Study On Level Of Serum 1, 25(OH)₂D₃ And The Correlation Between The Index And FEV₁,the Score Of Quality Of Life Of Patients With Chronic Obstructive Pulmonary Disease

OBJECTIVE:Metabolic disorder of serum 1,25(OH)₂D₃,calcium,magnesium and phosphorus always appears in patients with COPD,and can impact the progression and consequence of COPD.The aim of the investigation is to observe the effect of itself of COPD and smoking on the metabolism of above-mentioned index,and to explore the role and clinical significance of the metabolism of above-mentioned index in the evaluating the severity and progression of COPD.METHODS:30 selected patients with COPD as experiment group,be parted to acute stage group and stable stage group,and 30 collators as control group were investigated.All the subjects were divided into two groups by cigarette.The level of serum 1,25(OH)_D3 of all subjects were measured by radio-immunity method,serum calcium were detected by end-point chromatometry,serum magnesium were determined by xylidine blue assay,serum phosphorus were measured by ultraviolet spectrophotometry.Arterial blood gas indexs(PaO₂,SaO₂,PaCO₂,AaDO₂,PH),lung function(FEV₁,FEV₁/FVC),BMI and the St George's respiratory questionaire(SGRQ) score of the patients were observed simultaneously.We observe the variation of the level of serum 1,25(OH)₂D₃,calcium,magnesium,phosphorus of all subjects,the influence of cigarette on these index,and the correlation between these index with arterial blood gas,lung function,BMI and SGRQ score of patients with COPD.RESULTS:1,the compare result:the level of serum 1,25(OH)₂D₃ and calcium was significantly lower in acute stage COPD group than that in stable stage COPD group and control group(P＜0.01),the level of serum 1,25(OH)₂D₃ was significantly lower in stable stage COPD group than that in control group(P＜0.01);The level of serum phosphorus was significantly lower in acute stage COPD group than that in stable stage COPD group and control group(P＜0.01),the level of serum phosphorus was lower in stable stage COPD group than that in control group(P＞0.05);The level of serum magnesium was lower in acute stage COPD group than that in stable stage COPD group and control group(P＞0.05),the level of serum magnesium was lower in stable stage COPD group than that in control group(P＞0.05).2,correlation analytic result:â‘ In acute stage COPD group,the level of serum 1,25(OH)₂D₃ was positively correlated to the level of serum calcium and magnesium,the level of serum 1,25(OH)₂D₃ and calcium was positively correlated to FEV₁(%),FEV₁/FVC,PaO₂, SaO₂ and BMI;the level of serum phosphorus was positively correlated to FEV₁(%), PaO₂and SaO₂;â‘¡In stable stage COPD group,the level of serum 1,25(OH)₂D₃ was negtively correlated to the activity score of SGRQ;the level of serum calcium was positively correlated to the level of serum phosphorus;the level of serum magnesium was positively correlated to FEV₁/FVC;â‘¢In control group,the level of serum 1,25(OH)₂D₃ was positively correlated to the level of serum phosphours,FEV₁/FVC and BMI;the level of serum calcium was positively correlated to BMI.3,the influence of smoking:â‘ the FEV₁(%) of smoker was significantly lower than non-smoker(P＜0.05) In acute stage COPD group and In stable stage COPD group;â‘¡In control group,the level of serum l,25(OH)₂D₃,calcium and phosphorus of smoker was significantly lower than non-smoker(P＜0.01,P＜0.05),the level of serum magnesium of smoker was lower than non-smoker(P＞0.05);the FEV₁(%),FEV₁/FVC and of BMI smoker was significantly lower than non-smoker(P＜0.01,P＜0.05).CONCLUSIONS:1 the level of serum 1,25(OH)₂D₃,calcium and phosphorus was significantly lower in acute stage COPD group than that in stable stage COPD group and control group,the level of serum 1,25(OH)₂D₃,calcium and phosphorus was significantly lower in stable stage COPD group than that in control group,it suggests that the above-mentioned index were concerned with the severity of COPD.Therefore,it has an important clinical significance to prevent and treatment the infections and recurrent attacks of COPD and relieve systemic effect that the metabolic disorder of serum 1,25(OH)₂D₃,calcium and phosphorus was promptly detected and corrected in time.2 the level of serum 1,25(OH)₂D₃,calcium and phosphorus in acute stage COPD group was positively correlated to arterial blood gas parameters,lung function parameters and BMI,it indicates that the level of serum 1,25(OH)₂D₃,calcium and phosphorus may impact the progression of COPD,and can evaluate the severity and prognosis of COPD.3 the level of serum 1,25(OH)₂D₃ in stable stage COPD group was negtively correlated to the activity score of SGRQ,it means the level of serum 1,25(OH)₂D₃ may influence the quality of life of patients with COPD.4 in control group,the level of serum 1,25(OH)₂D₃,calcium,phosphorus,lung function,and BMI of smokers was significantly lower than that non-smokers;the level of serum 1,25(OH)₂D₃ was positively correlated to lung function parameters and BMI,the level of serum calcium was positively correlated to BMI,it demonstrates that smoking can result in the decrease of the level of serum 1,25(OH)_D3,calcium,and phosphorus,it can also effect health.So we should advocate smoke abatement to increase the the quality of life.