Sunday, October 21, 2012

 

Vitamin-D deficiency is associated with chronic bacterial colonisation and disease severity in bronchiectasis.


Vitamin-D deficiency is associated with chronic bacterial colonisation and disease severity in bronchiectasis.


Oct 2012

Source

The University of Edinburgh/MRC Centre for Research Inflammation, The Queen's Medical Research Institute, Edinburgh, UK.

Abstract

INTRODUCTION:

Vitamin-D deficiency has been linked to an increased risk of respiratory infections. The objective of this study was to determine the frequency and clinical importance of vitamin-D deficiency in patients with bronchiectasis.

METHODS:

25-hydroxyvitamin-D was measured by immunoassay in 402 stable patients with bronchiectasis. Patients were classified as vitamin-D deficient -serum 25-hydroxyvitamin-D less then 25 nmol/l, - insufficient - 25 nmol/l-74 nmol/l-  or sufficient (≥75 nmol/l). Disease severity was assessed, including exacerbation frequency, measurement of airway inflammatory markers, sputum bacteriology and lung function over 3 years follow-up.

RESULTS:

Fifty percent  of bronchiectasis patients were vitamin-D deficient, Forty three percent insufficient and onlyseven percent sufficient. This compared to only twelve percent of age and sex matched controls with vitamin-D deficiency. Vitamin-D deficient patients were more frequently chronically colonised with bacteria, twenty one point four percent of vitamin-D deficient subjects were colonised with Pseudomonas aeruginosa compared to ten point four percent of insufficient patients and Three point six percent of sufficient patients.. Vitamin-D deficient patients had lower FEV one percent predicted , and more frequent pulmonary exacerbations. Vitamin-D deficient patients had higher sputum levels of inflammatory markers and demonstrated a more rapid decline in lung function over 3 years follow-up. Defects in neutrophil function and assessment of airway LL-37 levels did not provide a mechanistic explanation for these findings. Vitamin-D deficient patients had, however, higher levels of Vitamin-D Binding Protein in sputum sol.

CONCLUSIONS:

Vitamin-D deficiency is common in bronchiectasis and correlates with markers of disease severity. The mechanism of this association is unclear.

British Medical Journal

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