Serum Vitamin D Concentration and Markers of Bone Metabolism in Perimenopausal and Postmenopausal Women with Asthma and COPD.

Aging and menopause are closely related to hormonal and metabolic changes. Vitamin D is a crucial factor modulating several metabolic processes. The aim of this study was to evaluate biomarkers of bone metabolism in peri- and postmenopausal women with obstructive lung diseases. Sixty two female patients, 27 with asthma and 35 with COPD, aged over 45 years (median age 58 and 64 years, respectively) were enrolled into the study. The evaluation included lung function, bone mineral density, serum concentration of vitamin D, and bone metabolism markers. The study groups differed significantly in terms of forced expiratory volume in 1 s (FEV1); median values of 1.79 L vs. 1.16 L (p = 0.0001) and 71.2% vs. 53.0% predicted (p = 0.0072) and in vitamin D concentration (12.3 ng/ml vs. 17.6 ng/ml). Total bone mineral density (BMD) was lower in the COPD group (p = 0.0115). Serum vitamin D inversely correlated with the number of pack-years in asthma patients (r = -0.45, p = 0.0192). There was no correlation between serum vitamin D and disease duration or severity, and the Asthma Control Test (ACT) and the modified Medical Research Council (mMRC) dyspnea scores. The serum bone metabolism markers C-terminal cross-linked telopeptide of collagen type I (BCROSS), N-terminal propeptides of procollagen type-1 (tP1NP), and N-mid osteocalcin (OCN) inversely correlated with age in the COPD, but not asthma, patients (r = -0.38, p = 0.0264; r = -0.37, p = 0.0270; and r = -0.42, p = 0.0125, respectively). We conclude that peri- and postmenopausal women with obstructive lung diseases had a decreased serum concentration of vitamin D. Furthermore, vitamin D and body mineral density were appreciably lower in women with COPD than those with asthma.

Metabolic Syndrome as a Factor Affecting Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is a systemic disease which may be associated with other comorbidities. The aim of the study was to estimate the incidence of metabolic syndrome (MS) in COPD patients and to assess its impact on systemic inflammation and lung function. MS was diagnosed in accordance with the recommendations of the Polish Forum for the Prevention of Cardiovascular Diseases. The study group consisted of 267 patients with stable COPD in all stages of severity. All patients underwent spirometry with bronchial reversibility testing and 6 min walk test (6MWT). The following blood tests were evaluated: lipid profile, glucose and C-reactive protein as well as serum concentration of IL-6, leptin, adiponectin, and endothelin. MS was diagnosed in 93 patients (35.8%). No differences were observed in the incidence of MS in relation to airflow limitation severity (mild; moderate; severe and very severe: 38.9; 36.3; 35.2 and 25.0%, respectively). FEV1 (% predicted), FVC (% predicted), 6MWT distance (6MWD), age, and the number of pack-years were similar in patients with and without MS. MS was more frequent in males than females (38.7 vs. 28.4%, p > 0.05). Serum concentrations of IL-6, endothelin, leptin, and CRP were higher in the MS group, contrary to adiponectin concentration which was lower (p < 0.01). MS was more frequent in male COPD patients, but there were no differences in its frequency between patients with different severity of airflow limitation. We conclude that MS, as a comorbidity, occurs in all COPD stages and affects systemic inflammation. MS incidence does not depend on COPD severity.