title: Relation between Vitamin D Deficiency and Severity of Chronic Obstructive Pulmonary Disease-A Case Control Study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder characterized by irreversible and progressive limitation of expiratory airflow. COPD is now considered as a systemic disease with several extra-pulmonary manifestations which include osteoporosis, muscle weakness, arrhythmia, stroke, cancer etc. The role of vitamin D in skeletal integrity is well established. Role of it in several other diseases like autoimmune, infectious, respiratory and cardiovascular diseases has been increasingly recognised. Data on vitamin D status in COPD in Indian population was limited while those comparing vitamin D with stage, pack year and body mass index were lacking.
  
  
  OBJECTIVE
  To assess Vitamin D in subjects with COPD and matched controls and also to study the variability in serum vitamin D levels with COPD disease characteristics.
  
  
  METHODS
  A total of 162 patients aged 18-65 years from south India presenting to kasturba hospital were included in the study. Serum 25- hydroxy-vitamin D were measured in 81 COPD patients (combined COPD stage A-D) and compared with 81 age and gender matched controls. Level < 20 ng/ml defined deficiency. Risk estimate with Odds ratio and association of COPD characteristics with Vitamin D was assessed using logistic regression analysis.
  
  
  RESULTS
  COPD patients had an increased risk for vitamin D deficiency compared to controls after adjustment for age and gender(OR =2.687 (1.40,5.13)). Variables associated with lower 25(OH) D levels in COPD patients were higher pack year (p=0.001), current smoking status (p=0.026), Low BMI (p=0.02), and GOLD stage III- IV (p=0.001).
  
  
  CONCLUSIONS
  COPD was associated with an increased risk of vitamin D deficiency, and there was a significant association between vitamin D levels and Combined COPD stage severity. Also, a higher pack year and a low BMI are associated with lower levels of vitamin D.
authors.affiliation: Post Graduate, Department of Medicine, Kasturba Medical College , Manipal University, Manipal, Karnataka, India .
authors.forename: Shah
authors.initials: S
authors.lastname: Sanket
authors.affiliation: Post Graduate, Department of Medicine, Kasturba Medical College , Manipal University, Manipal, Karnataka, India .
authors.forename: Jagadesh
authors.initials: J
authors.lastname: Madireddi
authors.affiliation: Associate Professor, Department of Medicine, Kasturba Medical College , Manipal University, Manipal, Karnataka, India .
authors.forename: Weena
authors.initials: W
authors.lastname: Stanley
authors.affiliation: Post Graduate, Department of Medicine, Kasturba Medical College , Manipal University, Manipal, Karnataka, India .
authors.forename: Pradeep
authors.initials: P
authors.lastname: Sura
authors.affiliation: Professor and Head of Unit, Department of Medicine, Kasturba Medical College , Manipal University, Manipal, Karnataka, India .
authors.forename: Mukhyaprana
authors.initials: M
authors.lastname: Prabhu
keywords: BMI; Osteomalacia; Osteoporosis; Smoking