维生素D缺乏及其与希腊克里特岛农村老年慢性阻塞性肺病患者健康状况的潜在关联：一项横断面研究

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-04-24 DOI:10.1016/j.clnesp.2025.04.013

Izolde Bouloukaki , Antonios Christodoulakis , Ioanna Tsiligianni

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引用次数: 0

摘要

背景,虽然低维生素D水平在慢性阻塞性肺疾病（COPD）中很常见，并且与各种不良COPD相关的结局有关，但农村COPD队列中维生素D状况的数据有限。因此，本研究旨在评估农村地区COPD患者维生素D缺乏症的患病率，并探讨其与整体健康状况的潜在关联。方法本横断面研究包括138名40岁COPD患者，他们来自前瞻性“COPD初级保健患者的协作护理与常规护理”（COCARE）研究。收集社会人口学特征、病史、患者健康相关生活质量（HRQoL） (COPD评估测试（CAT）、疲劳程度量表（FSS）、患者健康问卷-9 （PHQ-9）和一般焦虑障碍-7 （GAD-7）的生理参数、睡眠障碍(COPD和哮喘睡眠影响量表（CASIS）、雅典失眠量表（AIS）和Epworth嗜睡量表（ESS）。维生素D缺乏被定义为25-羟基(OH)-维生素D水平低于20 ng/mL。采用多元logistic回归分析来检验维生素D缺乏与CAT、FSS、PHQ-9、GAD-7、CASIS、AIS和ESS的相关性，并对年龄、性别、吸烟状况、合并症和季节性因素进行校正。结果大多数参与者为男性（70%），平均年龄68±9岁，平均体重指数（BMI）为30±6 kg/m2。此外，33%的参与者缺乏维生素D。缺乏维生素D增加了更糟的几率HRQoL(猫≥10或:2.3,置信区间:0.9 - -6.4,p = 0.008),更大的疲劳程度(fs,或:1.2,CI: 0.4 - -3.1, p = 0.756),更多的抑郁(phq - 9≥5,或者:2.9,CI: 1.1 - -7.4, p = 0.024),焦虑(GAD-7 OR: 0.8, CI: 0.3 - -2.1, p = 0.592)和失眠症状(AIS分数或:1.1,CI: 0.7 5, p = 0.29),日间极度嗜睡(5 ESS,或者:1.1,CI: 0.7, p = 0.29),并降低睡眠质量(属于接近或:2.5,CI: 0.9 - -6.5, p = 0.006)。总之，我们的研究结果表明，维生素D缺乏与COPD患者的许多负面健康结果呈正相关，包括HRQoL恶化、疲劳、抑郁、焦虑和睡眠障碍。然而，需要进一步的研究来确定维生素D在这些患者健康状况中的作用。

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Vitamin D deficiency and its potential associations on the health status of older patients with chronic obstructive pulmonary disease in rural Crete, Greece: A cross-sectional study

Background & aims

While low vitamin D levels are common in Chronic Obstructive Pulmonary Disease (COPD) and have been associated with various adverse COPD-related outcomes, data on vitamin D status in rural COPD cohorts is limited. Therefore, the present study aimed to assess the prevalence of Vitamin D deficiency among patients with COPD living in rural areas and explore its potential association on the overall health status.

Methods

This cross-sectional study included 138 participants >40 years with COPD from the prospective “COlaborative care vs usual CARE in primary care patients with COPD” (COCARE) study. Sociodemographic characteristics, medical history, patient's health-related quality of life (HRQoL) with the COPD Assessment Test (CAT), fatigue with the Fatigue Severity Scale (FSS), phycological parameters with Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7), sleep disorders with 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 CAT, FSS, PHQ-9, GAD-7, CASIS, AIS, and ESS, 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 Body Mass Index (BMI) of 30 ± 6 kg/m². Moreover, 33 % of the participants had Vitamin D deficiency. Vitamin D deficiency increased the odds for worse HRQoL (CAT≥10 OR: 2.3, CI: 0.9–6.4, p = 0.008), greater fatigue severity (FSS, OR: 1.2, CI: 0.4–3.1, p = 0.756), more depressive (PHQ-9≥5, OR: 2.9, CI: 1.1–7.4, p = 0.024), anxiety (GAD-7, OR: 0.8, CI: 0.3–2.1, p = 0.592) and insomnia symptoms (AIS score OR: 1.1, CI: 0.7–5, p = 0.29), excessive daytime sleepiness (ESS, OR: 1.1, CI: 0.7–5, p = 0.29), and lower sleep quality (CASIS OR: 2.5, CI: 0.9–6.5, p = 0.006).

Conclusion

In conclusion, our findings indicate that Vitamin D deficiency is positively associated with numerous negative health outcomes of patients with COPD, including worse HRQoL, fatigue, depression, anxiety and sleep disorders. However, further research is needed to determine the role of Vitamin D in the health status of these patients.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.