Journal of Nutrition and Health

  • 제47권5호
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  • Pages.321-329
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  • 2014
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  • 2288-3886(pISSN)
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  • 2288-3959(eISSN)
한국영양학회 (The Korean Nutrition Society)
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제5기 국민건강영양조사 자료 중 남성에서 혈청 중 25-hydroxyvitamin D와 만성폐쇄성폐질환의 상관관계

Relationship between serum 25-hydroxyvitamin D and chronic obstructive pulmonary disease in males in the fifth Korean national health and nutrition examination survey

  • 투고 : 2014.08.28
  • 심사 : 2014.10.14
  • 발행 : 2014.10.31
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초록

제5기국민건강영양조사 자료중 40세이상 남성을 대상으로 혈액 중 25(OH)D와 COPD의 상관관계를 조사하였다. 25(OH)D는 사분위로 군을 나누어 적용하였고, 2012년 개정된 진료지침에 따라 $FEV_1/FEV_6$ < 0.73인 경우를 COPD로 판정하였다. 다른 요인을 보정하지 않았을 경우에는 25(OH)D와 COPD 사이에 상관관계가 없었으나 흡연상태, 가계소득, 교육수준, 직업, BMI, 만연령및흡연지수를 보정하였을 때는 25(OH)D와 COPD사이에 유의한 상관관계를 보였다. 25(OH)D농도 17~21 ng/mL인 3/4분위군을 기준으로 1/4분위의 경우의 OR 1.643 (95% CI 1.161-2.236), 2/4분위는 OR 1.453 (95% CI 1.045-2.020)으로 유의하게 증가하였다. 결론적으로 40세 이상 남성에서 혈중 25(OH)D 농도는 COPD 유병가능성과 유의한 상관관계를 보였다. 즉, 3/4 분위군 [25(OH)D 17 ng/mL 이상 21 ng/mL 미만]을 기준으로 혈중농도가 낮을수록 COPD 유병가능성이 높았다.

Purpose: The aim of this study was to determine the relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and chronic obstructive pulmonary disease (COPD) prevalence. Methods: The analysis was performed using data from the Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional survey of the Korean civilian population conducted from 2010 to 2012. The analyses were restricted to males who were 40 years of age and above. Complex sample multiple logistic regression analyses were used to examine the associations of COPD prevalence with 25(OH)D and other factors. Results: $FEV_1/FEV_6$ varied significantly with smoking status, age, household income, education level, occupation, body mass index (BMI), and physical activity (p < 0.05). In univariate analysis, smoking status, BMI, household income, education level, and occupation showed association with COPD (p < 0.05), but vitamin D was not associated with COPD (p = 0.078). However, when adjusted with smoking status, household income, education level, occupation, BMI, age, and smoking index, the lowest quartile of 25(OH)D showed OR 1.643 (95% CI 1.161-2.236) compared to 3rd quartile (p = 0.024). Conclusion: A significant relationship was observed between serum concentration of 25(OH)D and COPD.

