Preliminary Observation Of Short-term Effects Of Calcium And Vitamin D Supplementation On Calcium And Phosphorus Metabolism,muscle Strength And Exercise Tolerance In COPD Patients

Objective:To observe the effects of calcium and vitamin D supplementation on calcium and phosphorus metabolism,muscle strength and exercise tolerance in patients with chronic obstructive pulmonary disease(COPD),so as to provide a new direction for clinical treatment.Methods:The patients with acute exacerbation of COPD(AECOPD)admitted to the department of respiratory medicine of Changshu No.2 people's hospital from June 2018 to December 2019 were selected as subjects for prospective self-control study.Routine treatment for COPD was given after admission,meanwhile,Vitamin D supplementation with calcium(calc D,1 tablet,bid,po)was given as treatment.To observe the metabolic index changes of calcium and phosphorus in patients with calcium and vitamin D supplementation after 60-75 days of treatment,including serum calcium(Ca),serum phosphorus(P),serum parathyroid hormone(PTH),serum alkaline phosphatase(AKP)and serum 25-hydroxyvitamin D3(25-(OH)D3),and the changes of hand grip strength test(HGS)and 6-minute walking test(6MWT).Severity of primary disease was assessed by chronic obstructive pulmonary disease score(CAT).To understand the correlation between calcium and phosphorus metabolism index and HGS,6MWT and CAT.Results:Sixty patients were enrolled,of which 50 completed the experimental study.After supplementation of calcium and vitamin D(P<0.05),serum calcium and serum 25-(OH)D3 levels increased(P<0.05),values of HGS and 6MWT increased(P<0.05),and CAT decreased(P<0.05),while serum phosphorus,serum PTH and serum AKP levels had no effect(P>0.05).Serum calcium values added in COPD patients were correlated with HGS values added and 6MWT values added(R=0.658,P=0.00;R=0.787,P=0.00),and they were independent with CAT scores changes(R=0.277,P=0.61).The increased values of serum 25-(OH)D3 were correlated with the increased value of HGS and 6MWT(R=0.681,P=0.00;R=0.690,P=0.00),and they were independent with CAT values changes(R=0.317,P=0.55).Conclusion:1)After 60-75 days of short-term calcium and vitamin D supplementation,serum calcium and 25-(OH)D3 levels in COPD patients were increased,and muscle strength(HGS)and exercise tolerance(6MWT)were improved.2)After 60-75 days of supplementation with calcium and vitamin D,changes in CAT scores in COPD patients were not associated with increased serum calcium and 25-(OH)D3 levels.