Treat vitamin D deficiency to prevent deadly lung attacks
Vitamin D supplements have been found to reduce the risk of potentially fatal lung attacks in some chronic obstructive pulmonary disease (COPD) patients, according to a study led by Queen Mary University of London.
The findings add to a growing list of health benefits for the ‘sunshine vitamin’. While vitamin D is best known for its effects on bone health, previous studies by Queen Mary researchers have revealed its role in protecting against colds, flu and asthma attacks, and even helping with weight gain and brain development in malnourished children.
The latest research, carried out at Queen Mary and funded by the National Institute for Health Research (NIHR), found that the use of vitamin D supplements led to a 45 per cent reduction in lung attacks among COPD patients who were deficient in vitamin D. No benefit was seen for patients with higher vitamin D levels.
COPD describes a number of lung conditions, including emphysema and chronic bronchitis, where a person’s airways become inflamed, making it harder to breathe 1. Almost all COPD deaths are due to lung attacks (termed ‘exacerbations’) in which symptoms worsen acutely. These are often triggered by viral upper respiratory infections – the type that cause the common cold.
The disease affects more than 170 million people worldwide, and caused an estimated 3.2 million deaths in 2015. 1.2m people have COPD in the UK, which is the cause of five per cent of the UK’s total deaths (around 30,000 per year), and costs the NHS £800m per year.
Lead researcher Professor Adrian Martineau from Queen Mary University of London said: “New treatments are urgently needed to prevent COPD attacks. Our study shows that giving supplements to vitamin D-deficient COPD patients nearly halves their rate of potentially fatal attacks.
“Vitamin D supplementation is safe, and it costs just a few pence to supplement a person for a year – so this is a potentially highly cost-effective treatment that could be targeted at those who have low vitamin D levels following routine testing.
“Around a fifth of COPD patients in the UK – about 240,000 people – have low levels of vitamin D. Reducing risk of attacks in such a large group would have major benefits for patients and for the NHS, since many attacks require costly hospital admission.”
The study, published in the journal Thorax, is based on a new analysis of data from 469 patients across three clinical trials in the UK, Belgium and the Netherlands.
Clinical trials investigating effects of vitamin D supplementation on COPD have shown conflicting results. By pooling all the individual patient data from different clinical trials, the team set out to determine whether vitamin D might have a protective effect on certain groups of COPD patients.
The analysis found that vitamin D supplements, given by mouth, reduced the rate of moderate/severe COPD exacerbations in patients with low vitamin D levels (less than 25 nmol per litre of blood or 10 nanograms per millilitre).
Doses of vitamin D ranged from 30 micrograms daily to 2500 micrograms monthly. Supplementation did not influence the proportion of participants experiencing serious adverse events, indicating that it was safe.
Giving supplements to patients who did not have such low levels of vitamin D did not reduce their risk of COPD attacks. The researchers therefore highlight that this would need to be a targeted therapy, with doctors first testing vitamin D levels in COPD patients who experience frequent attacks, and then giving vitamin D supplements to those who are deficient.
This echoes the Queen Mary team’s previous studies which found that vitamin D had the strongest protective effects against asthma exacerbation and acute respiratory infections such as colds and flu in people who had the lowest vitamin D levels to start with.
Public Health England and the Scientific Advisory Committee on Nutrition advise a daily intake of 10 micrograms of vitamin D.
The study is limited in that the data come from a relatively small number of trials, so the authors warn that the findings should be interpreted with a degree of caution.
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Notes to the editor
- Research paper: ‘Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials’ by David A. Jolliffe, Lauren Greenberg, Richard L. Hooper, Carolien Mathyssen, Rachida Rafiq, Renate T. de Jongh, Carlos A. Camargo Jr, Christopher J. Griffiths, Wim Janssens, Adrian R Martineau. Thorax. DOI: 10.1136/thoraxjnl-2018-212092
Available here after the embargo lifts: http://thorax.
bmj. com/ lookup/ doi/ 10. 1136/ thoraxjnl-2018-212092
- 1 COPD usually develops because of long-term damage to your lungs from breathing in a harmful substance, usually cigarette smoke, as well as smoke from other sources and air pollution. Jobs where people are exposed to dust, fumes and chemicals can also contribute to developing COPD. You’re most likely to develop COPD if you’re over 35 and are, or have been, a smoker. Source: https:/
/ www. blf. org. uk/ support-for-you/ copd/ causes
About Queen Mary University of London
Queen Mary University of London is a world-leading research-intensive university with over 25,000 students representing more than 160 nationalities.
A member of the prestigious Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research.
In the most recent exercise that rated research in the UK, we were ranked 5th in the country for the proportion of research outputs that were world-leading or internationally excellent. We offer more than 240 degree programmes and our reputation for excellent teaching was rewarded with a silver in the 2017 Teaching Excellence Framework (TEF) awards.
Queen Mary’s history dates back to 1785, with the foundation of the London Hospital Medical College. Our history also encompasses the establishment of the People’s Palace in 1887, which brought accessible education, culture and recreation to the East End of London. We also have roots in Westfield College, one of the first colleges to provide higher education to women.
About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:
- Funds, supports and delivers high quality research that benefits the NHS, public health and social care
- Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- Partners with other public funders, charities and industry to maximise the value of research to patients and the economy
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.