 all-cause deaths during the follow-up, resulting in a mortality rate of 21.06%. After adjusting for potential confounders, higher 25(OH)D levels significantly correlated with a lower risk of all-cause mortality in COPD patients (HR = 0.52, 95% CI: 0.37–0.72, p < 0.001). Restricted cubic spline analysis indicated a non-linear relationship between 25(OH)D levels and all-cause mortality (p for nonlinear = 0.023), with levels below 63.4 nmol/L posing an independent risk for all-cause mortality in COPD patients (HR = 0.98, 95% CI: 0.97–0.99, p = 0.005). Sensitivity and subgroup analyses confirmed our results’ robustness, with mediation analysis showing 25(OH)D’s 22% mediating effect on diet-induced inflammation and all-cause mortality in COPD patients.Conclusion25(OH)D independently lowers the risk of all-cause mortality in COPD patients, with a non-linear L-shaped correlation, and mediates the effect of Dietary Inflammatory Index on mortality, suggesting new therapeutic possibilities.

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Section: Discussionmentioning

confidence: 99%

Nonlinear correlation and mediation effects between serum 25-hydroxyvitamin D levels and all-cause mortality in COPD patients

Jiang,

et al. 2024

Front. Nutr.

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“…Several prospective cohort studies reported that vitamin D deficiency or insufficiency was associated with decreased lung function or increased risk of COPD 12 13 27. However, some other studies found no associations 14 28. Such inconsistency may be attributed to smaller sample size, short follow-up period and residual confounding caused by the incomprehensive adjustment.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D status and chronic obstructive pulmonary disease risk: a prospective UK Biobank study

et al. 2023

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BackgroundLow vitamin D status has been linked to an increased risk for various inflammatory diseases. Conflicting results have been reported regarding chronic obstructive pulmonary disease (COPD). This study aims to investigate the associations of serum 25-hydroxyvitamin D (25(OH)D) concentrations with COPD risk and survival.MethodsWe included 403 648 participants with serum 25(OH)D measurements and free of COPD at baseline from UK Biobank. Follow-up was until 30 September 2021. Multivariable-adjusted cox regression models were applied to estimate HRs and 95% CIs for the associations of season-standardised 25(OH)D concentrations with COPD risk and survival. The restricted cubic splines were used to assess dose–response relationship. Kaplan-Meier estimation was used to create graphs of the survival curves.ResultsDuring a median follow-up of 12.3 (IQR: 11.4–13.2) years, 11 008 cases of COPD were recorded. We observed a non-linear inverse association between 25(OH)D concentrations and COPD risk. Compared with participants in the fourth quintile of 25(OH)D, those in the lowest quintile were associated with a 23% higher risk (HR, 1.23; 95% CI, 1.16 to 1.31). Stronger associations were observed for the risk in men and current smokers (Both p for interaction <0.05). In survival analyses, compared with the fourth quintile, cases in the lowest quintile had a 38% higher risk for overall death (HR, 1.38; 95% CI, 1.22 to 1.56).ConclusionOur findings indicate that serum 25(OH)D concentrations are non-linearly negatively associated with incidence and mortality of COPD, suggesting a potential protective role of vitamin D in the pathogenesis of COPD.

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“…Several prospective cohort studies suggest an association between vitamin D de ciency and diminished lung function or an increased risk of acute exacerbation in COPD (41)(42)(43). Furthermore, multiple randomized controlled trials (RCTs) have demonstrated that vitamin D supplementation can decrease the incidence of moderate or severe COPD exacerbations in patients with lower baseline concentrations of 25(OH)D (11,44).…”

Section: Discussionmentioning

confidence: 99%

Association of vitamin D with all-cause and cardiovascular disease mortality in COPD population: A cohort study from NHANES 2007-2018

Jiang,

et al. 2023

Preprint

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Background The correlation between low levels of vitamin D and an increased risk of various inflammatory diseases has been well established. However, the specific relationship between vitamin D levels and mortality in individuals suffering from chronic obstructive pulmonary disease (COPD) remains unclear. Therefore, the aim of this investigation was to explore the link between serum 25-hydroxyvitamin D [25(OH)D] concentrations and the probability of mortality from all causes and cardiovascular diseases (CVD) in American adults diagnosed with COPD. Methods A total of 1796 adults diagnosed with COPD, who participated in the National Health and Nutrition Examination Survey (2007–2018), were enrolled in this study. Data regarding deaths were obtained through linkage to the National Death Index (NDI) records until December 31, 2019. The association between 25(OH)D concentrations and the risk of mortality was examined both continuously using restricted cubic splines and categorically (< 25.0, 25.0–49.9, 50.0–74.9, and ≥ 75.0 nmol/L) through Cox regression modeling. Competing risk models were employed to explore the relationship between serum 25(OH)D levels and the incidence of CVD-related mortality in individuals diagnosed with COPD. Sensitivity and stratified analyses were conducted to assess the robustness of the findings. Results Over the course of the follow-up period, a total of 357 cases of all-cause mortality were observed, of which 85 were attributed to CVD-related causes. After accounting for various confounding factors, the study revealed that lower serum 25(OH)D levels were significantly associated with a heightened risk of all-cause and CVD-related mortality among COPD patients. When compared to individuals in the lowest category, those in the highest category of serum 25(OH)D showed a 52% reduction in all-cause mortality (HR: 0.48, CI [0.24, 0.94]) and a 69% increase in CVD-related mortality (HR: 0.31, CI [0.11, 0.84]). No evidence of a non-linear association between DII levels and all-cause mortality (p-non-linear = 0.1145) was found. Conclusions Our research indicates that among COPD patients, those with high serum vitamin D concentrations have a lower risk of all-cause and cardiovascular death compared to those with vitamin D deficiency. This demonstrates a non-linear negative correlation, supporting the long-term beneficial effect of vitamin D on COPD patients.

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Vitamin D deficiency and lung function decline in healthy individuals: A large longitudinal observation study

Cited by 6 publications

References 22 publications

Nonlinear correlation and mediation effects between serum 25-hydroxyvitamin D levels and all-cause mortality in COPD patients

Nonlinear correlation and mediation effects between serum 25-hydroxyvitamin D levels and all-cause mortality in COPD patients

Vitamin D status and chronic obstructive pulmonary disease risk: a prospective UK Biobank study

Association of vitamin D with all-cause and cardiovascular disease mortality in COPD population: A cohort study from NHANES 2007-2018

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