Publication:

Vitamin D3 in severe chronic obstructive pulmonary disease: from profound deficiency to functional recovery

Background Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and systemic inflammation. Vitamin D deficiency is prevalent among COPD patients and correlates with disease severity. This study evaluated the association between serum vitamin D3 levels and COPD severity, and the therapeutic effect of vitamin D3 supplementation.

Methods A prospective interventional, single-blinded study enrolled 147 COPD patients. Baseline spirometry (FEV1), COPD assessment test (CAT), modified Medical Research Council (mMRC) scores, and serum vitamin D3 levels were recorded. Patients with severe and very severe COPD (GOLD stages 3 and 4, n=58) were randomized into group A (vitamin D3 supplementation) and group B (placebo). Follow-up spirometry and clinical scoring were performed at six months.

Results Mean serum vitamin D3 levels decreased significantly as GOLD classification increased, from 44.77 ng/ml in GOLD 1 to 18.00 ng/ml in GOLD 4 (p<0.001). A strong negative correlation existed between CAT scores and vitamin D levels (r=-0.822, p<0.0001). Post-intervention, group A showed a highly significant improvement in mean FEV1 from 34.5% to 60.2% (p=0.001). Furthermore, vitamin D3 supplementation significantly improved mMRC and CAT scores.

Conclusions Vitamin D deficiency is profoundly prevalent in advanced COPD. Targeted supplementation in deficient, severe COPD patients significantly improves FEV1, alleviates dyspnea, and reduces overall symptom burden, shifting patients to a moderate disease classification.