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van Iersel LEJ, Beijers RJHCG, Gosker HR, Schols AMWJ. Nutrition as a modifiable factor in the onset and progression of pulmonary function impairment in COPD: a systematic review. Nutr Rev 2021; 80:1434-1444. [PMID: 34537848 PMCID: PMC9086787 DOI: 10.1093/nutrit/nuab077] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
CONTEXT Chronic obstructive lung disease (COPD) is a progressive lung disease characterized by persistent airflow limitation. An increasing amount of evidence suggests an effect of dietary quality on the risk of COPD in the general population and pulmonary function decline in patients with COPD. OBJECTIVE The association of dietary intake and nutrient status with COPD risk and onset, as well as pulmonary function decline (change in forced expiratory volume in 1 second, forced vital capacity, or the ratio of the former to the latter) in patients with COPD was investigated in this systematic review. DATA SOURCES The PubMed database was searched by combining terms of pulmonary function or COPD with diet, nutrient status, or nutritional supplementation. DATA EXTRACTION Original studies and systematic reviews and meta-analyses were included. Articles obtained were independently screened for relevance on the bases of title and abstract by 2 researchers. Eventually, 89 articles were included in the analysis. RESULTS The unhealthy Western-style diet is associated with an increased risk of COPD and an accelerated decline of pulmonary function. Intake of fruit, vegetables, dietary fibers, vitamins C and E, polyphenols, and β-carotene were individually associated with lower COPD risk, whereas consumption of processed meat was associated with higher COPD risk. Data on the effect of dietary quality on pulmonary function decline in patients with COPD are limited and inconsistent. Strong evidence for beneficial effects on pulmonary function decline was found only for vitamin D supplementation. CONCLUSION Considering the increasing burden of COPD, more attention should be given to dietary quality as a modifiable factor in disease development and progression in patients with COPD. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021240183.
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Affiliation(s)
- Lieke E J van Iersel
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rosanne J H C G Beijers
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Harry R Gosker
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Annemie M W J Schols
- Lieke E.J. van Iersel, Rosanne J.H.C.G. Beijers, Harry R. Gosker, and Annemie M.W.J. Schols are with the Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Ahn KM, Kim SS, Lee SY, Lee SH, Park HW. Vitamin D deficiency and lung function decline in healthy individuals: A large longitudinal observation study. Respir Med 2021; 182:106395. [PMID: 33894439 DOI: 10.1016/j.rmed.2021.106395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/27/2021] [Accepted: 04/04/2021] [Indexed: 12/23/2022]
Abstract
AIM A reliable evidence from a comprehensive large-scale study supporting associations between serum vitamin D (25-hydroxyvitamin D) level (SVDL) and lung function decline (LFD) in healthy individuals has been unavailable. Using a well-established health screening database, we assessed the associations between SVDL and LFDs, measured as the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio. METHODS Serial SVDL and lung function data were analyzed using linear mixed models, which were performed in smokers and non-smokers, separately. Vitamin D-deficient individuals (VDDs) were defined when their SVDLs were consistently lower than 20 ng/mL at all measurements. RESULTS A total of 1371 individuals were analyzed. The mean FEV1 decline rates of VDDs and vitamin D-normal individuals (VDNs) in smokers were -33.35 mL/year (95% CI: 39.44 to -27.26 mL/year) and -15.61 mL/year (95% CI: 27.29 to -4.21 mL/year) respectively, over a mean of 6.29 years of observation with statistical significance (P < 0.001). However, there was no significant differences observed between decline rates of FEV1 in non-smokers. Similarly, FVC decline rates of VDDs were significantly greater than those of VDNs only in smokers (P < 0.001). However, FEV1/FVC ratio decline rates showed no significant difference between VDDs and VDNs regardless of their smoking status. CONCLUSIONS Consistently low SVDLs predicted more rapid FEV1 and FVC declines in smokers. However, FEV1/FVC decline rate was not associated with SVDL. SVDL may be used to identify healthy smoking individuals at high risk for accelerated LFD.
