PDF(Pubmed)
Abstract：
OBJECTIVE: The aim of this study was to determine the disturbances in the concentration of parathyroid hormone (PTH) and 25-hydroxyvitamin D (vitamin D) in patients with stable chronic obstructive pulmonary disease (COPD) and its correlation with airflow obstruction.
METHODS: A prospective study included 200 patients with a confirmed diagnosis of COPD in the Department of Lung Diseases and Tuberculosis and Pulmonology Polyclinic of University Clinical Hospital Mostar in the period of three years, between May 2021 and May 2024. Inclusion criteria were a stable phase of COPD, hemodynamically stable patients older than 40 years, forced vital capacities in the first second (FEV1)/forced vital capacities (FVC) <0.7, and patients with PTH, vitamin D, calcium, and phosphate measurements. Exclusion criteria were acute exacerbation of COPD in the last month; current treatment with nutritional supplements, vitamins, and statins; lack of availability of lung function data; use of systemic corticosteroids in the previous three months; chronic renal insufficiency, respiratory diseases other than COPD (asthma, pneumonia, tuberculosis, and bronchiectasis), and other diseases (cancer and parathyroid disease). Medical records about demographic data (age and gender), pulmonary function test (FVC, FEV1, FEV1%FVC, mean expiratory flow (MEF)50), body mass index (BMI), COPD assessment test (CAT), Modified Medical Research Council (mMRC) Dyspnea Scale, and serum PTH, vitamin D, calcium, and phosphate levels were obtained.
RESULTS: Patients with higher COPD stage had lower spirometry values, most significantly MEF50. The higher the COPD group (Global Initiative for Chronic Obstructive Lung Disease (GOLD) D), the lower vitamin D and the higher PTH levels were. Calcium and phosphate values were the same for all groups. Vitamin D and PTH levels significantly correlated with MEF50 values. The lower MEF50 level, the higher PTH levels, and lower vitamin D levels were found (P<0.05).
CONCLUSIONS: Our study showed that the patients in the higher COPD group have lower vitamin D levels and higher PTH levels, indicating that they developed secondary hyperparathyroidism. The levels of vitamin D and PTH correlated the most with MEF50 values while other spirometry parameters did not significantly correlate with vitamin D and PTH levels.
METHODS: A prospective study included 200 patients with a confirmed diagnosis of COPD in the Department of Lung Diseases and Tuberculosis and Pulmonology Polyclinic of University Clinical Hospital Mostar in the period of three years, between May 2021 and May 2024. Inclusion criteria were a stable phase of COPD, hemodynamically stable patients older than 40 years, forced vital capacities in the first second (FEV1)/forced vital capacities (FVC) <0.7, and patients with PTH, vitamin D, calcium, and phosphate measurements. Exclusion criteria were acute exacerbation of COPD in the last month; current treatment with nutritional supplements, vitamins, and statins; lack of availability of lung function data; use of systemic corticosteroids in the previous three months; chronic renal insufficiency, respiratory diseases other than COPD (asthma, pneumonia, tuberculosis, and bronchiectasis), and other diseases (cancer and parathyroid disease). Medical records about demographic data (age and gender), pulmonary function test (FVC, FEV1, FEV1%FVC, mean expiratory flow (MEF)50), body mass index (BMI), COPD assessment test (CAT), Modified Medical Research Council (mMRC) Dyspnea Scale, and serum PTH, vitamin D, calcium, and phosphate levels were obtained.
RESULTS: Patients with higher COPD stage had lower spirometry values, most significantly MEF50. The higher the COPD group (Global Initiative for Chronic Obstructive Lung Disease (GOLD) D), the lower vitamin D and the higher PTH levels were. Calcium and phosphate values were the same for all groups. Vitamin D and PTH levels significantly correlated with MEF50 values. The lower MEF50 level, the higher PTH levels, and lower vitamin D levels were found (P<0.05).
CONCLUSIONS: Our study showed that the patients in the higher COPD group have lower vitamin D levels and higher PTH levels, indicating that they developed secondary hyperparathyroidism. The levels of vitamin D and PTH correlated the most with MEF50 values while other spirometry parameters did not significantly correlate with vitamin D and PTH levels.
