Keywords: Vitamin D; health status; COPD; Rural areas
Background:
Vitamin D deficiency can lead to rapid deterioration in lung function and elevated risk of worse health status in patients with Chronic Obstructive Pulmonary Disease (COPD).
Aim of the study:
To assess the prevalence of Vitamin D deficiency among patients with COPD living in rural areas and explore its impact on disease severity and overall health status.
Methodology:
This cross-sectional study included 138 participants >40 years from the prospective COCARE COPD study. Sociodemographic characteristics, medical history, disease-specific quality of life, the COPD Assessment Test (CAT), fatigue, the Fatigue Severity Scale (FSS), phycological parameters, Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7), sleep complaints, the COPD and Asthma Sleep Impact Scale (CASIS), Athens Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS) were collected. Vitamin D deficiency was defined as levels of 25-hydroxy (OH)-vitamin D below 20 ng/mL. Multiple logistic regression analysis was conducted to test for associations of Vitamin D deficiency with COPD and overall health status, adjusting for age, gender, smoking status, comorbidities, and seasonality.
Results:
Most of the participants were male (70%) with a mean age of 68 ± 9 years and a mean BMI of 30 ± 6 kg/m2. Moreover, 33% of the participants had Vitamin D deficiency. Vitamin D deficiency increased the risk for worse COPD health status (CAT≥10 OR: 2.713, 95%CI: 1.068-6.896, p=0.036), excessive daytime sleepiness (ESS, OR: 1.067, 95% CI: 0.990-1.151, p=0.04), depressive symptoms (PHQ-9≥5, OR: 2.762, 95%CI: 1.236-6.170, p=0.013), insomnia symptoms (AIS score OR: 1.169, 25%CI 1.058:1.292, p=0.002), and sleep impairment (CASIS OR: 1.046, 95%CI: 1.015-1.078, p=0.004).
Conclusions:
Our findings indicate that a significant number of patients with COPD in this rural population, who have been consistently exposed to sunlight and predominantly engaged in agricultural activities, exhibit Vitamin D deficiency. However, further research is needed to determine the role of vitamin D in the health status of these patients.
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