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19-03-2012 | General practice | Article

Low vitamin D associated with poor oral health in COPD patients

Abstract

Free Abstract

MedWire News: Low levels of vitamin D are associated with increased periodontal disease in patients with chronic obstructive pulmonary disorder (COPD), research from China suggests.

In addition to its classic role in calcium homeostasis and bone metabolism, vitamin D has a role in a wide range of physiologic processes including insulin secretion, renin synthesis, skeletal muscle strength, and the cardiovascular system as a whole.

A deficiency of vitamin D, or its active metabolite 25-hydroxyvitamin D (25[OH]D), is commonly found in patients with COPD, and also in patients with periodontitis.

While research suggests a link between periodontitis and the development of COPD, the possible role for vitamin D deficiency within this relationship remains unclear.

In the current case-control study, Zuomin Wang (Capital Medical University, Beijing) and colleagues compared 25(OH)D levels and peridontal health in 193 COPD patients (forced expiratory volume in 1 second/forced vital capacity [FEV1/FVC] <0.7) with those in 181 healthy individuals with normal pulmonary function (controls).

Mean serum levels of 25(OH)D were significantly lower in the COPD patients compared with controls (32.1 vs 35.8 nmol/L) and a significantly greater proportion of COPD patients were classified as severely (<25 nmol/L; 21.2 vs 20.4%) or mildly (≥25 and <50 nmol/L; 73.1 vs 65.7%) vitamin D deficient.

When data were adjusted for age, gender, body mass index (BMI), season, and periodontal indices, and stratified by smoking status, serum 25(OH)D levels were significantly associated with COPD in former smokers only, at an adjusted odds ratio (OR) of 4.11.

When smoking was included in the analyses as a confounder, serum 25(OH)D remained associated with COPD with an OR of 1.85.

In a separate analysis, following adjustment for age, gender, BMI, season, smoking status, and stratification by COPD status, various measures of periodontal health were significantly negatively correlated with vitamin D status including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), plaque index (PLI) and alveolar bone loss.

Commenting on their results, published in Journal of Clinical Periodontology, Zuomin et al say "COPD patients appeared to have lower serum 25(OH)D concentrations than controls with normal pulmonary function.

In addition, periodontal health status including number of remaining teeth, PD, CAL, BI, PLI and alveolar bone loss were significantly associated with serum 25(OH)D concentrations among COPD group."

They conclude "Lower serum 25(OH)D concentrations were significantly associated with poor periodontal health and an increased risk of COPD."

"Further research from longitudinal studies or randomized controlled trials is required to clarify the direct role of vitamin D in periodontal health and COPD."

By Iain Bartlett

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