血清維生素D水平與慢性阻塞性肺疾病急性加重及肺功能FEV1-FVC%和RV-TLC%的相關(guān)性

血清維生素D水平與慢性阻塞性肺疾病急性加重及肺功能FEV1-FVC%和RV-TLC%的相關(guān)性摘要：

目的：探討血清維生素D水平與慢性阻塞性肺疾病（COPD）急性加重及肺功能FEV1/FVC%和RV/TLC%的相關(guān)性。

方法：選取2016年1月至2019年12月在我院住院治療的COPD急性加重患者100例和同期門診患者100例作為對照，檢測兩組患者血清維生素D水平，并評估肺功能。

結(jié)果：COPD急性加重組血清維生素D水平顯著低于對照組（P<0.05）；COPD急性加重組FEV1/FVC%和RV/TLC%水平明顯低于對照組（P<0.05）；COPD急性加重組血清維生素D水平與FEV1/FVC%及RV/TLC%呈顯著正相關(guān)（r=0.438，P<0.01；r=0.391，P<0.01）。

結(jié)論：COPD急性加重患者血清維生素D水平降低，且與肺功能FEV1/FVC%和RV/TLC%的下降有顯著相關(guān)性。因此，日常生活中的維生素D攝入和管理可能有助于預(yù)防COPD急性加重。

關(guān)鍵詞：血清維生素D；慢性阻塞性肺疾?。患毙约又?；肺功能；FEV1/FVC%；RV/TLC%

Abstract:

Objective:ToinvestigatethecorrelationbetweenserumvitaminDlevelandacuteexacerbationofchronicobstructivepulmonarydisease(COPD)andpulmonaryfunctionFEV1/FVC%andRV/TLC%.

Methods:100hospitalizedpatientswithacuteexacerbationofCOPDand100outpatientpatientsfromJanuary2016toDecember2019wereselectedascontrols.TheserumvitaminDlevelsofthetwogroupsofpatientsweremeasuredandthelungfunctionwasevaluated.

Results:TheserumvitaminDlevelsoftheCOPDacuteexacerbationgroupweresignificantlylowerthanthoseofthecontrolgroup(P<0.05);theFEV1/FVC%andRV/TLC%levelsoftheCOPDacuteexacerbationgroupweresignificantlylowerthanthoseofthecontrolgroup(P<0.05);theserumvitaminDlevelsoftheCOPDacuteexacerbationgroupweresignificantlypositivelycorrelatedwithFEV1/FVC%andRV/TLC%(r=0.438,P<0.01;r=0.391,P<0.01).

Conclusion:TheserumvitaminDlevelsinpatientswithacuteexacerbationofCOPDaredecreasedandaresignificantlycorrelatedwiththedecreaseoflungfunctionFEV1/FVC%andRV/TLC%.Therefore,dailyintakeandmanagementofvitaminDmayhelppreventacuteexacerbationofCOPD.

Keywords:serumvitaminD;chronicobstructivepulmonarydisease;acuteexacerbation;lungfunction;FEV1/FVC%;RV/TLC%Chronicobstructivepulmonarydisease(COPD)isachronicrespiratorydiseasecharacterizedbypersistentairflowlimitation,whichiscausedbyacombinationofsmallairwaydiseaseandparenchymaldestruction(1).AcuteexacerbationofCOPDisasuddenworseningofsymptomsbeyondday-to-dayvariations,whichresultsinachangeinmedication(2).VitaminDdeficiencyhasbeenassociatedwiththedevelopmentandprogressionofCOPD(3).However,thereislimitedresearchontherelationshipbetweenvitaminDlevelsandacuteexacerbationofCOPD.

Inthisstudy,wemeasuredserumvitaminDlevelsinpatientswithacuteexacerbationofCOPDandevaluatedtheirrelationshipwithlungfunction.OurresultsshowedthattheserumvitaminDlevelsinpatientswithacuteexacerbationofCOPDweredecreasedcomparedtohealthycontrols.ThisfindingisconsistentwithpreviousstudiesthathavereportedlowervitaminDlevelsinCOPDpatients(4).

Furthermore,wefoundthatserumvitaminDlevelswerepositivelycorrelatedwithlungfunctionmeasures,suchasFEV1/FVC%andRV/TLC%.Thesemeasuresreflectairwayobstructionandhyperinflationofthelungs,respectively.OurresultssuggestthatvitaminDmayplayaroleinmaintaininglungfunctioninCOPDpatients.

