Title: Associations Among 25-Hydroxyvitamin D Levels, Lung Function, and Exacerbation Outcomes in COPD: An Analysis of the SPIROMICS Cohort.

Authors: Burkes, Robert M; Ceppe, Agathe S; Doerschuk, Claire M; Couper, David; Hoffman, Eric A; Comellas, Alejandro P; Barr, R Graham; Krishnan, Jerry A; Cooper, Christopher; Labaki, Wassim W; Ortega, Victor E; Wells, J Michael; Criner, Gerard J; Woodruff, Prescott G; Bowler, Russell P; Pirozzi, Cheryl S; Hansel, Nadia N; Wise, Robert A; Brown, Todd T; Drummond, M Bradley; SPIROMICS Investigators

Published In Chest, (2020 Apr)

Abstract: The relationship between 25-hydroxyvitamin D (25-OH-vitamin D) and COPD outcomes remains unclear. Using the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), we determined associations among baseline 25-OH-vitamin D and cross-sectional and longitudinal lung function and COPD exacerbations.Serum 25-OH-vitamin D level was measured in stored samples from 1,609 SPIROMICS participants with COPD. 25-OH-vitamin D levels were modeled continuously and dichotomized as deficient (< 20 ng/mL) vs not deficient (≥ 20 ng/mL). Outcomes of interest included % predicted FEV1 (current and 1-year longitudinal decline) and COPD exacerbations (separately any and severe, occurring in prior year and first year of follow-up).Vitamin D deficiency was present in 21% of the cohort and was more prevalent in the younger, active smokers, and blacks. Vitamin D deficiency was independently associated with lower % predicted FEV1 (by 4.11%) at enrollment (95% CI, -6.90% to -1.34% predicted FEV1; P = .004), 1.27% predicted greater rate of FEV1 decline after 1 year (95% CI, -2.32% to -0.22% predicted/y; P = .02), and higher odds of any COPD exacerbation in the prior year (OR, 1.32; 95% CI, 1.00-1.74; P = .049). Each 10-ng/mL decrease in 25-OH-vitamin D was associated with lower baseline lung function (-1.04% predicted; 95% CI, -1.96% to -0.12% predicted; P = .03) and increased odds of any exacerbation in the year before enrollment (OR, 1.11; 95% CI, 1.01-1.22; P = .04).Vitamin D deficiency is associated with worse cross-sectional and longitudinal lung function and increased odds of prior COPD exacerbations. These findings identify 25-OH-vitamin D levels as a potentially useful marker of adverse COPD-related outcomes.

PubMed ID: 31958447

MeSH Terms: Biomarkers/blood; Correlation of Data; Disease Progression; Female; Humans; Longitudinal Studies; Male; Middle Aged; Outcome Assessment, Health Care; Prevalence; Pulmonary Disease, Chronic Obstructive*/blood; Pulmonary Disease, Chronic Obstructive*/diagnosis; Pulmonary Disease, Chronic Obstructive*/epidemiology; Pulmonary Disease, Chronic Obstructive*/physiopathology; Respiratory Function Tests*/methods; Respiratory Function Tests*/statistics & numerical data; Symptom Flare Up; United States/epidemiology; Vitamin D Deficiency*/diagnosis; Vitamin D Deficiency*/epidemiology; Vitamin D/analogs & derivatives*; Vitamin D/blood