SESSION TITLE: Biomarkers for COPD
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 30, 2013 at 07:30 AM - 09:00 AM
PURPOSE: Vitamin D deficiency is a modifiable factor in various diseases. However, it’s status among Indians COPD patients is unknown.To find out vitamin D levels in COPD patients and correlate with BMD, clinical severity, and pulmonary functions.
METHODS: Study design-Observational case control study. 50 patients with COPD and 50 controls. Patients on calcium or vitamin D or drugs modifying vitamin D levels, with liver or renal diseases, hypoparathyroidism, malabsorption; and on systemic corticosteroids for ≥3months were excluded. Serum calcium, phosphate, alkaline phosphatase, parathormone(chemiluminescence), 25-hydroxy vitamin D(OHD)(radioimmunoassay) and BMD (lumbar spine, neck of femur and forearm) by Dual energy X-ray absorptiometry were performed in all. Cohort was classified normal(>30ng/ml), vitamin D insufficient (21-29ng/ml) and vitamin D deficient (<20 ng/ml). Analysis was done using STATA Statistics,version 9 software .
RESULTS: 50 cases (35 male,mean age 48.22±6.71 years) were enrolled from outpatient of a tertiary care hospital in India from May2010 to January2012. 50 healthy controls (36 male, mean age 48.99±6.04 years) were also studied. 72% cases were smokers and 66% were using inhaled corticosteroids. 5 had stage-I, 20 had stage-II, 21 had stage-III and 4 had stage-IV disease(GOLD 2007). Subnormal BMD was observed among 84% of cases and 44% of controls. 68% cases had osteoporosis and 32% had osteopenia. There was significant correlation between BMD and FEV1 (lumbar spine R2=0.61, p<0.05; femoral neck R2=0.41, p<0.05; and forearm R2=0.43,p<0.05). The mean OHD levels of cases was 10.23±3.4 ng/ml and that of controls 9.1+4.16ng/ml (p=0.88). 94% of the cases showed subnormal levels (58%insufficient and 34%deficient) of OHD. Secondary hyperparathyroidism was observed among 70% of cases. There was no correlation of OHD levels and clinical parameters.
CONCLUSIONS: Osteopenia and osteoporosis are common among COPD patients. Low BMD is correlated with clinical severity and pulmonary functions. Vitamin D deficiency is common in healthy and COPD patients.
CLINICAL IMPLICATIONS: There may be therapeutic role of vitamin D and calcium in management of COPD .
DISCLOSURE: The following authors have nothing to disclose: Gopi Khilnani, N Raj Kanna, Nandita Gupta, Vijay Hadda, Neetu Jain, A. Amini, R. Pandey, S. Sharma
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