The Association Between Vitamin D Status and Obstructive Lung Disease Among U.S. Adults Aged 40+: 2007-2010 National Health and Nutrition Examination Survey (NHANES) Öffentlichkeit
Seedahmed, Mohamed (Spring 2018)
Published
Abstract
For the last few decades, multiple epidemiological studies have shown that low 25-hydroxyvitamin D [25(OH)D] level is a potential risk factor for multiple chronic diseases and conditions including osteoporosis, type 1 diabetes, hypertension, infections and respiratory diseases. The primary goal of our study was to examine the association between vitamin D status and the lung function measured as the ratio of the Forced Expiratory Volume in the 1stsecond over the Forced Vital Capacity (FEV1/FVC) via spirometry screening test. We conducted a multi-year cross-sectional study of individuals aged 40 years and older, who participated in the 2007/2008 and 2009/2010 cycles of the National Health and Nutrition Examination Survey (NHANES). All statistical analyses were conducted with SAS 9.4 using PROC SURVEY procedures. The odds ratios (ORs) and 95% confidence intervals (CIs) for the association between 25(OH)D concentration and FEV1/FVC ratio below the lower limit of normal (LLN) were estimated by crude logistic regression. Further adjustment for a priori selected covariates did not affect the results. Of 5,477 participants who were eligible for the study, 378 had a baseline serum 25(OH)D < 30 nmol/L, 3,029 had a baseline 25(OH)D between 30-74 nmol/L and 1,558 had 25(OH)D level ≥ 75 nmol/L. Among individuals with FEV1/FVC ≥ LLN, 8% were vitamin D deficient [25(OH)D<30 nmol/L], and 31% had 25(OH)D level ≥ 75 nmol/L. Compared to those with FEV1/FVC < LLN, 7% were vitamin D deficient, and 33% had 25(OH)D level ≥ 75 nmol/L. In unadjusted analyses (crude model), 25(OH)D was not associated with baseline FEV1/FVC ratio < LLN [OR = 1.06, 95% CI: 0.96-1.16 per 25 nmol/L increases in 25(OH)D]. Furthermore, there was no significant association with baseline FEV1/FVC < LLN when we analyzed 25(OH)D as a categorical variable (p for trend = 0.79), with unadjusted ORs of 0.88 (95%: 0.60-1.36) for those with 25(OH)D < 30 nmol/L, and 0.96 (95% CI: 0.77-1.19) for those with 25(OH)D ≥ 75 nmol/L, when compared to individuals with 25(OH)D between 30 and 74 nmol/L. In this study, we did not find an association between 25(OH)D measurements and baseline FEV1/FVC < LLN. Our findings, though statistically non-significant, were contrary to our initial hypothesis. However, if confirmed, could be suggestive for new evidence that higher vitamin D might be associated with obstructive lung disease.
Table of Contents
TABLE OF CONTENTS
I. CHAPTER I: BACKGROUND & LITERATURE REVIEW …...10
II. CHAPTER II: MANUSCRIPT .……...............15
II A. ABSTRACT …………….....................15
II B. INTRODUCTION ……..…..................16
II C. METHODS …......................................19
II D. RESULTS …………....……...............24
II E. DISCUSSION ……….............……….28
III. CHAPTER III: SUMMARY ………….................31
IV. REFRENCES ……………………………...............32
V. APPENDICES …………………………..............…37
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