Vitamin D status is associated with muscle strength and quality of life in patients with chronic obstructive pulmonary disease (COPD): a seasonal prospective observation study

Emma Carson, L.K. Pourshahidi, Sharon Madigan, FR Baldrick, Martin Kelly, Eamon Laird, Martin Healy, JJ Strain, Maria S Mulhern

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Abstract

Background: Owing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, sub-optimal vitamin D status (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) is prevalent among chronic obstructive pulmonary disease (COPD) patients.
Objective: This study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat free mass (FFM), muscle strength and quality of life (QoL) in COPD patients.
Methods: COPD patients living in Northern Ireland (n 51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time-points, serum concentration of 25(OH)D was quantified by LC-MS/MS, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire.
Results: Mean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter [52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001]; and housebound patients had significantly lower 25(OH)D concentration compared to non-housebound patients at the end of summer [42.9±4.2 vs 57.2±9.9 nmol/L; P<0.001]. Muscle strength (at both time-points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status.
Conclusion: This study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in non-housebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.
LanguageEnglish
Article number13
Pages2613-2622
Number of pages9
JournalInternational Journal of Chronic Obstructive Pulmonary Disease
Volume13
Early online date28 Aug 2018
Publication statusE-pub ahead of print - 28 Aug 2018

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Muscle Strength
Vitamin D
Chronic Obstructive Pulmonary Disease
Quality of Life
Observation
Prospective Studies
Fats
Northern Ireland
Sunlight
Health Policy
Electric Impedance
Hospitalization
Smoking
Health
Serum

Keywords

  • vitamin D
  • COPD
  • muscle strength
  • quality of life
  • seasonal
  • 25(OH)D

Cite this

@article{57fe4df20ff5410e96b32acbbb1ff5d8,
title = "Vitamin D status is associated with muscle strength and quality of life in patients with chronic obstructive pulmonary disease (COPD): a seasonal prospective observation study",
abstract = "Background: Owing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, sub-optimal vitamin D status (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) is prevalent among chronic obstructive pulmonary disease (COPD) patients. Objective: This study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat free mass (FFM), muscle strength and quality of life (QoL) in COPD patients. Methods: COPD patients living in Northern Ireland (n 51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time-points, serum concentration of 25(OH)D was quantified by LC-MS/MS, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire. Results: Mean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter [52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001]; and housebound patients had significantly lower 25(OH)D concentration compared to non-housebound patients at the end of summer [42.9±4.2 vs 57.2±9.9 nmol/L; P<0.001]. Muscle strength (at both time-points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status. Conclusion: This study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in non-housebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.",
keywords = "vitamin D, COPD, muscle strength, quality of life, seasonal, 25(OH)D",
author = "Emma Carson and L.K. Pourshahidi and Sharon Madigan and FR Baldrick and Martin Kelly and Eamon Laird and Martin Healy and JJ Strain and Mulhern, {Maria S}",
year = "2018",
month = "8",
day = "28",
language = "English",
volume = "13",
pages = "2613--2622",
journal = "International Journal of Chronic Obstructive Pulmonary Disease",
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TY - JOUR

T1 - Vitamin D status is associated with muscle strength and quality of life in patients with chronic obstructive pulmonary disease (COPD): a seasonal prospective observation study

AU - Carson, Emma

AU - Pourshahidi, L.K.

AU - Madigan, Sharon

AU - Baldrick, FR

AU - Kelly, Martin

AU - Laird, Eamon

AU - Healy, Martin

AU - Strain, JJ

AU - Mulhern, Maria S

PY - 2018/8/28

Y1 - 2018/8/28

N2 - Background: Owing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, sub-optimal vitamin D status (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) is prevalent among chronic obstructive pulmonary disease (COPD) patients. Objective: This study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat free mass (FFM), muscle strength and quality of life (QoL) in COPD patients. Methods: COPD patients living in Northern Ireland (n 51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time-points, serum concentration of 25(OH)D was quantified by LC-MS/MS, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire. Results: Mean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter [52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001]; and housebound patients had significantly lower 25(OH)D concentration compared to non-housebound patients at the end of summer [42.9±4.2 vs 57.2±9.9 nmol/L; P<0.001]. Muscle strength (at both time-points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status. Conclusion: This study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in non-housebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.

AB - Background: Owing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, sub-optimal vitamin D status (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) is prevalent among chronic obstructive pulmonary disease (COPD) patients. Objective: This study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat free mass (FFM), muscle strength and quality of life (QoL) in COPD patients. Methods: COPD patients living in Northern Ireland (n 51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time-points, serum concentration of 25(OH)D was quantified by LC-MS/MS, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire. Results: Mean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter [52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001]; and housebound patients had significantly lower 25(OH)D concentration compared to non-housebound patients at the end of summer [42.9±4.2 vs 57.2±9.9 nmol/L; P<0.001]. Muscle strength (at both time-points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status. Conclusion: This study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in non-housebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.

KW - vitamin D

KW - COPD

KW - muscle strength

KW - quality of life

KW - seasonal

KW - 25(OH)D

M3 - Article

VL - 13

SP - 2613

EP - 2622

JO - International Journal of Chronic Obstructive Pulmonary Disease

T2 - International Journal of Chronic Obstructive Pulmonary Disease

JF - International Journal of Chronic Obstructive Pulmonary Disease

SN - 1176-9106

M1 - 13

ER -