25-Hydroxy vitamin D and body composition are associated with pulmonary function in non-cystic fibrosis bronchiectasis: A cross-sectional study

Abstract

Previous studies have emphasized the effects of vitamin D on the lung function of cystic fibrosis (CF) adult patients. The main aim of the present study sought to determine the association between circulating 25-hydroxyvitamin D (25-OH D) concentration and clinical outcomes in non-cystic fibrosis (non-CF) bronchiectasis subjects. Secondary, we assessed the possible relationship between body composition and respiratory dysfunction in these patients. Sixty-two non-CF bronchiectasis patients (24 male/38 female), aged 18-72, were recruited in this cross-sectional study. Anthropometric indices, lung function tests, and bronchiectasis severity valuations were determined. Body composition, including Mid-arm muscle circumference (MAMC, cm) was calculated using triceps skinfold (TSF,mm) and mid-arm circumference (MAC,cm) under the reference formula. Then serum 25-hydroxyvitamin D concentration and C-reactive protein level were measured. The correlation between vitamin D level and pulmonary function and disease exacerbation tests was primarily assessed. Additionally, we evaluated the correlation between body composition and lung function tests. Circulating 25-hydroxyvitamin D status positively was correlated with lung function tests, including FEV1 (r=0.30, p value=0.035) and FVC (r=0.36, p value=0.011), and also be associated with the extent of pulmonary involvement (r=-0.34, p value=0.03). There was a significant negative correlation between percentage body fat and respiratory function, FEV1/FVC ratio (r=-0.43, p value<0.001). In contrast, there was a strong correlation between skeletal muscle mass and pulmonary function tests (r=0.26, p value=0.04). There is a positive association between low 25-hydroxyvitamin D status and lung dysfunction in participants with non-CF bronchiectasis. The pulmonary dysfunction also correlated with more percentage body fat and low skeletal muscle mass in these patients. Therefore, the evaluation of body composition and serum vitamin D are suggested in the disease management of the patients with non-CF bronchiectasis. However, these associations should be interpreted with caution due to the likelihood of reverse causation. More high-quality prospective studies are warranted to confirm our observations and determine the mechanisms underlying these findings.