, Volume 192, Issue 4, pp 493–497 | Cite as

Association Between Vitamin D Status and COPD Phenotypes

  • Mia Moberg
  • Thomas Ringbaek
  • Nassim Bazeghi Roberts
  • Jørgen Vestbo



It has been suggested that identifying phenotypes in chronic obstructive pulmonary disease (COPD) might improve treatment outcome and the accuracy of prediction of prognosis. In observational studies vitamin D deficiency has been associated with decreased pulmonary function, presence of emphysema and osteoporosis, upper respiratory tract infections, and systemic inflammation. This could indicate a relationship between vitamin D status and COPD phenotypes. The aim of this study was to assess the association between vitamin D levels and COPD phenotypes. In addition, seasonality of vitamin D levels was examined.


A total of 91 patients from a Danish subpopulation of the “Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points” cohort took part in a biomarker substudy. Vitamin D concentration was measured from blood samples taken at two visits, approximately 6 months apart. The participants were 40–75-year-old patients with COPD and had a smoking history of >10 pack-years.


Fifty-six patients had 25-hydroxyvitamin D measured from blood samples from both visits. In the final model of the multivariate analyses, the factors that were associated with vitamin D deficiency at the first visit were age (OR: 0.89, p = 0.02) and summer season (OR: 3.3, p = 0.03). Factors associated with vitamin D level also at the first visit were age (B: 0.9, p = 0.02) and 6 min walking distance (B: 0.05, p = 0.01).


Vitamin D was not associated with COPD phenotypes and season did not seem to be a determinant of vitamin D levels in patients with moderate to severe COPD.


