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Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.
- Source :
-
The Journal of steroid biochemistry and molecular biology [J Steroid Biochem Mol Biol] 2018 Jan; Vol. 175, pp. 138-145. Date of Electronic Publication: 2017 Feb 01. - Publication Year :
- 2018
-
Abstract
- Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV <subscript>1</subscript> ), % predicted forced vital capacity (FVC), the ratio of FEV <subscript>1</subscript> to FVC (FEV <subscript>1</subscript> :FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration <50nmol/L). Lower vitamin D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (P<0.001), sampling in Winter or Spring (P for trend=0.006) and lack of a recent sunny holiday (P=0.002). Vitamin D deficiency associated with reduced % predicted FEV <subscript>1</subscript> (P for trend=0.060) and % predicted FVC (P for trend=0.003), but it did not associate with FEV <subscript>1</subscript> :FVC, ICS dose, QoL, QS, or the percentage of eosinophils or neutrophils in induced sputum. After correction for multiple comparisons testing, genetic variation in the vitamin D pathway was not found to associate with serum 25(OH)D concentration or clinical correlates of COPD severity. Vitamin D deficiency was common in this group of COPD patients in the UK, and it associated independently with reduced % predicted FEV1 and FVC. However, genetic variation in the vitamin D pathway was not associated with vitamin D status or severity of COPD.<br /> (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Body Mass Index
Cross-Sectional Studies
Cytochrome P-450 Enzyme System blood
Cytochrome P-450 Enzyme System genetics
DNA-Binding Proteins blood
DNA-Binding Proteins genetics
Eosinophils metabolism
Eosinophils pathology
Female
Gene Expression Regulation
Humans
London epidemiology
Low Density Lipoprotein Receptor-Related Protein-2 blood
Low Density Lipoprotein Receptor-Related Protein-2 genetics
Male
Middle Aged
Neutrophils metabolism
Neutrophils pathology
Oxidoreductases Acting on CH-CH Group Donors blood
Oxidoreductases Acting on CH-CH Group Donors genetics
Prevalence
Pulmonary Disease, Chronic Obstructive blood
Pulmonary Disease, Chronic Obstructive complications
Pulmonary Disease, Chronic Obstructive genetics
Racial Groups
Receptors, Calcitriol blood
Receptors, Calcitriol genetics
Receptors, Cell Surface blood
Receptors, Cell Surface genetics
Respiratory Function Tests
Severity of Illness Index
Transcription Factors blood
Transcription Factors genetics
Vitamin D blood
Vitamin D Deficiency blood
Vitamin D Deficiency complications
Vitamin D Deficiency genetics
Pulmonary Disease, Chronic Obstructive epidemiology
Vitamin D analogs & derivatives
Vitamin D Deficiency epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1220
- Volume :
- 175
- Database :
- MEDLINE
- Journal :
- The Journal of steroid biochemistry and molecular biology
- Publication Type :
- Academic Journal
- Accession number :
- 28161533
- Full Text :
- https://doi.org/10.1016/j.jsbmb.2017.01.019