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Affiliation(s)
- Kyung-Min Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun-Sin Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - So-Hee Lee
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Decreased lung function is associated with vitamin D deficiency in apparently health, middle aged Koreans: the Kangbuk Samsung Health Study. Eur J Clin Nutr 2020; 75:501-512. [PMID: 32934338 DOI: 10.1038/s41430-020-00748-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 08/19/2020] [Accepted: 09/04/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES There has been inconsistent relationships between serum vitamin D levels and lung function in previous studies. However, previous studies included patients with medical diseases, affecting both vitamin D levels and lung function. Considering this view of potential confounders, we investigated if vitamin D deficiency (VDD) is linked to lung function in health screening examinee without overt medical conditions. SUBJECTS/METHODS We conducted a cohort study on 68,457 healthy Koreans (36,759 males, mean age: 37.7 years) with a health examination in 2015. Measured forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were categorized in quartiles. To examine the relationships between VDD and lung function, adjusted odds ratios (aORs) for VDD were estimated by logistic regression. RESULTS Median vitamin D level was 14.9 ng/mL. The prevalence of VDD (defined as <20 ng/ml) was 74.5%. Compared with the highest quartile (Q4, reference), the aORs for VDD across decreasing quartiles (from Q3 to Q1) were 1.05, 1.06, 1.10 for FVC, and 1.07, 1.10, 1.10 for FEV1 (P for trend < 0.01 for both), in all subjects. Similarly, the aOR of having VDD for men also increased with decreasing quartiles of FVC and FEV1 in a dose-response manner (p for trend < 0.01 for both). However, neither FVC nor FEV1 was associated with VDD in women. CONCLUSIONS VDD was associated with decreased lung function in middle aged Korean men without overt medical conditions. VDD could be a modifiable risk factor for impaired lung function, in men but not in women.
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Garshick E, Walia P, Goldstein RL, Teylan MA, Lazzari AA, Tun CG, Hart JE. Associations between vitamin D and pulmonary function in chronic spinal cord injury. J Spinal Cord Med 2019; 42:171-177. [PMID: 29424660 PMCID: PMC6419689 DOI: 10.1080/10790268.2018.1432305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT/OBJECTIVE Individuals with chronic spinal cord injury (SCI) have an increased risk of morbidity and mortality attributable to respiratory diseases. Previous studies in non-SCI populations suggest that vitamin D may be a determinant of respiratory health. Therefore, we sought to assess if lower vitamin D levels were associated with decreased pulmonary function in persons with chronic SCI. DESIGN Cross-sectional study. SETTING Veterans Affairs Medical Center. PARTICIPANTS 312 participants (260 men and 52 women) with chronic SCI recruited from VA Boston and the community participating in an epidemiologic study to assess factors influencing respiratory health. METHODS Participants provided a blood sample, completed a respiratory health questionnaire, and underwent spirometry. Linear regression methods were used to assess cross-sectional associations between plasma 25-hydroxyviatmin D and spirometric measures of pulmonary function. OUTCOME MEASURES Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC. RESULTS Adjusted and unadjusted for a number of confounders, there was no significant association between plasma vitamin D levels and FEV1, FVC, or FEV1/FVC. For example, in fully adjusted models, each 10 ng/ml increase in vitamin D was associated with a 4.4 ml (95%CI -64.4, 73.2, P = 0.90) ml change in FEV1. Conclusion: There was no significant cross-sectional association between plasma vitamin D and FEV1, FVC, or FEV1/FVC in this cohort of individuals with chronic SCI.
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Affiliation(s)
- Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, Massachusetts, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA,Correspondence to: Eric Garshick, MD, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA02132, USA.
| | - Palak Walia
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Rebekah L. Goldstein
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Merilee A. Teylan
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Antonio A. Lazzari
- Divison of Primary Care and Rheumatology Section, VA Boston Healthcare System, Boston, Massachusetts, USA,Boston University School of Medicine, Boston, Massachusetts, USA
| | - Carlos G. Tun
- Department of Physical Medicine and Rehabilitation, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Craveiro V, Cabral M, Araújo J, Falcão H, Guimarães JT, Ramos E. Association of Serum 25-Hydroxyvitamin D Concentration with Pulmonary Function in Young Adults. Nutrients 2018; 10:nu10111728. [PMID: 30423859 PMCID: PMC6266201 DOI: 10.3390/nu10111728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 02/06/2023] Open
Abstract
The role of vitamin D on pulmonary function is unclear and is mostly studied in patients, smokers and elderly people. The aim of this paper was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and pulmonary function in young adults. Cross-sectional analysis of 499 individuals that were evaluated at 21 years of age as part of the population-based cohort Epidemiological Health Investigation of Teenagers in Porto (EPITeen). Serum 25(OH)D was categorized according to the Institute of Medicine. Pulmonary function was evaluated using spirometry. Linear regression models were used to estimate the regression coefficients (β) and its 95% confidence intervals (95% CI), and were adjusted for confounders. Education, smoking, body mass index, and season of evaluation were determinants of serum 25(OH)D concentration. Prevalence of serum 25(OH)D concentration <50 nmol/L was 48.9%. A decrease in all pulmonary function parameters, with the decrease of serum 25(OH)D, was observed. The higher effect was found for peak expiratory flow (PEF). Having as reference participants with serum 25(OH)D concentration ≥50 nmol/L, PEF was significantly lower for those with a concentration of 30 to <50 nmol/L (β= −0.576; 95% CI: −0.943, −0.210), and for those with a concentration of <30 nmol/L (β= −0.650; 95% CI: −1.155, −0.146). Although only PEF attained statistical significance, the consistent results with the other parameters support the role of serum 25(OH)D to promote better pulmonary function in young adults.