25(OH)D Biomarker Seasonality COPD Vitamin D Phenotypes 


  1. 1.
    Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R (2013) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD Executive Summary. Am J Respir Crit Care Med 187(4):347–365. doi:10.1164/rccm.201204-0596PP CrossRefPubMedGoogle Scholar
  2. 2.
    Han MK, Agusti A, Calverley PM, Celli BR, Criner G, Curtis JL, Fabbri LM, Goldin JG, Jones PW, MacNee W, Make BJ, Rabe KF, Rennard SI, Sciurba FC, Silverman EK, Vestbo J, Washko GR, Wouters EFM, Martinez FJ (2010) Chronic obstructive pulmonary disease phenotypes. Am J Respir Crit Care Med 182(5):598–604. doi:10.1164/rccm.200912-1843CC CrossRefPubMedGoogle Scholar
  3. 3.
    Janssens W, Bouillon R, Claes B, Carremans C, Lehouck A, Buysschaert I, Coolen J, Mathieu C, Decramer M, Lambrechts D (2010) Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Thorax 65(3):215–220. doi:10.1136/thx.2009.120659 CrossRefPubMedGoogle Scholar
  4. 4.
    Black PN, Scragg R (2005) Relationship between serum 25-hydroxyvitamin D and pulmonary function in the third national health and nutrition examination survey. Chest 128(6):3792–3798. doi:10.1378/chest.128.6.3792 CrossRefPubMedGoogle Scholar
  5. 5.
    Berg I, Hanson C, Sayles H, Romberger D, Nelson A, Meza J, Miller B, Wouters EF, Macnee W, Rutten EP, Romme EA, Vestbo J, Edwards L, Rennard S (2013) Vitamin D, vitamin D binding protein, lung function and structure in COPD. Respir Med 107(10):1578–1588. doi:10.1016/j.rmed.2013.05.010 CrossRefPubMedGoogle Scholar
  6. 6.
    Biskobing DM (2002) COPD and osteoporosis. Chest 121(2):609–620CrossRefPubMedGoogle Scholar
  7. 7.
    Ginde AA, Mansbach JM, Camargo CA Jr (2009) Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 169(4):384–390. doi:10.1001/archinternmed.2008.560 PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Guillot X, Semerano L, Saidenberg-Kermanac’h N, Falgarone G, Boissier MC (2010) Vitamin D and inflammation. Joint Bone Spine 77(6):552–557. doi:10.1016/j.jbspin.2010.09.018 CrossRefPubMedGoogle Scholar
  9. 9.
    Vestbo J, Anderson W, Coxson HO, Crim C, Dawber F, Edwards L, Hagan G, Knobil K, Lomas DA, MacNee W, Silverman EK, Tal-Singer R (2008) Evaluation of COPD longitudinally to identify predictive surrogate end-points (ECLIPSE). Eur Respir J 31(4):869–873. doi:10.1183/09031936.00111707 CrossRefPubMedGoogle Scholar
  10. 10.
    Bazeghi N, Gerds TA, Budtz-Jorgensen E, Hove J, Vestbo J (2011) Exhaled nitric oxide measure using multiple flows in clinically relevant subgroups of COPD. Respir Med 105(9):1338–1344. doi:10.1016/j.rmed.2011.03.015 CrossRefPubMedGoogle Scholar
  11. 11.
    Hurst JR, Vestbo J, Anzueto A, Locantore N, Mullerova H, Tal-Singer R, Miller B, Lomas DA, Agusti A, Macnee W, Calverley P, Rennard S, Wouters EF, Wedzicha JA (2010) Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 363(12):1128–1138. doi:10.1056/NEJMoa0909883 CrossRefPubMedGoogle Scholar
  12. 12.
    Jacobs ET, Martinez ME, Jurutka PW (2011) Vitamin D: marker or mechanism of action? Cancer Epidemiol Biomarkers Prev 20(4):585–590. doi:10.1158/1055-9965.epi-10-1257 PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Lehouck A, Mathieu C, Carremans C, Baeke F, Verhaegen J, Van Eldere J, Decallonne B, Bouillon R, Decramer M, Janssens W (2012) High doses of vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med 156(2):105–114. doi:10.1059/0003-4819-156-2-201201170-00004 CrossRefPubMedGoogle Scholar
  14. 14.
    Bjerk SM, Edgington BD, Rector TS, Kunisaki KM (2013) Supplemental vitamin D and physical performance in COPD: a pilot randomized trial. Int J Chron Obstruct Pulmon Dis 8:97–104. doi:10.2147/copd.s40885 PubMedCentralPubMedGoogle Scholar
  15. 15.
    Holmgaard DB, Mygind LH, Titlestad IL, Madsen H, Fruekilde PB, Pedersen SS, Pedersen C (2013) Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality—results from a 10-year prospective cohort study. PLoS One 8(1):e53670. doi:10.1371/journal.pone.0053670 PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Persson LJ, Aanerud M, Hiemstra PS, Hardie JA, Bakke PS, Eagan TM (2012) Chronic obstructive pulmonary disease is associated with low levels of vitamin D. PLoS One 7(6):e38934. doi:10.1371/journal.pone.0038934 PubMedCentralCrossRefPubMedGoogle Scholar
  17. 17.
    Klenk J, Rapp K, Denkinger MD, Nagel G, Nikolaus T, Peter R, Koenig W, Bohm BO, Rothenbacher D (2013) Seasonality of vitamin D status in older people in Southern Germany: implications for assessment. Age Ageing 42(3):404–408. doi:10.1093/ageing/aft042 CrossRefPubMedGoogle Scholar
  18. 18.
    Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF, Yetley EA (2008) Serum 25-hydroxyvitamin D status of the US population: 1988–1994 compared with 2000–2004. Am J Clin Nutr 88(6):1519–1527. doi:10.3945/ajcn.2008.26182 PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Jackson AS, Shrikrishna D, Kelly JL, Kemp SV, Hart N, Moxham J, Polkey MI, Kemp P, Hopkinson NS (2013) Vitamin D and skeletal muscle strength and endurance in COPD. Eur Respir J 41(2):309–316. doi:10.1183/09031936.00043112 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mia Moberg
    • 1
  • Thomas Ringbaek
    • 1
  • Nassim Bazeghi Roberts
    • 1
  • Jørgen Vestbo
    • 2
    • 3
    • 4
  1. 1.Section of Respiratory MedicineHvidovre University HospitalHvidovreDenmark
  2. 2.Department of Respiratory MedicineOdense University HospitalOdense CDenmark
  3. 3.Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation TrustThe University of ManchesterManchesterUK
  4. 4.NIHR South Manchester Respiratory and Allergy Clinical Research FacilityManchesterUK

Personalised recommendations