Association of Serum Vitamin D Levels in Acute Exacerbation of COPD

Authors

  • Amna Baig Combined Military Hospital (CMH) Rawalakot, Azad Kashmir, Pakistan.
  • Shazia Siddiq Combined Military Hospital (CMH) Rawalakot, Azad Kashmir, Pakistan.
  • Mehwish Rasheed Butt Combined Military Hospital (CMH) Rawalakot, Azad Kashmir, Pakistan.
  • Sabah Salik Combined Military Hospital (CMH) Rawalakot, Azad Kashmir, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i5.2209

Keywords:

COPD, Vitamin D, Deficiency, Acute Exacerbation, Respiratory Infections

Abstract

Background: Chronic obstructive pulmonary disease represents a major health challenge worldwide, accounting for substantial illness and death. Episodes of acute deterioration accelerate the decline in respiratory capacity and are a leading cause of hospital admissions. Adequate vitamin D status is integral to immune regulation and pulmonary health, whereas deficiency has been consistently linked with heightened vulnerability to infections and more frequent disease flare-ups in individuals with chronic obstructive pulmonary disease. Objective: To determine the association of serum vitamin D concentrations in patients admitted with acute exacerbation of COPD. Design of the Study: Case-control study: Study duration and settings: The study was conducted in the Department of Pulmonology, Combined Military Hospital (CMH) Rawalakot, Azad Kashmir, from March to August 2024. Methodology: A total of 84 participants were included, comprising 42 patients aged 40 years and above with acute exacerbation of COPD and 42 healthy controls without chronic respiratory disease. Detailed clinical histories and physical examinations were conducted. Serum 25-hydroxy vitamin D concentrations were measured using chemiluminescence immunoassay. Study Results: In this study the mean serum vitamin D level in COPD patients was 26.32 ± 10.39 ng/mL, significantly lower than that of controls, which was 34.14 ± 11.09 ng/mL (p = 0.001). Vitamin D deficiency was more frequent among COPD patients (35.7%) compared with controls (14.3%). Conclusion: In this study COPD exhibited markedly reduced serum vitamin D concentrations in comparison with healthy control subjects.

Downloads

Download data is not yet available.

References

1. López-Campos JL, Soler-Cataluña JJ, Miravitlles M. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2019 report: future challenges. Arch Bronconeumol. 2020;56(2):65-7.

https://doi.org/10.1016/j.arbres.2019.06.001

2. Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med. 2020;41(3):421-9.

https://doi.org/10.1016/j.ccm.2020.06.007

3. Hogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C. Risk factors of chronic obstructive pulmonary disease exacerbations. Clin Respir J. 2020;14(3):183-97.

https://doi.org/10.1111/crj.13129

4. Rana JS, Khan SS, Lloyd-Jones DM, Sidney S. Changes in mortality in top 10 causes of death from 2011 to 2018. J Gen Intern Med. 2021;36(8):2517-8.

https://doi.org/10.1007/s11606-020-06070-z

5. Thakur JS, Paika R, Singh S. Burden of noncommunicable diseases and implementation challenges of national NCD programmes in India. Med J Armed Forces India. 2020;76(3):261-7.

https://doi.org/10.1016/j.mjafi.2020.03.002

6. Nafees AA, Khan AA, Rabbani U, Zahidie A, Haq RU, Irfan M, et al. Prevalence and factors associated with respiratory symptoms in an urban population: findings from BOLD study in Karachi, Pakistan. Discov Med. 2025;2(1):194-8.

https://doi.org/10.1007/s44337-025-00432-4

7. Jarhyan P, Hutchinson A, Khaw D, Prabhakaran D, Mohan S. Prevalence of chronic obstructive pulmonary disease and chronic bronchitis in eight countries: a systematic review and meta-analysis. Bull World Health Organ. 2022;100(3):216-20.

https://doi.org/10.2471/blt.21.286870

8. Islam R, Hossain MT, Chakma N, Khanom A, Mazumder T, Islam MT. Prevalence, risk factors, and interventions for chronic obstructive pulmonary disease in South Asia: a scoping review protocol. Syst Rev. 2021;10(1):20-5.

https://doi.org/10.1186/s13643-020-01556-7

9. Bikle DD. Vitamin D regulation of immune function. Curr Osteoporos Rep. 2022;20(3):186-93.

https://doi.org/10.1007/s11914-022-00732-z

10. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-6.

https://doi.org/10.2310/JIM.0b013e31821b8755.