摘要：
目的：本研究的目的是确定慢性阻塞性肺疾病（COPD）稳定期患者甲状旁腺激素（PTH）和25-羟维生素D（维生素D）浓度的紊乱及其与气流阻塞的相关性。
方法：一项前瞻性研究纳入了200名确诊为COPD的患者，这些患者在莫斯塔尔大学临床医院的肺病和结核病科及肺科综合诊所进行了为期三年的研究，2021年5月至2024年5月。纳入标准为COPD稳定期，40岁以上血液动力学稳定的患者，第1秒用力肺活量（FEV1）/用力肺活量（FVC）<0.7，PTH患者，维生素D,钙，和磷酸盐测量。排除标准为上个月COPD急性加重；目前使用营养补充剂治疗，维生素,和他汀类药物；缺乏肺功能数据；在过去三个月使用全身性皮质类固醇；慢性肾功能不全，COPD以外的呼吸系统疾病（哮喘，肺炎,结核病,和支气管扩张)，和其他疾病（癌症和甲状旁腺疾病）。有关人口统计数据（年龄和性别）的医疗记录，肺功能试验(FVC，FEV1,FEV1%FVC,平均呼气流量（MEF）50），体重指数（BMI），COPD评估测试（CAT），改良医学研究委员会（mMRC）呼吸困难量表，和血清PTH,维生素D,钙，并获得磷酸盐水平。
结果：COPD分期较高的患者肺活量测定值较低，最显著的MEF50。COPD组越高（全球慢性阻塞性肺疾病倡议（GOLD）D），维生素D越低，PTH水平越高。所有组的钙和磷酸盐值相同。维生素D和PTH水平与MEF50值显着相关。较低的MEF50水平，PTH水平越高,发现维生素D水平较低（P<0.05）。
结论：我们的研究表明，COPD较高组患者的维生素D水平较低，PTH水平较高，表明他们出现了继发性甲状旁腺功能亢进.维生素D和PTH水平与MEF50值的相关性最大，而其他肺活量测定参数与维生素D和PTH水平没有显着相关性。
方法：一项前瞻性研究纳入了200名确诊为COPD的患者，这些患者在莫斯塔尔大学临床医院的肺病和结核病科及肺科综合诊所进行了为期三年的研究，2021年5月至2024年5月。纳入标准为COPD稳定期，40岁以上血液动力学稳定的患者，第1秒用力肺活量（FEV1）/用力肺活量（FVC）<0.7，PTH患者，维生素D,钙，和磷酸盐测量。排除标准为上个月COPD急性加重；目前使用营养补充剂治疗，维生素,和他汀类药物；缺乏肺功能数据；在过去三个月使用全身性皮质类固醇；慢性肾功能不全，COPD以外的呼吸系统疾病（哮喘，肺炎,结核病,和支气管扩张)，和其他疾病（癌症和甲状旁腺疾病）。有关人口统计数据（年龄和性别）的医疗记录，肺功能试验(FVC，FEV1,FEV1%FVC,平均呼气流量（MEF）50），体重指数（BMI），COPD评估测试（CAT），改良医学研究委员会（mMRC）呼吸困难量表，和血清PTH,维生素D,钙，并获得磷酸盐水平。
结果：COPD分期较高的患者肺活量测定值较低，最显著的MEF50。COPD组越高（全球慢性阻塞性肺疾病倡议（GOLD）D），维生素D越低，PTH水平越高。所有组的钙和磷酸盐值相同。维生素D和PTH水平与MEF50值显着相关。较低的MEF50水平，PTH水平越高,发现维生素D水平较低（P<0.05）。
结论：我们的研究表明，COPD较高组患者的维生素D水平较低，PTH水平较高，表明他们出现了继发性甲状旁腺功能亢进.维生素D和PTH水平与MEF50值的相关性最大，而其他肺活量测定参数与维生素D和PTH水平没有显着相关性。
