Robert M Burkes1, David J Couper2, Igor Z Barjaktarevic3, Christopher B Cooper4, Wassim W Labaki5, Meilan K Han5, Prescott G Woodruff6, Stephen C Lazarus6, Trisha M Parekh7, Robert Paine8, Alejandro P Comellas9, Russell P Bowler10, Laura R Loehr11, Nirupama Putcha12, Robert A Wise12, Todd T Brown13, M Bradley Drummond1. 1. Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States. 2. Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States. 3. Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, United States. 4. Departments of Medicine and Physiology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, United States. 5. Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States. 6. Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California-San Francisco, San Francisco, California, United States. 7. Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of Alabama-Birmingham, Birmingham, Alabama, United States. 8. Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States. 9. Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, Iowa, United States. 10. Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Hospital, Denver, Colorado, United States. 11. Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States. 12. Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, Maryland, United States. 13. Division of Endocrinology and Metabolism, Johns Hopkins University, Baltimore, Maryland, United States.
Abstract
INTRODUCTION: Age and vitamin D levels may affect symptom burden in chronic obstructive pulmonary disease (COPD). We used the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) to determine independent associations between vitamin D levels and COPD symptoms in different age strata. METHODS: Serum 25-hydroxy (OH)-vitamin D levels were modeled continuously and categorically (<20 ng/ml versus ≥20 ng/ml). Stratifying by age group (middle-age: 40-64 years old and older: >65 years old), multivariable modeling was performed to identify relationships between 25-OH-vitamin D levels and the COPD Assessment Test (CAT), the modified Medical Research Council score (mMRC), the St George's Respiratory Questionnaire (SGRQ) total and subdomain scores, the Veterans' Specific Activity Questionnaire, and the 6-minute walk test distance. RESULTS: InIn the middle-aged group, each 5 ng/ml higher 25-OH-vitamin D level was independently associated with more favorable CAT score (-0.35 [-0.67 to -0.03], P=0.03), total SGRQ (-0.91 [-1.65 to -0.17]; P=0.02), and the SGRQ subdomains (Symptoms:-1.07 [-1.96 to -0.18], P=0.02; Impact: -0.77 [-1.53 to -0.003], P=0.049; Activity: -1.07 [-1.96 to -0.18], P=0.02). These associations persisted after the addition of comorbidity score, reported vitamin D supplementation, outdoor time, or season of blood draw to models. No associations were observed between 25-OH-vitamin D levels and symptom scores in the older age group. DISCUSSION: When controlled for clinically relevant covariates, higher 25-OH-vitamin D levels are associated with more favorable respiratory-specific symptoms and quality-of-life assessments in middle-age but not older COPD individuals. Study of the role of vitamin D supplementation in the symptom burden of younger COPD patients is needed. JCOPDF
INTRODUCTION: Age and vitamin D levels may affect symptom burden in chronic obstructive pulmonary disease (COPD). We used the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) to determine independent associations between vitamin D levels and COPD symptoms in different age strata. METHODS: Serum 25-hydroxy (OH)-vitamin D levels were modeled continuously and categorically (<20 ng/ml versus ≥20 ng/ml). Stratifying by age group (middle-age: 40-64 years old and older: >65 years old), multivariable modeling was performed to identify relationships between 25-OH-vitamin D levels and the COPD Assessment Test (CAT), the modified Medical Research Council score (mMRC), the St George's Respiratory Questionnaire (SGRQ) total and subdomain scores, the Veterans' Specific Activity Questionnaire, and the 6-minute walk test distance. RESULTS: InIn the middle-aged group, each 5 ng/ml higher 25-OH-vitamin D level was independently associated with more favorable CAT score (-0.35 [-0.67 to -0.03], P=0.03), total SGRQ (-0.91 [-1.65 to -0.17]; P=0.02), and the SGRQ subdomains (Symptoms:-1.07 [-1.96 to -0.18], P=0.02; Impact: -0.77 [-1.53 to -0.003], P=0.049; Activity: -1.07 [-1.96 to -0.18], P=0.02). These associations persisted after the addition of comorbidity score, reported vitamin D supplementation, outdoor time, or season of blood draw to models. No associations were observed between 25-OH-vitamin D levels and symptom scores in the older age group. DISCUSSION: When controlled for clinically relevant covariates, higher 25-OH-vitamin D levels are associated with more favorable respiratory-specific symptoms and quality-of-life assessments in middle-age but not older COPD individuals. Study of the role of vitamin D supplementation in the symptom burden of younger COPD patients is needed. JCOPDF
Authors: Kristen E Holm; Melissa R Plaufcan; Dee W Ford; Robert A Sandhaus; Matthew Strand; Charlie Strange; Frederick S Wamboldt Journal: J Behav Med Date: 2013-05-04
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Authors: Nirupama Putcha; Milo A Puhan; M Bradley Drummond; MeiLan K Han; Elizabeth A Regan; Nicola A Hanania; Carlos H Martinez; Marilyn Foreman; Surya P Bhatt; Barry Make; Joe Ramsdell; Dawn L DeMeo; R Graham Barr; Stephen I Rennard; Fernando Martinez; Edwin K Silverman; James Crapo; Robert A Wise; Nadia N Hansel Journal: PLoS One Date: 2014-12-16 Impact factor: 3.240
Authors: Emma L Carson; L Kirsty Pourshahidi; Sharon M Madigan; Francina R Baldrick; Martin G Kelly; Eamon Laird; Martin Healy; J J Strain; Maria S Mulhern Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-08-28