Effects of High-Dose Vitamin D Replacement on the Serum Levels of Systemic Inflammatory Biomarkers in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Figures & data

Figure 1. Study flowchart.

Table 1. Demographic and baseline characteristics of the recruited patients.

P-value	Vitamin D group (n = 33)	Placebo group (n = 34)	Variable
0.55	64.42 ± 7.58^a	63.24 ± 8.41^a	Age (year)
0.96	Male: 28 (85%) Female: 5 (15%)	Male: 29 (85%) Female: 5 (15%)	Sex
0.10	21.03 ± 1.97^a	20.27 ± 1.67^a	BMI (kg/m²)
0.57	50 (39.75,50)^b	46.50 (40,57)^b	Smocking (pack/year)
0.40	13 (39%)	10 (29%)	Water pipe use
0.42	Ex-smokers: 27 (82%) Current smokers: 6 (18%)	Ex-smokers: 25 (74%) Current smokers: 9 (26%)	Smoking status
0.93	II (FEV1 50–79%): 15 (46%) III(FEV1 30–49%): 12 (36%) IV(FEV1 < 30%): 6 (18%)	II (FEV1 50–79%): 16 (47%) III (FEV1 30–49%):13 (38%) IV (FEV1 < 30%): 5 (15%)	COPD stage (FEV1 )
0.73	Moderate: 11 (33%) Severe: 22 (67%)	Moderate: 10 (29%) Severe: 24 (71%)	AECOPD severity
0.45	10.59 ± 3.90^a	11.25 ± 3.09^a	Vitamin D (ng/ml)
0.78	9.10 (8.55,9.45)^b	9 (8.60, 9.40)^b	Calcium (mg/dl)
0.45	3.10 (2.65, 3.60)^b	3.10 (2.90, 3.40)^b	Phosphate (mg/dl)
0.44	III: 7 (21%) IV: 26 (79%)	III: 10 (29%) IV: 24 (71%)	mMRC(0–4)
0.48	28.30 (22.07, 38.97)^b	24.52 (18.11, 43.50)^b	Interleukine-6 (pg/ml)
0.88	51.33 (31.32, 84.80)^b	45.95 (37.15, 71.84)^b	Interleukine-8 (pg/ml)
0.78	11.00 (8.00, 18.24)^b	12.12 (8.10, 18.72)^b	hs-CRP (mg/dl)
0.73	8.71 ± 2.65^a	8.48 ± 2.43^a	WBC count. × 10³(cell/μl)

BMI: body mass index; COPD: chronic obstructive pulmonary disease; AECOPD: acute exacerbations of COPD; mMRC: modified Medical Research Council; hs-CRP: high sensitivity C-reactive protein; WBC: white blood cells; P-values <0.05 were considered statistically significant.

^aData has been presented as mean ± standard deviation.

^b Data has been presented as median (interquartile range 25th, 75th percentiles).

Table 2. Levels of systemic inflammatory biomarkers at baseline and day 6 in the study groups.

	Study groups	Baseline	Day 6	P-value
Interleukine-6 (pg/ml)	Placebo	33.67 ± 21.62^a 24.52(18.11, 43.50)^b	16.95 ± 10.76^a 15.60 (8.75, 22.01)^b	<0.01
	Vitamin D	33.18 ± 16.87^a 28.30 (22.07, 38.97)^b	11.11 ± 7.83^a 9.48 (5.34, 14.69)^b	<0.01
Interleukine-8 (pg/ml)	Placebo	62.55 ± 44.54^a 45.96(37.15, 71.84)	29.11 ± 16.66^a 23.13 (16.82, 39.33)^b	<0.01
	Vitamin D	67.72 ± 53.32^a 51.33 (31.33, 84.81)	26.37 ± 22.78 17.23(9.60, 34.49)^b	<0.01
hs-CRP (pg/ml)	Placebo	14.88 ± 10.50^a 12.13(8.10, 18.73)	8.50 ± 5.58^a 7.14 (4.66, 10.69)^b	<0.01
	Vitamin D	13.92 ± 9.06^a 11.00 (8.00, 18.24)^b	6.24 ± 4.56^a 5.32 (3.19, 7.20)^b	<0.01

hs-CRP: high sensitivity C-reactive protein; P-values <0.05 were considered statistically significant.

^a Data has been presented as mean ± standard deviation.

^b Data has been presented as median (interquartile range 25th, 75th percentile).

Table 3. Changes in the levels of the systemic biomarkers from the baseline through the 6^th day and comparisons of changes between the groups.

	Study groups	Mean ± SD	Median (interquartile range)	P-value
Interleukine-6 (pg/ml)	Placebo	16.72 ± 13.49	13.81 (7.53,21.81)	0.02
	Vitamin D	22.06 ± 12.58	19.76 (14.31,25.93)
Interleukine-8 (pg/ml)	Placebo	33.44 ± 34.73	23.02 (16.21,35.29)	0.15
	Vitamin D	42.67 ± 35.99	32.91 (19.03,51.27)
hs-CRP (pg/ml)	Placebo	6.38 ± 5.89	4.30 (2.76,9.16)	0.24
	Vitamin D	7. 69 ± 6.71	6.01 (3.75,8.50)

hs-CRP; high sensitivity C-reactive protein, P-values <0.05 were considered statistically significant.