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介绍维生素D缺乏和许多慢性疾病相关,对其与慢性阻塞性肺疾患(COPD)的关联还了解甚少。目的 >50岁,414例戒烟者做血清25-羟维生素D(25-OHD)水平检测,评估维生素D状况与发生COPD的关联。属维生素D结合基因(GC)典型基因rs7041和rs4588变异,检测他们对25-OHD水平影响。结果 COPD患者,25-OHD水平与1秒钟用力呼气量(FEV1)显著相关(r=0.28,P<0.0001)。与肺功能正常吸烟者的31%比较,全球阻塞性肺倡议会(Global Initiative for Obstruc-tive Lung Disease,GOLD)3、4期患者有60%和77%表现缺乏,25-OHD<20 ng/ml(P<0.0001)。此外,T等位基因易感因子rs7041纯合子携带者使25-OHD水平减少25%(P<0.0001)。此相关不依赖于COPD严重性、吸烟史、性别、季节变化和rs4588(P<0.0001)。值得注意,COPD 3和4期T等位基因rs7041纯合子携带患者,25-OHD水平<20 ng/ml占76%和100%。年龄、性别、吸烟史逻辑回归校正,进一步表明rs7041 T等位基因纯合子携带者增加了患COPD风险[OR=2.11,95%CI(1.20,3.71),P=0.009]。结论维生素D缺乏常发生于COPD,且与COPD严重程度相关。严重COPD患者,尤其是rs7041变异体携带者,需补充维生素D的数据可靠。
Introduction Vitamin D deficiency is associated with many chronic diseases and little is known about its association with chronic obstructive pulmonary disease (COPD). PURPOSE> Fifty years of age, 414 smokers were tested for serum 25-hydroxyvitamin D (25-OHD) levels to assess the association between vitamin D status and COPD. Is a genotype of vitamin D binding gene (GC) rs7041 and rs4588 typical mutations, their 25-OHD levels were measured. Results There was a significant correlation between 25-OHD levels and forced expiratory volume in 1 second (FEV1) in patients with COPD (r = 0.28, P <0.0001). Compared with 31% of smokers with normal lung function, 60% and 77% of Global Initiative for Obstructive Lung Disease (GOLD) patients in stage 3 and 4 showed a lack of performance, 25-OHD <20 ng / ml (P <0.0001). In addition, carriers of the T allele rs7041 homozygote reduced 25-OHD by 25% (P <0.0001). This correlation did not depend on the severity of COPD, smoking history, sex, seasonal change, and rs4588 (P <0.0001). It is noteworthy that patients with stage 3 and 4 T allele rs7041 homozygotes carried 76% and 100% of 25-OHD levels <20 ng / ml. Logistic regression analysis of age, sex, and smoking history further showed that homozygous carriers of the rs7041 T allele increased the risk of COPD [OR = 2.11, 95% CI (1.20, 3.71), P = 0.009]. Conclusion Vitamin D deficiency often occurs in COPD and is related to the severity of COPD. Severe COPD patients, especially rs7041 variant carriers, the data to be vitamin D supplementation is reliable.