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Affiliation(s)
- Vanda Craveiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
| | - Maria Cabral
- Unidade de Epidemiologia-Departamento de Ciências da Saúde Pública e Forenses e Educação Médica da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
| | - Joana Araújo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
| | - Helena Falcão
- Serviço de Imunoalergologia do Centro Hospitalar do Porto, E.P.E., 4099-001 Porto, Portugal.
| | - João Tiago Guimarães
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
- Serviço de Patologia Clínica do Centro Hospitalar de São João, E.P.E., 4200-319 Porto, Portugal.
- Departamento de Biomedicina da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
| | - Elisabete Ramos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
- Unidade de Epidemiologia-Departamento de Ciências da Saúde Pública e Forenses e Educação Médica da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
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Brumpton BM, Langhammer A, Henriksen AH, Romundstad PR, Chen Y, Camargo CA, Mai XM. Serum 25-hydroxyvitamin D, vitamin D supplement and asthma control: The HUNT study. Respir Med 2018; 136:65-70. [PMID: 29501248 DOI: 10.1016/j.rmed.2018.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/09/2018] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
Abstract
Few studies have investigated the association between serum 25-hydroxyvitamin D (25[OH]D), vitamin D supplement and asthma control among adults. We aimed to examine whether low levels of serum 25(OH)D or not taking vitamin D supplement were associated with an increased risk of poorly controlled asthma among Norwegian adults with asthma. We used a definition of asthma control adapted from the Global Initiative for Asthma. We first examined cross-sectional associations between serum 25(OH)D (n = 806) or vitamin D supplement (n = 1179) and poorly controlled asthma. Next, among those with well controlled asthma at baseline, we examined prospective associations between serum 25(OH)D (n = 147) or vitamin D supplement (n = 208) and poorly controlled asthma at follow-up, approximately 11 years later. We estimated risk ratios (RR) and 95% confidence intervals (CI) with Poisson regression. The adjusted RR for poorly controlled asthma was 1.00 (95% CI, 0.89-1.13) for adults with serum 25(OH)D < 50 nmol/L in cross-sectional and 1.50 (95% CI, 0.46-4.95) in prospective analyses. The adjusted RR for poorly controlled asthma was 1.17 (95% CI 1.00-1.37) for non-users of vitamin D supplement in cross-sectional and 1.66 (95% CI 0.49-5.67) in prospective analyses. Our study did not show strong evidence that among adults with asthma, having a low serum 25(OH)D or being a non-user of vitamin D supplement was associated with an increased risk of poorly controlled asthma. Some point estimates indicated an increased risk, however our estimates were generally imprecise and further evidence is needed.
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Affiliation(s)
- Ben M Brumpton
- Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Norway; MRC Integrative Epidemiology Unit, University of Bristol, UK.
| | - Arnulf Langhammer
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne H Henriksen
- Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Norway
| | - Pål R Romundstad
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Xiao-Mei Mai
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Effect of Monthly, High-Dose, Long-Term Vitamin D on Lung Function: A Randomized Controlled Trial. Nutrients 2017; 9:nu9121353. [PMID: 29236049 PMCID: PMC5748803 DOI: 10.3390/nu9121353] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 01/08/2023] Open
Abstract
Although observational studies suggest positive vitamin D-lung function associations, randomized trials are inconsistent. We examined effects of vitamin D supplementation on lung function. We recruited 442 adults (50–84 years, 58% male) into a randomized, double-blinded, placebo-controlled trial. Participants received, for 1.1 years (median; range = 0.9–1.5 years), either (1) vitamin D3 200,000 IU, followed by monthly 100,000 IU doses (n = 226); or (2) placebo monthly (n = 216). At baseline and follow-up, spirometry yielded forced expiratory volume in 1 s (FEV1; primary outcome). Mean (standard deviation) 25-hydroxyvitamin D increased from 61 (24) nmol/L at baseline to 119 (45) nmol/L at follow-up in the vitamin D group, but was unchanged in the placebo group. There were no significant lung function improvements (vitamin D versus placebo) in the total sample, vitamin D-deficient participants or asthma/chronic obstructive pulmonary disease (COPD) participants. However, among ever-smokers (n = 217), the mean (95% confidence interval) FEV1 increase in the vitamin D versus placebo was 57 (4, 109) mL (p = 0.03). FEV1 increases were larger among vitamin D-deficient ever-smokers (n = 54): 122 (8, 236) mL (p = 0.04). FEV1 improvements were largest among ever-smokers with asthma/COPD (n = 60): 160 (53, 268) mL (p = 0.004). Thus, vitamin D supplementation did not improve lung function among everyone, but benefited ever-smokers, especially those with vitamin D deficiency or asthma/COPD.