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참고문헌

  1. Wacker M, Holick MF. Vitamin D: Effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 2013; 5(1): 111-148. https://doi.org/10.3390/nu5010111
  2. Muscogiuri G, Sorice GP, Ajjan R, Mezza T, Pilz S, Prioletta A, Scragg R, Volpe SL, Witham MD, Giaccari A. Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr Metab Cardiovasc Dis 2012; 22(2): 81-87. https://doi.org/10.1016/j.numecd.2011.11.001
  3. Holgate ST. The epidemic of asthma and allergy. J R Soc Med 2004 Mar; 97(3): 103-110.
  4. Evatt ML, Delong MR, Khazai N, Rosen A, Triche S, Tangpricha V. Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease. Arch Neurol 2008; 65(10): 1348-1352.
  5. Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin D and pulmonary function in the third national health and nutrition survey. Chest 2005; 128: 3792-3798. https://doi.org/10.1378/chest.128.6.3792
  6. World Health Organization [Internet]. Geneva: The top 10 causes of death; [Cited 2014 May]. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/.
  7. Sundar IK, Hwang JW, Wu S, Sun J, Rahman I. Deletion of vitamin D receptor leads to premature emphysema/COPD by increased matrix metalloproteinases and lymphoid aggregates formation. Biochem Biophys Res Commun 2011; 406(1): 127-133. https://doi.org/10.1016/j.bbrc.2011.02.011
  8. Kunisaki KM, Niewoehner DE, Singh RJ, Connett JE. Vitamin D status and longitudinal lung function decline in the Lung Health Study. Eur Respir J 2011; 37(2): 238-243. https://doi.org/10.1183/09031936.00146509
  9. Crane-Godreau MA, Black CC, Giustini AJ, Dechen T, Ryu J, Jukosky JA, Lee HK, Bessette K, Ratcliffe NR, Hoopes PJ, Fiering S, Kelly JA, Leiter JC. Modeling the influence of vitamin D deficiency on cigarette smoke-induced emphysema. Front Physiol 2013; 4: 132.
  10. Finklea JD1, Grossmann RE, Tangpricha V. Vitamin D and chronic lung disease: a review of molecular mechanisms and clinical studies. Adv Nutr 2011; 2(3): 244-253. https://doi.org/10.3945/an.111.000398
  11. Monadi M, Heidari B, Asgharpour M, Firouzjahi A, Monadi M, Ghazi Mirsaied MA. Relationship between serum vitamin D and forced expiratory volume in patients with chronic obstructive pulmonary disease (COPD). Caspian J Intern Med 2012; 3(3): 451-455.
  12. Shaheen SO, Jameson KA, Syddall HE, Aihie Sayer A, Dennison EM, Cooper C, Robinson SM. The relationship of dietary patterns with adult lung function and COPD. Eur Respir J 2010; 36(2): 277-284. https://doi.org/10.1183/09031936.00114709
  13. Shaheen SO, Jameson KA, Robinson SM, Boucher BJ, Syddall HE, Sayer AA, Cooper C, Holloway JW, Dennison EM. Relationship of vitamin D status to adult lung function and COPD. Thorax 2011; 66(8): 692-698. https://doi.org/10.1136/thx.2010.155234
  14. Guessous I, Dudler V, Glatz N, Theler JM, Zoller O, Paccaud F, Burnier M, Bochud M. Vitamin D levels and associated factors: a population-based study in Switzerland. Swiss Med Wkly 2012; 142: w13719.
  15. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, Kim KJ, Rhee Y, Lim SK. Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 2011; 96(3): 643-651. https://doi.org/10.1210/jc.2010-2133
  16. Jung IK. Prevalence of vitamin D deficiency in Korea: Results from KNHANES 2010 to 2011. J Nutr Health 2013; 46(6): 540-551. https://doi.org/10.4163/jnh.2013.46.6.540
  17. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1), Cheongwon: Korea Centers for Disease Control and Prevention;2011
  18. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2), Cheongwon: Korea Centers for Disease Control and Prevention;2012
  19. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3), Cheongwon: Korea Centers for Disease Control and Prevention;2013
  20. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: The Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014; 43: 69-77. https://doi.org/10.1093/ije/dyt228
  21. Weisman Y. Vitamin D deficiency and insufficiency. Isr Med Assoc J 2013(7): 377-378.
  22. Haddad JG, Rojanasathit S. Acute administration of 25 hydroxycholecalciferol in man. J Clin Endocrinol Metab 1976; 42(2): 284-290. https://doi.org/10.1210/jcem-42-2-284
  23. Stamp TC, Round JM, Rowe DJ, Haddad JG. Plasma levels and therapeutic effect of 25-hydroxycholecalciferol in epileptic patients taking anticonvulsant drugs. Br Med J 1972 ; 4(5831): 9-12. https://doi.org/10.1136/bmj.4.5831.9
  24. Birge SJ, Haddad JG. 25-Hydroxycholecalciferol stimulation of muscle metabolism. J Clin Invest 1975; 56: 1100-1107. https://doi.org/10.1172/JCI108184
  25. The Korean Academy of Tuberculosis and Respiratory Disease, Guide to COPD diagnosis, 2012 revision, Seoul; 2012.
  26. Persson LJ, Aanerud M, Hiemstra PS, Hardie JA, Bakke PS, Eagan TM. Chronic obstructive pulmonary disease is associated with low levels of vitamin D. PLoS One 2012; 7(6): e38934.
  27. Korn S, Hubner M, Jung M, Blettner M, Buhl R. Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency. Respir Res 2013; 14: 25. https://doi.org/10.1186/1465-9921-14-25
  28. Kunisaki KM, Niewoehner DE, Connett JE; COPD Clinical Research Network. Vitamin D levels and risk of acute exacerbations of chronic obstructive pulmonary disease: a prospective cohort study. Am J Respir Crit Care Med 2012; 185(3): 286-290. https://doi.org/10.1164/rccm.201109-1644OC
  29. Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: metabolism. Endocrinol Metab Clin North Am 2010; 39(2): 243-253. https://doi.org/10.1016/j.ecl.2010.02.002
  30. Christakos S, Hewison M, Gardner DG, Wagner CL, Sergeev IN, Rutten E, Pittas AG, Boland R, Ferrucci L, Bikle DD. Vitamin D: beyond bone. Ann N Y Acad Sci 2013; 1287: 45-58. https://doi.org/10.1111/nyas.12129
  31. Christakos S, DeLuca HF. Minireview: Vitamin D: is there a role in extraskeletal health? Endocrinology 2011; 52(8): 2930-2936.
  32. Hughes DA, Norton R. Vitamin D and respiratory health. Clin Exp Immunol 2009; 158(1): 20-25. https://doi.org/10.1111/j.1365-2249.2009.04001.x
  33. Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol 2008; 181(10): 7090-7099. https://doi.org/10.4049/jimmunol.181.10.7090
  34. Hansdottir S, Monick MM. Vitamin D effects on lung immunity and respiratory diseases. Vitam Horm 2011; 86: 217-237. https://doi.org/10.1016/B978-0-12-386960-9.00009-5
  35. Schrumpf JA, van Sterkenburg MA, Verhoosel RM, Zuyderduyn S, Hiemstra PS. Interleukin 13 exposure enhances vitamin D-mediated expression of the human cathelicidin antimicrobial peptide 18/LL-37 in bronchial epithelial cells. Infect Immun 2012; 80(12): 4485-4494. https://doi.org/10.1128/IAI.06224-11
  36. Gilbert CR, Arum SM, Smith CM. Vitamin D deficiency and chronic lung disease. Can Respir J 2009; 16(3): 75-80. https://doi.org/10.1155/2009/829130