TUESDAY, Jan. 17 (HealthDay News) -- Vitamin D supplements don't
seem to help most patients suffering from chronic obstructive
pulmonary disease (COPD), according to a new study by Belgian
investigators.
Emphysema and chronic bronchitis are the two main forms of COPD,
and many sufferers have both. The condition makes it hard for
people to breathe.
Since most COPD patients are vitamin D deficient and vitamin D
helps fight inflammation, the hope was that high doses of the
sunshine vitamin would reduce the number of severe flare-ups
("exacerbations") that can land patients in the hospital,
researchers said.
"There are studies showing that patients with vitamin D deficiency are more susceptible to different inflammatory, infectious and autoimmune diseases, and most likely COPD," said lead investigator Dr. Wim Janssens, from the respiratory division at University Hospital Gasthuisberg in Leuven.
However, this study found only a limited benefit from vitamin D
supplementation, he said.
"Vitamin D restoration to normal levels in COPD patients does not reduce the number of exacerbations, does not reduce the infections and inflammation," Janssens said.
However, it had an effect on patients with the lowest vitamin D
levels, he said. "These patients had benefit from supplementation
in terms of exacerbations," he said.
"But this does not allow us to conclude that we need to give all COPD patients these high doses of vitamin D; it just strengthens us in the idea that severe deficiency many enhance inflammation in COPD," Janssens said.
"New studies are needed to confirm what we found," he added.
The report was published in the Jan. 17 issue of the
Annals of Internal Medicine.
For the study, Janssens' team randomly assigned 182 patients
with moderate to very severe COPD to 100,000 IU (international
units) of vitamin D supplements or placebos every month for one
year.
Over that time, researchers looked for the rate of flare-ups and
hospitalizations as well as quality of life and deaths.
Although blood levels of vitamin D rose significantly in those
taking the supplement, there was no significant difference in the
time to a first exacerbation or the number of flare-ups between
these patients and those receiving placebos, the researchers
found.
There also was no significant difference between the groups in
hospitalizations, quality of life and deaths, the authors
added.
However, 30 patients with severe vitamin D deficiencies who were
taking the supplement did have a significant reduction in
exacerbations, the researchers found.
Dr. Diane Gold, a professor of medicine at Harvard Medical
School and a professor of environmental health at the Harvard
School of Public Health, is the co-author of an accompanying
journal editorial. She said that "COPD ranks in the top 10 causes
of morbidity and mortality in the United States."
Unfortunately, COPD therapies other than stopping smoking have
limited effect in reducing COPD-associated deaths, she said.
This study "does not definitively refute the benefit of vitamin
D supplements for reducing COPD exacerbations," Gold said.
"Variability in the underlying disease and genetics are likely to modify the respiratory responses to vitamin D supplementation in people with COPD," she added.
Larger trials with longer follow-up and daily vitamin D dosing
are needed to understand the variability in respiratory responses
to vitamin D supplementation, Gold said. "And also to assess rarer
COPD outcomes such as hospitalization or deaths, or outcomes with
longer latency such as changes in lung function, fractures, cardiac
outcomes or lung cancer."
Another expert, Dr. Michael Holick, a professor of medicine,
physiology and biophysics at Boston University School of Medicine,
said he is not surprised some patients benefited from vitamin
D.
"There is evidence that vitamin D deficiency exacerbates asthma and lung function," he said.
"We know vitamin D has an impact on reducing inflammatory activity and fighting infections, all of which are chronic problems in patients with COPD," Holick said.
More information
For more information on COPD, visit the
U.S. National Library of Medicine.