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Abstract
Lutein, a fat-soluble carotenoid with antioxidant properties, may have an effect on respiratory health. However, the evidence is inconsistent. We aimed to cross-sectionally investigate the association between lutein intake and lung function by measuring forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC% in adults (aged 45-79 years). We included 4402 participants from the Rotterdam Study, a prospective cohort study in The Netherlands. Lutein intake was assessed using a validated FFQ. Lung function was assessed using spirometry around the same time point as the dietary assessment. No independent association was found between lutein intake and FEV1 (-12·17 (95 % CI -34·21, 9·87) ml per sd increase in lutein) after adjustment for age, sex, height, cohort effect, ethnicity, education, weight, total daily energy intake, smoking status, physical activity, and intakes of fatty acids, dietary fibre, alcohol, β-carotene, β-crypotoxanthin, lycopene and zeaxanthin. There was also no association between lutein and FVC or FEV1/FVC%. However, after stratification by smoking status, lutein intake was significantly associated with lower FEV1/FVC% in current smokers (-1·69 (95 % CI -2·93, -0·45) % per sd increase of lutein) independent of other carotenoids. The present study does not support an independent association between lutein intake and lung function in adults. However, future studies should focus on the potential inverse association between high lutein intake and lung function in specific risk groups such as smokers.
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Kaul A, Gläser S, Hannemann A, Stubbe B, Felix SB, Nauck M, Ewert R, Friedrich N. No mediating effects of glycemic control and inflammation on the association between vitamin D and lung function in the general population. Respir Med 2017; 125:1-7. [PMID: 28340855 DOI: 10.1016/j.rmed.2017.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/30/2017] [Accepted: 02/17/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Vitamin D deficiency is discussed to be associated with lung health. While former studies focused on subjects suffering from pulmonary diseases, we aimed to investigate the association of 25-hydroxy vitamin D [25(OH)D] with lung function in the general population and examined whether mediating effects of inflammation, glycemic control or renal function exist. METHODS 1404 participants from the Study of Health in Pomerania with pulmonary function testing assessed by expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity and Krogh index were used. Adjusted analysis of variance, linear regression models and mediation analyses were performed. RESULTS Significant positive associations between 25(OH)D levels and FEV1, FVC and Krogh index were found. Mediator analyses revealed no mediating effect of inflammation (fibrinogen), glycemic control (HbA1c) or renal function (eGFR) on associations with FEV1 or FVC. With respect to Krogh-Index, the association to 25(OH)D was slightly mediated by fibrinogen with a proportion mediated of 9.7%. CONCLUSION Significant positive associations of 25(OH)D with lung function were revealed in a general population. The proposed mediating effects of inflammation, glycemic control and renal function on these relations were not confirmed. Further studies examining the causality of the association between 25(OH)D and lung function are necessary.
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Affiliation(s)
- Anne Kaul
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sven Gläser
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany; Vivantes Klinikum Spandau, Department of Pulmonary Medicine, Berlin, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Stefan B Felix
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany.
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Brumpton BM, Langhammer A, Henriksen AH, Camargo CA, Chen Y, Romundstad PR, Mai XM. Vitamin D and Lung Function Decline in Adults With Asthma: The HUNT Study. Am J Epidemiol 2016; 183:739-46. [PMID: 26994061 DOI: 10.1093/aje/kwv243] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 09/04/2015] [Indexed: 12/17/2022] Open
Abstract
We investigated whether low 25-hydroxyvitamin D (25(OH)D) levels were associated with more lung function decline in adults with asthma and whether this association was modified by smoking status or inhaled corticosteroid (ICS) use. We analyzed data on 395 adults with asthma from the Nord-Trøndelag Health Study (1995-2008), Norway. Plasma 25(OH)D and lung function were measured at baseline, and lung function measurements were repeated at follow-up, approximately 11 years later. Linear regression was used to estimate lung function decline. Participants with low 25(OH)D (<50 nmol/L) had more decline in lung function measurements for forced expiratory volume in 1 second (FEV1) (388 mL), forced vital capacity (298 mL), and the FEV1/forced vital capacity ratio (3.7%) over the follow-up, compared with those with high 25(OH)D (≥50 nmol/L) who declined 314 mL, 246 mL, and 3.0%, respectively (P = 0.08, 0.30, and 0.23, respectively). The associations were stronger in never smokers and non-ICS users. In never smokers, low 25(OH)D levels were associated with more decline in FEV1 (445 vs. 222 mL) (P = 0.01). In non-ICS users, low 25(OH)D levels were associated with more decline in FEV1 (467 vs. 320 mL) (P = 0.02). Low serum 25(OH)D levels were weakly associated with more lung function decline in adults with asthma, and stronger associations were observed in never smokers and non-ICS users.
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