Volume 20 Issue 4
Apr.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(4): 615-619
HE Han-fu, NIE Xiao-hong, JIN Yu, LUO Li, LAI Xiao-rong, ZHU Peng-fei. Protective effect of active vitamin D3 on airway remodelling in elderly patients with chronic obstructive pulmonary disease and vitamin D deficiency[J]. Chinese Journal of General Practice, 2022, 20(4): 615-619. doi: 10.16766/j.cnki.issn.1674-4152.002413
Citation: HE Han-fu, NIE Xiao-hong, JIN Yu, LUO Li, LAI Xiao-rong, ZHU Peng-fei. Protective effect of active vitamin D3 on airway remodelling in elderly patients with chronic obstructive pulmonary disease and vitamin D deficiency[J]. Chinese Journal of General Practice, 2022, 20(4): 615-619. doi: 10.16766/j.cnki.issn.1674-4152.002413
shu

Protective effect of active vitamin D3 on airway remodelling in elderly patients with chronic obstructive pulmonary disease and vitamin D deficiency

doi: 10.16766/j.cnki.issn.1674-4152.002413
  • 1.

    Department of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610051, China

Funds:

 2019YJ0649

  • Received Date: 2021-01-20
    Available Online: 2022-08-20
    Abstract
  •   Objective  To explore the protective effect of active vitamin D3 (alfacalcidol) on airway remodelling in elderly patients with chronic obstructive pulmonary disease (COPD) and vitamin D deficiency.  Methods  Forty healthy people (healthy control group) and 146 stable COPD patients with 25(OH)D level lower than 20 ng/mL were selected from January 2019 to January 2020. Patients with chronic obstructive pulmonary disease were randomly divided into three groups: high-dose group (n=48), low-dose group (n=49) and control group (n=49). The levels of 25(OH)D, matrix metalloproteinase-9 (MMP-9), transforming growth factor β1 (TGF-β1), tissue inhibitor of metallo-proteinase-1 (TIMP-1) in blood and HRCT were measured. The ratio of bronchial wall thickness to outer diameter (T/D) and the percentage of airway wall area to total airway cross-sectional area (WA%) were measured at the time of admission and at 3 and 6 months later.  Results  The 25(OH)D level in the COPD group was (13.47±5.32) ng/mL, which was significantly lower than that in the healthy control group [(20.35±8.34) ng/mL], P < 0.05. Meanwhile, the levels of MMP-9, TGF β-1, TIMP-1, T/D and WA% were significantly higher in the COPD group than in the healthy control group (P < 0.05). The levels of 25(OH)D, MMP-9, TGF-β1 and WA% in the low-dose group significantly improved after 3 months of supplementation (P < 0.05), and the levels of TIMP-1 and T/D in the low-dose group significantly improved after 6 months of supplementation (P < 0.05). The level of 25(OH)D and all airway remodelling indexes in the high-dose group after 3 and 6 months of treatment improved (all P < 0.05). The levels of 25(OH)D, TGF-β1 and WA% after 6 months of treatment were different from those in the low-dose group (P < 0.05). The 25(OH)D level negatively correlated with MMP-9, TGF-β1 and WA% (r=-0.287, -0.311, -0.389, respectively, all P < 0.05).  Conclusion  In elderly patients with COPD vitamin D deficiency, daily supplement of alfacalcidol exerts a better protective effect on the improvement of 25(OH)D level and airway remodelling, and high-dose supplement for 6 months exerts a better effect.

     

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