Associations between vitamin D, adiposity, and respiratory symptoms in chronic spinal cord injury

Abstract

Context/ObjectivePersons with chronic spinal cord injury (SCI) have an increased risk of respiratory-related morbidity and mortality and chronic respiratory symptoms are clinical markers of future respiratory disease. Therefore, we sought to assess potentially modifiable factors associated with respiratory symptoms, with a focus on circulating vitamin D and measures of body fat.DesignCross-sectional study.SettingVeterans Affairs Medical Center.ParticipantsThree hundred forty-three participants (282 men and 61 women) with chronic SCI participating in an epidemiologic study to assess factors influencing respiratory health recruited from VA Boston and the community.MethodsParticipants provided a blood sample, completed a respiratory health questionnaire, and underwent dual x-ray absorptiometry (DXA) to assess % body fat. Logistic regression was used to assess cross-sectional associations between respiratory symptoms and plasma vitamin D and measures of body fat with adjustment for a number of potential confounders.Outcome MeasuresChronic cough, chronic phlegm, any wheeze, persistent wheeze.ResultsAfter adjustment for a number of confounders (including smoking), participants with greater %-android, gynoid, trunk, or total body fat had increased odds ratios for any wheeze and suggestive associations with persistent wheeze, but not with chronic cough or phlegm. Vitamin D levels were not associated with any of the respiratory symptoms.ConclusionIncreased body fat, but not vitamin D, was associated with wheeze in chronic SCI independent of a number of covariates.