Discussion About The Relationship Between The Levels Of Serum Vitamin D And Concentration Of IL-17、TNF-a And Lung Function In COPD Patients

Objective:Our purpose is to analyze whether the levels of vitamin D(measured as serum25hydroxyl vitamin D-25[OH]D3) are correlated with concentration of serum IL-17、serum TNF-a and lung function(FEV1%pred) in COPD patients, to then explore the possible mechanisms of vitamin D on lung function from the aspects of inflammatory factor in COPD patients, and to provide some theoretical basis for early effective intervention in COPD.Methods:Thirty hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (A group); twenty-eight outpatients with clinical stability of COPD (B group) from Jan2013and May2013were selected. At the same time, thirty healthy people were enrolled from Physical examination center. We used enzyme-linked immune sorbent assay(Elisa) to respectively detect the levels of serum25(OH) D3, IL-17and TNF-a. Lung function was measured with lung function instrument, which include forced expiratory volume in1second(FEV1),forced vital capacity(FVC),FEV1%predicted and FEV1/FVC ratio were then calculated. Then we evaluated the relationship between serum25(OH) D3and inflammatory factor IL-17, TNF-a and lung function.Results:(1)60.0%(18/30) of AECOPD had a deficient or insufficient serum25(OH)D (<30Ngami), whereas stable patients with COPD and normal people respectively32.1%(9/28),23.3%(7/30).And the incident of serum25(OH)D deficiency or insufficiency in COPD is more common than that of normal people, the difference was statistically significant (P<0.05).(2) Among them, the incident of serum25(OH)D deficiency or insufficiency in AECOPD is more common than that of stable patients with COPD, the difference was also statistically significant (P<0.05).(3) Compared with normal people, the levels of IL-17in acute exacerbation and stability of COPD were higher, and AECOPD were higher than stable COPD, the differences were both significant statistically (P<0.05). A negative correlation was observed between serum25(OH) D3levels and serum interleukin-17in acute exacerbation and stability of COPD(respectively:r1=-0.359,P1=0.039; r2=-0.38, P2=0.046).(4) Compared with normal people, the levels of TNF-an in acute exacerbation and stability of COPD were higher, and AECOPD were higher than stable COPD, the differences were both significant statistically (P<0.05). No correlation was observed between serum25(OH) D3levels and serum TNF-a in acute exacerbation and stability of COPD(respectively:ri=-0.097,P1=0.612; r2=-0.127,P2=0.52).(5) Serum25(OH) D3affects lung function(FEV1%pred) in both of acute exacerbation and stable patients of COPD (P<0.05),and a positive correlation was observed between serum25(OH) D3levels and FEV1%pred(r,=0.38,P1=0.038; r2=0.403, P2=0.034).(6) A negative correlation was observed between IL-17and FEV1%pred (r1=-0.373,P1=0.042; r2=-0.426, P2=0.024)Conclusion:1. The levels of serum vitamin D in COPD patients are lower than than of normal people,and they associate with the severity of the disease and degree of airflow limitation.2. Concentration of IL-17is associated with the severity of the disease and degree of airflow limitati-on in COPD patients.