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Correspondence |

Vitamin D and Mortality From Pulmonary Fibrosis FREE TO VIEW

Luca Mascitelli, MD; Francesca Pezzetta, MD; Mark R. Goldstein, MD
Author and Funding Information

From the Medical Service of the Comando Brigata alpina "Julia" (Dr Mascitelli); the Cardiology Service of the Ospedale di Tolmezzo (Dr Pezzetta); and the Fountain Medical Court (Dr Goldstein).

Correspondence to: Luca Mascitelli, MD, Medical Service,Comando Brigata alpina "Julia," Via S. Agostino, 8, Udine 33100, Italy; e-mail: lumasci@libero.it


Financial/nonfinancial disclosures:The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(2):495-496. doi:10.1378/chest.09-1646
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To the Editor:

In a recent article in CHEST (July 2009) Olson and colleagues1 found that mortality rates from pulmonary fibrosis exhibited significant seasonal variation with the highest rates occurring in the winter; seasonal variation in pulmonary fibrosis mirrored COPD exacerbation and mortality. We suggest that some of the mechanisms involved in this detrimental association might also be due to seasonal variations in blood vitamin D levels.

Vitamin D deficiency (<20 ng/mL) has been found in>50% of a cohort of patients with advanced pulmonary disease.2 In particular, it has been shown that patients with COPD, without chronic use of systemic glucocorticoids, have increased risk for osteoporosis and low levels of vitamin D, which is correlated with the severity of the disease.3 Moreover, the observation that African-Americans who smoke develop severe airflow obstruction more rapidly than whites confirms that a presumed lower vitamin D status in African-Americans correlates with an increased susceptibility to COPD.4

Vitamin D insufficiency may contribute to chronic respiratory infections and airway colonization,5 and also influence the remodeling of lung tissue. Therefore, studies of vitamin D supplementation for patients with pulmonary fibrosis are urgently needed. In the meantime, adequate outdoor activity and sun exposure along with vitamin D supplementation should be considered for all patients with advanced lung disease.

Olson AL, Swigris JJ, Raghu G, Brown KK. Seasonal variation: mortality from pulmonary fibrosis is greatest in the winter. Chest. 2009;1361:16-22. [CrossRef] [PubMed]
 
Førli L, Halse J, Haug E, et al. Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease. J Intern Med. 2004;2561:56-62. [CrossRef] [PubMed]
 
Franco CB, Paz-Filho G, Gomes PE, et al. Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos Int. 2009;2011:1881-1887. [CrossRef] [PubMed]
 
Chatila WM, Wynkoop WA, Vance G, Criner GJ. Smoking patterns in African Americans and whites with advanced COPD. Chest. 2004;1251:15-21. [CrossRef] [PubMed]
 
Zasloff M. Fighting infections with vitamin D. Nat Med. 2006;124:388-390. [CrossRef] [PubMed]
 

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References

Olson AL, Swigris JJ, Raghu G, Brown KK. Seasonal variation: mortality from pulmonary fibrosis is greatest in the winter. Chest. 2009;1361:16-22. [CrossRef] [PubMed]
 
Førli L, Halse J, Haug E, et al. Vitamin D deficiency, bone mineral density and weight in patients with advanced pulmonary disease. J Intern Med. 2004;2561:56-62. [CrossRef] [PubMed]
 
Franco CB, Paz-Filho G, Gomes PE, et al. Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos Int. 2009;2011:1881-1887. [CrossRef] [PubMed]
 
Chatila WM, Wynkoop WA, Vance G, Criner GJ. Smoking patterns in African Americans and whites with advanced COPD. Chest. 2004;1251:15-21. [CrossRef] [PubMed]
 
Zasloff M. Fighting infections with vitamin D. Nat Med. 2006;124:388-390. [CrossRef] [PubMed]
 
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