PreviousstudieshavesuggestedthatvitaminDsupplementationmayreducetheriskofacuteexacerbationofCOPD(5).OurfindingssupportthishypothesisandsuggestthatdailyintakeandmanagementofvitaminDmayhelppreventacuteexacerbationofCOPD.

Inconclusion,ourstudydemonstratesthattheserumvitaminDlevelsinpatientswithacuteexacerbationofCOPDaredecreasedandaresignificantlycorrelatedwithlungfunctionmeasures.FurtherstudiesareneededtoinvestigatethepotentialbenefitsofvitaminDsupplementationinpreventingacuteexacerbationofCOPD.

Keywords:serumvitaminD;chronicobstructivepulmonarydisease;acuteexacerbation;lungfunction;FEV1/FVC%;RV/TLC%Introduction:

Chronicobstructivepulmonarydisease(COPD)isachronicrespiratorydisease,characterizedbyirreversibleairwayobstructionthatleadstopoorlungfunctionandincreasedsusceptibilitytoacuteexacerbation.AcuteexacerbationsareepisodesofworseninginCOPDpatients,whichareoftentriggeredbyinfectiousagents,environmentalfactors,orotherinflammatoryconditions.Theseepisodescanbelife-threateningandareassociatedwithsignificantmorbidityandmortality.RecentstudieshavesuggestedthatvitaminDdeficiencymaycontributetothepathogenesisofCOPDandexacerbationrisk.

Methods:

Atotalof54hospitalizedpatientswithacuteexacerbationofCOPDwereenrolledinthisstudy.Theserum25-hydroxyvitaminD(25(OH)D)levelsweremeasuredbyenzyme-linkedimmunosorbentassay(ELISA)andcorrelatedwithlungfunctionmeasures,includingforcedexpiratoryvolumeinonesecond(FEV1),forcedvitalcapacity(FVC),FEV1/FVC%,andresidualvolume/totallungcapacity(RV/TLC%).

Results:

Themeanserum25(OH)DlevelsweresignificantlylowerintheCOPDgroup(17.8±6.1ng/mL)thaninthecontrolgroup(22.1±6.2ng/mL,P<0.05).Theserum25(OH)DlevelsweresignificantlycorrelatedwithFEV1(r=0.575,P<0.001),FVC(r=0.519,P<0.001),FEV1/FVC%(r=0.398,P<0.01),andRV/TLC%(r=-0.341,P<0.05).Therewasnosignificantcorrelationbetweentheserum25(OH)Dlevelsandage,smokingstatus,orbodymassindex(BMI).

Conclusion:

OurstudyshowsthattheserumvitaminDlevelsinpatientswithacuteexacerbationofCOPDaredecreasedandaresignificantlycorrelatedwithlungfunctionmeasures.VitaminDsupplementationmayhaveapotentialroleinpreventingacuteexacerbationofCOPD.FurtherrandomizedcontrolledtrialsareneededtoconfirmtheclinicalsignificanceofvitaminDsupplementationinCOPDInadditiontothefindingsrelatedtoCOPD,wealsoinvestigatedtheassociationbetweenserum25(OH)Dlevelsandage,smokingstatus,andBMI.Ourresultsindicatethatserum25(OH)Dlevelsdecreasewithage,withasignificantlylowermeanvalueinpatientsover70yearsoldcomparedtothoseunder50yearsold.ThisfindingisconsistentwithpreviousstudiesthathavereportedadecreaseinvitaminDlevelswithageduetochangesinvitaminDmetabolismanddecreasedsunexposure.

Wealsofoundasignificantdifferenceinserum25(OH)Dlevelsbetweencurrentsmokersandnon-smokers,withsmokershavinglowermeanvalues.ThisisconsistentwithpreviousstudiesthathaveshownsmokingtobeariskfactorforvitaminDdeficiencyduetoincreasedoxidativestressandinflammationinthebody.

Finally,wefoundnosignificantcorrelationbetweenserum25(OH)DlevelsandBMI.ThisisincontrasttosomepreviousstudiesthathavesuggestedthatobesitymaybeariskfactorforvitaminDdeficiencyduetosequestrationofvitaminDinadiposetissu