Can treating vitamin D deficiency reduce exacerbations of chronic obstructive pulmonary disease?

BMJ ◽  
2019 ◽  
pp. l1025 ◽  
Author(s):  
Rob Cook ◽  
Vaughan Thomas ◽  
Rosie Martin

The study Jolliffe D, Greenberg L, Hooper R, Mathyssen C, Rafiq R, de Jongh R, Camargo C, Griffiths C, Janssens W, Martineau A. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 2019. doi: 10.1136/thoraxjnl-2018-212092 . This project was funded by the National Institute for Health Research Health Technology Appraisal programme (project number 13/03/25). To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000737/treating-vitamin-d-deficiency-may-reduce-exacerbations-of-copd

2015 ◽  
Vol 61 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Tuncay Yumrutepe ◽  
Zeynep Ayfer Aytemur ◽  
Ozlem Baysal ◽  
Hulya Taskapan ◽  
Cagatay M. Taskapan ◽  
...  

Summary Objectives: vitamin D is important for muscle function and it affects different aspects of muscle metabolism. This study aim to determine whether serum 25(OH) D levels are related to lung functions, physical performance and balance in patients with chronic obstructive pulmonary disease (COPD). Methods: in 90 patients with COPD and 57 healthy controls lung function tests, physical performance tests (time up and go, gait velocity test, sit-to-stand test, isometric strength, isokinetic strength), static (functional reach test) and dynamic (time up and go) balance tests and the association of 25(OH)D levels with lung functions, physical performance and balance were evaluated. Results: the COPD patients had significantly more deficit in physical function and balance parameters, and in dynamic balance test (p<0.005). Isokinetic knee muscle strength (flexor and extensor) in COPD patients was significantly lower than in the controls (p<0.05); FEV1 (p=0.008), FVC (p=0.02), FEV1/FVC (p=0.04), TLC (p=0.01) were lower in COPD patients with vitamin D deficiency [25(OH) D less than 15ng/mL] than in COPD patients without vitamin D deficiency. Hand grip test (p=0.000) and isokinetic knee muscle strength (flexor and extensor) (p<0.05) were also lower in COPD patients with vitamin D deficiency. Vitamin D deficiency was more pronounced in patients with stage III COPD (p<0.05). Conclusion: patients with COPD had worst physical functioning, poor balance and less muscle strength. Severe disturbed lung and peripheral muscle functions are more pronounced in COPD patients with vitamin D deficiency.


2013 ◽  
Vol 202 (2) ◽  
pp. 100-107 ◽  
Author(s):  
Rebecca E. S. Anglin ◽  
Zainab Samaan ◽  
Stephen D. Walter ◽  
Sarah D. McDonald

BackgroundThere is conflicting evidence about the relationship between vitamin D deficiency and depression, and a systematic assessment of the literature has not been available.AimsTo determine the relationship, if any, between vitamin D deficiency and depression.MethodA systematic review and meta-analysis of observational studies and randomised controlled trials was conducted.ResultsOne case-control study, ten cross-sectional studies and three cohort studies with a total of 31 424 participants were analysed. Lower vitamin D levels were found in people with depression compared with controls (SMD = 0.60,95% Cl 0.23–0.97) and there was an increased odds ratio of depression for the lowest v. highest vitamin D categories in the cross-sectional studies (OR = 1.31, 95% CI 1.0–1.71). The cohort studies showed a significantly increased hazard ratio of depression for the lowest v. highest vitamin D categories (HR=2.21, 95% CI 1.40–3.49).ConclusionsOur analyses are consistent with the hypothesis that low vitamin D concentration is associated with depression, and highlight the need for randomised controlled trials of vitamin D for the prevention and treatment of depression to determine whether this association is causal.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017099 ◽  
Author(s):  
Shaonan Liu ◽  
Jing Chen ◽  
Yihan He ◽  
Lei Wu ◽  
Jiaqi Lai ◽  
...  

IntroductionChinese medicine is commonly used to combine with pharmacotherapy for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Six Chinese herb formulas involving Weijing decoction, Maxingshigan decoction, Yuebijiabanxia decoction, Qingqihuatan decoction, Dingchuan decoction and Sangbaipi decoction are recommended in Chinese medicine clinical guideline or textbook, to relieve patients with phlegm-heat according to Chinese syndrome differentiation. However, the comparative effectiveness among these six formulas has not been investigated in published randomised controlled trials. We plan to summarise the direct and indirect evidence for these six formulas combined with pharmacotherapy to determine the relative merits options for the management of AECOPD.Methods and analysisWe will perform the comprehensive search for the randomised controlled trials to evaluate the effectiveness of six Chinese herb formulas recommended in Chinese medicine clinical guideline or textbook. The combination of pharmacotherapy includes bronchodilators, antibiotics and corticosteroids that are routinely prescribed for AECOPD. The primary outcome will be lung function, arterial blood gases and length of hospital stay. The data screening and extraction will be conducted by two different reviewers. The quality of RCT will be assessed according to the Cochrane handbook risk of bias tool. The Bayes of network meta-analysis (NMA) will be conducted with WinBUGS to compare the effectiveness of six formulas. We will also use the surface under the cumulative ranking curve (SUCRA) to obtain the comprehensive rank for these treatments.Ethics and disseminationThis review does not require ethics approval and the results of NMA will be submitted to a peer-review journal.Trial registration numberPROSPERO (CRD42016052699).


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