Kronik obstruktif akciğer hastalığı ile vitamin D düzeyi arasındaki ilişki

Amaç: Vitamin D eksikliği, solunum fonksiyonlarında bozulma ile ilişkili olabilir. Çalışmamızda Kronik Obstruktif Akciğer Hastalığı (KOAH) hastalarında solunum fonksiyonları, hastalığın şiddeti ve alevlenme sıklığı ile serum Vitamin D düzeyi arasındaki ilişkiyi belirlemeyi amaçladık. Yöntemler: Polikliniğimize başvuran 70 KOAH hastası (GOLD Sınıflaması Evre II-IV) çalışmaya alındı. 30 sağlıklı gönüllü kontrol grubunu oluşturdu. Klinik bulgular ve solunum fonksiyon testine göre KOAH tanısı kondu. Serum 25-hidroksi vitamin D (25(OH)D) seviyesi immünofloresan yöntemi ile ölçüldü. 20 ng/mL altındaki değerler eksiklik olarak kabul edildi. Vitamin D düzeyi ile cinsiyet, yaş, Vücut Kitle İndeksi (VKİ), sigara içme durumu, komorbiditeler, alevlenme sıklığı arasındaki ilişki araştırıldı.Bulgular: Hasta grubunun yaş ortalaması 60,7 yıldı. Hastaları GOLD sınıflamasına göre ayırdığımızda %40’ı Evre II, %30’u Evre III, %30’u Evre IV KOAH’tı. Hasta ve kontrol grupları arasında serum 25(OH)D düzeyi bakımından anlamlı farklılık görülmedi. Vitamin D düzeyi kontrol grubunda 9,3 ±6,0 ng/mL, Evre II KOAH’da 9,7± 8,5 ng/mL, Evre III’te 9,6 ± 6,2 ng/mL ve Evre IV’te 5,1 ±2,4 ng/mL olarak belirlendi. Evre IV te Vitamin D düzeyi düşüklüğü istatistiksel olarak anlamlıydı (p=0.03).Hasta grubunda düşük FEV1, düşük 25(OH)D ile ilişkili bulundu (p=0.03). En sık görülen komorbidite hipertansiyon (%61,4) ve kalp yetmezliği idi (%27,1). Sigara içenlerde 25(OH)D düzeyi daha düşüktü (p=0,004). Son 12 aydaki alevlenme sıklığı ile serum 25(OH)D düzeyi düşüklüğü arasında ilişki saptandı (p=0.02).Sonuç: GOLD evrelemesine göre KOAH şiddeti ile 25(OH)D düzeyi düşüklüğü arasında ilişki vardır. Sigara içen KOAH hastalarında 25(OH)D düzeyi daha düşüktür. Ciddi Vitamin D eksikliği alevlenme sıklığında artış ile ilişkilidir. 25(OH)D düzeyi ile KOAH arasındaki ilişki, KOAH hastalarında Vitamin D düzeyini iyileştirmek gerektiğini düşündürmektedir

Anahtar Kelimeler:

Solunum fonksiyonları, KOAH, Vitamin D

Relationship between chronic obstructive pulmonary disease and levels of vitamin D

Objective: Vitamin D deficiency may be associated with pulmonary function deterioration. The aim of this study is to assess the relationship of serum vitamin D levels with pulmonary functions, disease severity and exacerbation frequency in Chronic Obstructive Pulmonary Disease (COPD) patients.Methods: Seventy consecutive patients with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II-IV) who presented to our outpatient clinic and thirdty controls entered to the study. Diagnosis of COPD was confirmed according to clinical findings and pulmonary function test. Serum 25-hydroxyvitamin D (25(OH)D levels were measured by immunofluorescence method. Levels <20 ng/mL defined deficiency. Associations between Vitamin D levels and sex, age, body mass index (BMI), smoking habit, comorbidities, exacerbation frequency were examined.Results: The mean age of patients was 60.7 years. The proportion of patients in stages 2 of GOLD was 40 %, in stages 3 was 30 % and stages 4was 30 %. There was no significant difference in serum levels of 25(OH)D between COPD patients and controls. Vitamin D level was 9.3 ±6.0 ng/mL in control group and 9.7± 8.5 ng/mL in GOLD stage 2, 9.6 ± 6.2 ng/mL in stage 3 and 5.1 ±2.4 ng/mL in stage 4. In stage 4, vitamin D levels was significantly lower statistically (p=0.03). Among the COPD patients, lower FEV1 was associated with lower levels of 25(OH)D (p= 0.03). The most frequent comorbidities were hypertension (61.4%) and heart failure (27.1%). Among the COPD patients smoking associated with significantly lower levels of serum 25(OH) D (p=0.04). We find an association with exacerbation frequency in the previous 12 months and levels of 25(OH) D (p=0.02).Conclusion: COPD severity according to GOLD stage is also associated with low levels of 25(OH)D. Serum vitamin D levels are lower in COPD patients who are current smokers. Severe vitamin D deficiency is related to more frequent disease exacerbations. These findings indicated a relationship between serum 25(OH)D concentrations and COPD which suggests optimization of serum vitamin D levels in COPD.Key words: Pulmonary functions, Vitamin D, COPD

Keywords:

Pulmonary functions, Vitamin D, COPD,

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