Chest
Volume 128, Issue 6, December 2005, Pages 3792-3798
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Clinical Investigations
COPD
Relationship Between Serum 25-Hydroxyvitamin D and Pulmonary Function in the Third National Health and Nutrition Examination Survey

https://doi.org/10.1378/chest.128.6.3792Get rights and content

Context:

Age, gender, height, ethnicity, and smoking are important determinants of lung function but do not explain all of the variation between individuals. Low concentrations of vitamin D have been associated with a number of diseases, including osteoporosis, hypertension, and type I diabetes. It is possible that serum concentrations of vitamin D might also influence pulmonary function.

Objectives:

To determine the relationship between serum concentrations of 25-hydroxy vitamin D and pulmonary function.

Design, setting and participants:

The analysis was conducted using data from the Third National Health and Nutrition Examination Survey, which was a cross-sectional survey of the US civilian population that was conducted from 1988 to 1994. The analyses were restricted to 14,091 people who ≥ 20 years of age, were interviewed at mobile examination centers, and had undergone spirometry, and in whom serum 25-hydroxy vitamin D levels had been measured.

Results:

After adjustment for age, gender, height, body mass index, ethnicity, and smoking history, the mean FEV1 was 126 mL (SE, 22 mL), and the mean FVC was 172 mL (SE, 26 mL) greater for the highest quintile of serum 25-hydroxy vitamin D level (≥ 85.7 nmol/L) compared with the lowest quintile (≤ 40.4 nmol/L; p < 0.0001). With further adjustment for physical activity, the intake of vitamin D supplements, milk intake, and the level of serum antioxidants, the mean difference between the highest and lowest quintiles of 25-hydroxy vitamin D was 106 mL (SE, 24 mL) for FEV1, and 142 mL (SE, 29 mL) for FVC (p < 0.0001).

Conclusions:

There is a strong relationship between serum concentrations of 25-hydroxy vitamin D, FEV1, and FVC. Further studies are necessary to determine whether supplementation with vitamin D is of any benefit in patients with respiratory disease.

Section snippets

Materials and Methods

A cross-sectional survey representative of the US civilian noninstitutionalized population (NHANES III) was carried out from 1988 to 1994 by the National Center for Health Statistics of the Centers for Disease Control and Prevention. A stratified, multistage sampling design was used to recruit participants from household clusters, with oversampling of non-Hispanic blacks and Mexican Americans. After an initial interview at home, participants visited mobile centers where they underwent an

Results

The adjusted mean serum concentrations of 25-hydroxyvitamin D for the main covariates are shown in Table 1. The serum 25-hydroxyvitamin D concentration was higher in men than in women, was inversely related to BMI, and declined with age. It was also lower in non-Hispanic blacks and Mexican Americans compared with non-Hispanic whites, and it was lower in participants smoking > 20 cigarettes a day compared with nonsmokers.

Table 2shows the mean (SE) FEV1 by gender, age, ethnicity, BMI, cigarette

Discussion

We have a found a dose-response relationship between the serum concentration of 25-hydroxyvitamin D and FEV1. Even after adjustment for age, gender, ethnicity, height, and smoking, all of which can affect lung function, and for BMI, which can affect both lung function and vitamin D concentrations, the mean difference between the lowest quintile of 25-hydroxyvitamin D and the next quintile was 79 mL. This increased to 126 mL when the lowest and highest quintiles were compared. The difference in

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    The authors have received funding from the Health Research Council of New Zealand.

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