11. Lokesh KS, Chaya SK, Jayaraj BS, Praveena AS, Krishna M, Madhivanan P, et al. Vitamin D deficiency is associated with chronic obstructive pulmonary disease and exacerbation of COPD. Clin Respir J. 2021;15(4):389-99.

https://doi.org/10.1111/crj.13310

12. Rocha L, Figueiredo B, Martins SE. How important is vitamin D supplementation in the prevention of exacerbations in patients with chronic obstructive pulmonary disease (COPD): an evidence-based review. Cureus. 2025;17(2):150-5.

https://doi.org/10.7759/cureus.79787

13. Sun M, Qian Y, Cai C, Zhang J, Qi R, Ma H, et al. The role and clinical significance of vitamin D in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2025;12(5):2023-33.

https://doi.org/10.2147/copd.s520795

14. Li X, He J, Yu M, Sun J. The efficacy of vitamin D therapy for patients with COPD: a meta-analysis of randomized controlled trials. Ann Palliat Med. 2020;9(2):28697-297.

https://doi.org/10.21037/apm.2020.02.26

15. Islam S, Sarkar NK, Mujahid AA, Bennoor KS, Hossain SS, Attar MM, et al. Association of serum vitamin D (25OHD) level with acute exacerbation of chronic obstructive pulmonary disease. Mymensingh Med J. 2019;28(2):441-8.

16. Janssens W, Bouillon R, Claes B. Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Thorax. 2020;65(3):215-20.

https://doi.org/10.1136/thx.2009.120659

17. Camargo CA, Toop L, Sluyter J, Lawes CM, Waayer D, Khaw KT, et al. Effect of monthly vitamin D supplementation on preventing exacerbations of asthma or chronic obstructive pulmonary disease in older adults: post hoc analysis of a randomized controlled trial. Nutrients. 2021;13(2):521-25.

https://doi.org/10.3390/nu13020521

18. Kunisaki KM, Niewoehner DE, Singh RJ. Vitamin D status and supplementation in COPD: a randomized trial. Am J Respir Crit Care Med. 2022;185(3):286-90.

https://doi.org/10.1164/rccm.201109-1644oc

19. Li K, Zhang Y, Guo X. The association of serum vitamin D and risk of COPD: a meta-analysis. Int J Chron Obstruct Pulmon Dis. 2021;11:2633-43.

20. Persson LJ, Aanerud M, Hiemstra PS. Vitamin D, vitamin D binding protein, and longitudinal outcomes in COPD. PLoS One. 2022;10(3):e0121622.

https://doi.org/10.1371/journal.pone.0121622

21. Iftikhar IH, Noor S, Ghani F. Vitamin D deficiency in patients with chronic obstructive pulmonary disease and its correlation with severity of disease. Pak J Med Sci. 2018;34(5):1141-6.

22. Mishra V, Mishra R, Banga N. Assessment of serum vitamin D levels in chronic obstructive pulmonary disease patients. J Clin Diagn Res. 2021;11(8):OC35-7.

23. Agarwal A, Prasad R, Aggarwal S. Vitamin D status in chronic obstructive pulmonary disease and its correlation with disease severity and exacerbations. Lung India. 2020;35(4):341-5.

24. Hashim A, Al-Shehri FS, Alzahrani SH. Serum vitamin D levels in patients with COPD in Saudi Arabia. Int J Gen Med. 2018;11:277-83.

25. Lehouck A, Mathieu C, Carremans C. High doses of vitamin D to reduce exacerbations in COPD: a randomized trial. Ann Intern Med. 2022;156(2):105-14.

https://doi.org/10.7326/0003-4819-156-2-201201170-00004

26. Mete B, Pehlivan Y, Yildiz S. The relation between vitamin D levels and chronic obstructive pulmonary disease. Turk Thorac J. 2021;19(1):19-23.

27. Zhou Y, Zhao G, Wang L. Vitamin D deficiency and the risk of acute exacerbation in chronic obstructive pulmonary disease: a meta-analysis. Int J Chron Obstruct Pulmon Dis. 2021;12:2483-90.

28. Rafiq R, Prins HJ, Boersma WG. Effects of daily vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients: a pilot study. Int J Chron Obstruct Pulmon Dis. 2017;12:2583-9.

https://doi.org/10.2147/copd.s132117

29. Martineau AR, Jolliffe DA, Hooper RL. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2022;356:i6583.

https://doi.org/10.1136/bmj.i6583

Downloads

Published

2025-05-30

How to Cite

Baig, A., Siddiq, S., Butt, M. R., & Salik, S. (2025). Association of Serum Vitamin D Levels in Acute Exacerbation of COPD. Indus Journal of Bioscience Research, 3(5), 1010-1014. https://doi.org/10.70749/ijbr.v3i5.2209