■维生素D缺乏症（VDD，据报道，25-羟基维生素D<20ng/mL）与慢性阻塞性肺疾病（COPD）的恶化有关，但有时存在争议。研究严重的维生素D缺乏（SVDD，25-羟基维生素D<10ng/mL）在COPD恶化中是有限的。
■我们在134例COPD加重住院患者中进行了一项回顾性观察研究。将25-羟基维生素D建模为连续或二分（截止值：10或20ng/mL）变量，以评估前一年SVDD与住院的关联。进行受试者工作特征（ROC）分析以找到25-羟基维生素D的最佳临界值。
■总共有23％的患者患有SVDD。SVDD在女性中更为普遍，和SVDD组倾向于有较低的血液嗜酸性粒细胞计数。前一年住院患者的25-羟基维生素D水平明显较低（13.6比16.7ng/mL，P=0.044),SVDD的患病率更高(38.0%vs14.3%，P=0.002)。在住院加重的COPD患者中，SVDD与前一年的住院独立相关[比值比（OR）4.34，95％CI1.61-11.72，P=0.004]，而连续25-羟基维生素D和VDD则没有（P=0.1，P=0.9，分别）。ROC曲线的曲线下面积为0.60（95％CI0.50-0.71），最佳的25-羟基维生素D截止值为10.4ng/mL。
■在住院加重的COPD患者中，SVDD可能显示出与前一年住院更稳定的相关性。SVDD组嗜酸性粒细胞计数较低的原因需要进一步探索。
UNASSIGNED: Vitamin D deficiency (VDD, 25-hydroxyvitamin D < 20 ng/mL) has been reported associated with exacerbation of chronic obstructive pulmonary disease (COPD) but sometimes controversial. Research on severe vitamin D deficiency (SVDD, 25-hydroxyvitamin D < 10 ng/mL) in exacerbation of COPD is limited.
UNASSIGNED: We performed a retrospective observational study in 134 hospitalized exacerbated COPD patients. 25-hydroxyvitamin D was modeled as a continuous or dichotomized (cutoff value: 10 or 20 ng/mL) variable to evaluate the association of SVDD with hospitalization in the previous year. Receiver operator characteristic (ROC) analysis was performed to find the optimal cut-off value of 25-hydroxyvitamin D.
UNASSIGNED: In total 23% of the patients had SVDD. SVDD was more prevalent in women, and SVDD group tended to have lower blood eosinophils counts. 25-hydroxyvitamin D level was significantly lower in patients who were hospitalized in the previous year (13.6 vs 16.7 ng/mL, P = 0.044), and the prevalence of SVDD was higher (38.0% vs 14.3%, P = 0.002). SVDD was independently associated with hospitalization in the previous year [odds ratio (OR) 4.34, 95% CI 1.61-11.72, P = 0.004] in hospitalized exacerbated COPD patients, whereas continuous 25-hydroxyvitamin D and VDD were not (P = 0.1, P = 0.9, separately). The ROC curve yielded an area under the curve of 0.60 (95% CI 0.50-0.71) with an optimal 25-hydroxyvitamin D cutoff of 10.4 ng/mL.
UNASSIGNED: SVDD probably showed a more stable association with hospitalization in the previous year in hospitalized exacerbated COPD patients. Reasons for lower eosinophil counts in SVDD group needed further exploration.
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