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VOLUME 9 , ISSUE 1 ( January-June, 2020 ) > List of Articles

Original Article

Baseline Vitamin D as a Predictor of Mortality among Hospitalized Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in an Endemically Vitamin D-Deficient Area in North India

Mohammad Ramzan Bhat, Shabir Ahmad Dar, Mir Waseem, Mir Nadeem

Keywords : Chronic obstructive pulmonary disease, hazard ratio, mortality, Vitamin D

Citation Information : Bhat MR, Dar SA, Waseem M, Nadeem M. Baseline Vitamin D as a Predictor of Mortality among Hospitalized Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in an Endemically Vitamin D-Deficient Area in North India. Indian J Respir Care 2020; 9 (1):88-93.

DOI: 10.4103/ijrc.ijrc_48_19

License: CC BY-NC-SA 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2020; Indian Journal of Respiratory Care.


Abstract

Background: Conflicting data suggest that Vitamin D reduces the risk of developing chronic obstructive pulmonary disease (COPD) and COPD exacerbations. Scant data are available regarding the Vitamin D status in patients with COPD in India where Vitamin D deficiency is rampant. Objectives: We set out to study the role of baseline Vitamin D on the outcome of acute exacerbation of COPD (AECOPD) in terms of exacerbations, hospitalizations, and mortality. Materials and Methods: In a prospective observational design, 147 consenting participants with AECOPD were recruited and serum Vitamin D assessed at admission. The patients were followed for 3 months for treatment outcomes in terms of mortality, readmissions and exacerbations. Standard statistical methods were used to compare the results among those with sufficient and insufficient Vitamin D status at baseline. Results: Out of 147 completely followed participants, 113 (76.9%) were deficient in Vitamin D (mean ± standard deviation = 11.79 ± 8.5 [normal 30–100 ng/ml]). Patients with low Vitamin D were found to have a significantly higher 90-day mortality than those with normal Vitamin D status (P = 0.42; hazard ratio 4.8, P = 0.032). No statistically significant differences were observed in rates of exacerbations or hospital admission. Conclusion: Patients of AECOPD having baseline Vitamin D deficiency at admission have a higher mortality than those with normal Vitamin D level. Thus, Vitamin D level can serve as a prognostic indicator of the outcome of AECOPD. Larger studies are suggested to further study the association and also determine any role of Vitamin D in the treatment of such cases.

