Serum Vitamin D Levels, Systemic Inflammation, and Exacerbation Among Patients with COPD GOLD Group E

Background: Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation and frequent exacerbations, leading to disease progression and increased morbidity. Vitamin D deficiency has been suggested to contribute to COPD inflammation and exacerbations. Aim: This study investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels, systemic inflammation, and exacerbation frequency among patients with COPD GOLD group E. Methods: A cross-sectional study was conducted on 111 patients with stable COPD. Patients were divided into two groups based on their serum 25(OH)D levels (<50 nmol/L vs. ≥50 nmol/L). Data on exacerbation frequency for the past year, inflammatory markers, spirometric lung function parameters, and symptom burden were collected. Results: Patients with low serum 25(OH)D (<50 nmol/L) had a significantly higher CAT score and level of serum high-sensitivity (hs)-CRP and exhibited significantly more exacerbations compared to those with higher 25(OH)D levels (p < 0.001, p < 0.001, and p < 0.0001, respectively). Furthermore, lower vitamin D levels were associated with higher CAT scores (Pearson's correlation coefficient, r = -0.30, p < 0.01) and higher serum hs-CRP levels (Spearman's rank correlation coefficient, r = -0.25, p < 0.01), as well as a higher number of exacerbations (Pearson's correlation coefficient, r = -0.74, p < 0.0001). Conclusions: Low vitamin D levels are significantly associated with greater symptom burden, elevated hs-CRP, and increased exacerbation frequency, indicating a strong relationship between vitamin D deficiency, systemic inflammation, and disease burden in patients with COPD belonging to GOLD group E. However, due to the cross-sectional design, no causal relationship can be inferred and prospective interventional studies are required to determine whether treating vitamin D deficiency improves clinical outcomes.