Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? a compherensive review for pulmonologists

Clin Respir J. 2018 Feb;12(2):382-397. doi: 10.1111/crj.12588. Epub 2017 Jan 5.


Objectives: Vitamin D deficiency and Chronic Obstructive Pulmonary Disease (COPD) are both under-recognized health problems, world-wide. Although Vitamin D has long been known for calcemic effects it also has less known noncalcemic effects. Recent data have shown that Vitamin D deficiency is highly prevalent in patients with COPD and correlates with forced expiratory volume in one second (FEV1 ) and FEV1 decline. The objective of this work was to review the current literature on vitamin D deficiency in relation with COPD.

Data source: A literature search, using the words "vitamin D" and "COPD", was undertaken in Pubmed database.

Results: The noncalcemic effects of vitamin D relating with COPD may be summarised as increasing antimicrobial peptide production, regulation of inflammatory response and airway remodelling. Vitamin D inhibits the production of several proinflammatory cytokines and leads to suppression Th1 and Th17 responses which may be involved in the pathogenesis of COPD. Vitamin D insufficiency may also contribute to chronic respiratory infections and airway colonization so returning vitamin D concentrations to an optimal range in patients with COPD might reduce bacterial load and concomitant exacerbations.Vitamin D is also important for COPD-related comorbodities such as osteoporosis, muscle weakness and cardiovascular diseases. Data about the effect of Vitamin D supplementation on those comorbidities in relation with COPD are been scarce.

Conclusion: Improving the blood level of Vitamin D into the desired range may have a beneficial effect bones and muscles, but more studies are needed to test to test that hypothesis.

Keywords: COPD; prevention and treatment; vitamin D; vitamin D deficiency.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacterial Load / drug effects
  • Calcium / metabolism
  • Cytokines / drug effects
  • Cytokines / metabolism
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / complications
  • Osteoporosis / epidemiology*
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / physiopathology
  • Vitamin D / blood*
  • Vitamin D / metabolism
  • Vitamin D / pharmacology
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology*
  • Vitamin D Deficiency / prevention & control


  • Cytokines
  • Vitamin D
  • Calcium