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  1. Fabbri LM, Hurd SS; GOLD Scientific Committee. Global strategy for the diagnosis, management and prevention of COPD: 2003 update. Eur Respir J 2003;22:1-2.
  2. Burney P, Jithoo A, Kato B, Janson C, Mannino D, Niankowska-Mogilnicka E, et al. Chronic obstructive pulmonary disease mortality and prevalence: The associations with smoking and poverty-a BOLD analysis. Thorax 2014;69:465-73.
  3. Koul PA, Dar HA, Jan RA, Shah S, Khan UH. Two-year mortality in survivors of acute exacerbations of chronic obstructive pulmonary disease: A North Indian study. Lung India 2017;34:511-6.
  4. Foong RE, Zosky GR. Vitamin D deficiency and the lung: Disease initiator or disease modifier? Nutrients 2013;5:2880-900.
  5. Koul PA. Vitamin D and respiratory infections J Med Med Sci 2012;3:83-6.
  6. Khan DM. Role of Vitamin D in reducing number of acute exacerbations in COPD patients. J Med Sci 2017;33:610-4.
  7. Zargar AH, Ahmad S, Masoodi SR, Wani AI, Bashir MI, Laway BA, et al. Vitamin D status in apparently healthy adults in Kashmir Valley of Indian subcontinent. Postgrad Med J 2007;83:713-6.
  8. Lehouck A, Mathieu C, Carremans C, Baeke F, Verhaegen J, Van Eldere J, et al. High doses of Vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: A randomized trial. Ann Intern Med 2012;156:105-14.
  9. Mekov E, Slavova Y, Tsakova A, Genova MP, Kostadinov DT, Minchev D, et al. One-year mortality after severe COPD exacerbation in Bulgaria. PeerJ 2016;4:e2788.
  10. Zhu M, Wang T, Wang C, Ji Y. The association between vitamin D and COPD risk, severity, and exacerbation: An updated systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2016;11:2597-607.
  11. Khan DM, Ullah A, Randhawa FA, Iqtadar S, Butt NF, Waheed K. Role of Vitamin D in reducing number of acute exacerbations in chronic obstructive pulmonary disease (COPD) patients. 2017;33:610-4.
  12. Gupta BK, Meena SL, Saini M, Nehara HR, Saini ML, Gupta J. Evaluation of Vitamin-D level in patients of chronic obstructive pulmonary disease (COPD) and its clinical correlation. Innov J Med Health Sci 2016;3:107-12.
  13. Janssens W, Bouillon R, Claes B, Carremans C, Lehouck A, Buysschaert I, et al. Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the Vitamin D-binding gene. Thorax 2010;65:215-20.
  14. Hornikx M, Van Remoortel H, Lehouck A, Mathieu C, Maes K, Gayan-Ramirez G, et al. Vitamin D supplementation during rehabilitation in COPD: A secondary analysis of a randomized trial. Respir Res 2012;13:84.
  15. Monadi M, Heidari B, Asgharpour M, Firouzjahi A, Monadi M, Ghazi Mirsaied MA. Relationship between serum Vitamin D and forced expiratory volume in patients with chronic obstructive pulmonary disease (COPD). Caspian J Intern Med 2012;3:451-5.
  16. Lee HM, Liu M, Lee K, Luo Y, Wong ND. Does low Vitamin D amplify the association of COPD with total and cardiovascular disease mortality? Clin Cardiol 2014;37:473-8.
  17. Malinovschi A, Masoero M, Bellocchia M, Ciuffreda A, Solidoro P, Mattei A, et al. Severe Vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. Respir Res 2014;15:131.
  18. Puhan MA, Siebeling L, Frei A, Zoller M, Bischoff-Ferrari H, Ter Riet G. No association of 25-hydroxyvitamin D with exacerbations in primary care patients with COPD. Chest 2014;145:37-43.
  19. Martineau AR, James WY, Hooper RL, Barnes NC, Jolliffe DA, Greiller CL, et al. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): A multicentre, double-blind, randomised controlled trial. Lancet Respir Med 2015;3:120-30.
  20. Said AF, Abd-Elnaeem EA. Vitamin D and chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc 2015;64:67-73.
  21. Avenell A, Cook JA, Maclennan GS, Macpherson GC. Vitamin D supplementation to prevent infections: A sub-study of a randomised placebo-controlled trial in older people (RECORD trial, ISRCTN 51647438). Age Ageing 2007;36:574-7.
  22. Li-Ng M, Aloia JF, Pollack S, Cunha BA, Mikhail M, Yeh J, et al. A randomized controlled trial of Vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections. Epidemiol Infect 2009;137:1396-404.
  23. Vieth R, Chan PC, MacFarlane GD. Efficacy and safety of Vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 2001;73:288-94.
  24. Barger-Lux MJ, Heaney RP, Dowell S, Chen TC, Holick MF. Vitamin D and its major metabolites: Serum levels after graded oral dosing in healthy men. Osteoporos Int 1998;8:222-30.
  25. Laaksi I, Ruohola JP, Tuohimaa P, Auvinen A, Haataja R, Pihlajamäki H, et al. An association of serum Vitamin D concentrations and 40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr 2007;86:714-7.
  26. Roth DE, Shah R, Black RE, Baqui AH. Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh. Acta Paediatr 2010;99:389-93.
  27. Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical Vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr 2004;58:563-7.
  28. Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A. Association of subclinical Vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 2009;63:473-7.
  29. McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009;44:981-8.
  30. Roth DE, Jones AB, Prosser C, Robinson JL, Vohra S. Vitamin D status is not associated with the risk of hospitalization for acute bronchiolitis in early childhood. Eur J Clin Nutr 2009;63:297-9.
  31. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009;169:384-90.
  32. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81.
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