Vitamin D, vitamin D binding protein, lung function and structure in COPD

Respir Med. 2013 Oct;107(10):1578-88. doi: 10.1016/j.rmed.2013.05.010. Epub 2013 Jul 1.


Rationale: Vitamin D and vitamin D binding protein (DBP) have been associated with COPD and FEV1. There are limited data regarding emphysema and vitamin D and DBP.

Objective: This is a pilot study of a portion of the subjects in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study designed to examine the relationship between vitamin D status, DBP, FEV1 and emphysema in COPD patients.

Methods: We measured serum 25(OH)D and DBP in 498 ECLIPSE subjects. Subjects were distributed amongst smoker controls, non-smoker controls, and GOLD stages 2, 3 and 4. Within each GOLD stage, the subjects were equally divided amongst high and low emphysema burden. The associations between 25(OH)D, DBP, and free vitamin D with FEV1, CT-defined emphysema, biomarkers and clinical data including CT-measured bone attenuation were assessed.

Measurements: 25(OH)D and DBP were measured using tandem mass spectroscopy and competitive enzyme-linked immunosorbent assay, respectively,

Main result: 25(OH)D was correlated with FEV1 (p = 0.01) and with severity of emphysema (p < 0.01). 25(OH)D was also associated with six-minute walk (p = 0.02), bronchodilator response (p = 0.04), and Clara cell secretory protein (CC-16) (p = 0.01). 25(OH)D levels were not associated with CT-measured bone attenuation, however DBP was associated with bone attenuation in subjects with emphysema. DBP was not associated with FEV1 or emphysema. 25(OH)D and DBP were inversely associated (p = 0.01).

Conclusion: This is the first study to demonstrate a relationship between emphysema and vitamin D. We also provide further evidence for a relationship between vitamin D and FEV1.

Trial registration: NCT00292552.

Keywords: 25(OH)D; Emphysema; FEV1; Free vitamin D.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Bronchodilator Agents / therapeutic use
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pilot Projects
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Emphysema / blood
  • Pulmonary Emphysema / etiology
  • Pulmonary Emphysema / physiopathology
  • Severity of Illness Index
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / physiopathology
  • Vitamin D-Binding Protein / blood*
  • Walking / physiology


  • Biomarkers
  • Bronchodilator Agents
  • Vitamin D-Binding Protein
  • Vitamin D
  • 25-hydroxyvitamin D

Associated data