Evaluation of vitamin B12 and D, folic acid and homocystein levels in stable COPD patients

Abstract

Introduction: As COPD is a disease with malnutrition, catabolic process and chronic inflamation, vitamin deficiency may be seen frequently in COPD patients. We aimed to evaluate the levels of vitamin B12 and D, folic acid and homocystein in stable COPD patients, compare the results with healthy controls and determine the relationship between vitamin levels and pulmonary parameters.

Methods: There were 168 COPD patients from six pulmonology departments in Turkey, with 36 healthy controls. Pulmonary function test and St. George's Respiratory Questionnaire (SGRQ) were performed. The levels of vitamin B12, folic acid and homocystein were measured in all subjects by immunochemical method, and vitamin D by HPLC (High-performance liquid chromatography) method.

Results: There were 152 men (90.5%) and 16 women (9.5%) with the mean age of 65.9±8.6 in our patient group. Our results revealed vitamin D deficiency in 68.9% (59.6% mild, 25.7%: intermediate, 14.7% severe), B12 deficiency in 21.7%, folic acid deficiency in 3.7%. The mean plasma 25-OH-D levels was significantly lower in COPD patients than healthy controls (p=<0.01). There was a positive correlation between plasma 25-OH D levels and SGRQ (impacts) score (r=0.174, p=0.028), when plasma levels of 25-OH D showed a negative correlation with age and number of exacerbations (respectively, r=-0.248, p=0.002, and r=-0.160, p=0.044).

Conclusion: The findings of this study show that vitamin D (especially in older patients), B12 and folic acid deficiency can frequently occur in COPD patients.Low plasma levels of 25-OH D may cause worsening in health quality and increase the number of exacerbations in COPD patients.