The relationship between Vitamin D status and exacerbation in COPD patients– a literature review

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Ferrari, Renata [UNESP]
Caram, Laura M.O. [UNESP]
Tanni, Suzana E. [UNESP]
Godoy, Irma [UNESP]
Rupp de Paiva, Sergio Alberto [UNESP]
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Objective: To investigate the relationship between Vitamin D and exacerbation in COPD patients. Methods: The PubMed database was searched for articles published from 2012 onwards using search terms related to Vitamin D and exacerbation in COPD patients. Meta-analysis, clinical trials, observational studies, and human studies were included. Non-English articles or articles with full text unavailable were excluded; a total of 15 articles were selected. Results: The association between exacerbation frequency and Vitamin D levels in observational studies remains controversial, however, meta-analysis revealed a negative association between serum Vitamin D and exacerbation. Also, two clinical trials showed that Vitamin D3 supplementation in COPD patients reduced the risk of moderate and severe exacerbation. Vitamin D binding protein (VDBP) polymorphisms seem to affect patient exacerbation susceptibility. Conclusions: Few studies in literature have data related to diet, 25-hydroxyVitamin D [25(OH)D] and polymorphism in COPD exacerbation. One clinical trial indicates Vitamin D supplementation plays a role in COPD patients with hypovitaminosis D in preventing exacerbations. Further studies are needed to elucidate the role of Vitamin D in this population and to establish the best marker for Vitamin D, which patient subgroups will benefit, and the best supplement dosage without leading to toxicity.
Chronic obstructive pulmonary disease, Exacerbation, Polymorphisms, Supplementation, Vitamin D
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Respiratory Medicine, v. 139, p. 34-38.