Vitamin D Levels Influence COPD Exacerbations

Among patients with chronic obstructive pulmonary disease (COPD), 25-hydroxyvitamin D (25-OH-vitamin D) levels may be a useful marker of adverse COPD-related outcomes, according to a new analysis of the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS).

The determination comes after the researchers found that vitamin D deficiency is associated with worse cross-sectional and longitudinal lung function, as well as with increased odds of prior COPD exacerbations. 

To evaluate the association between baseline 25-OH-vitamin D, lung function, and COPD exacerbations, the researchers analyzed data on 1609 participants from SPIROMICS who had COPD. 

After using stored samples to measure the participants’ serum 25-OH-vitamin D level, the levels were modeled continuously and labeled as either deficient (<20 ng/mL) or 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),” according to the authors.

Overall, 21% of the participants had vitamin D deficiency. Participants who were younger, active smokers, and black were more likely to have the deficiency. 

Vitamin D deficiency was independently associated with lower percentage of predicted FEV1 (by 4.11%) at enrollment, 1.27% predicted greater rate of FEV1 decline after 1 year, and higher odds of any COPD exacerbation in the prior year.

For each 10-ng/mL decrease in 25-OH-vitamin D, there was a decrease in baseline lung function (–1.04% predicted) and an increase in the odds of any exacerbation in the year prior to enrollment.

Listen to our interview with lead author, Robert Burkes, MD, here:

—Colleen Murphy


Burkes RM, Ceppe AS, Doerschuk CM, et al; SPIROMICS investigators. Associations among 25-hydroxyvitamin D levels, lung function, and exacerbation outcomes in COPD. Chest. 2020;157(4):856-865. doi:10.1016/j.chest.2019.11.047