Effects of calcium and vitamin D supplementation on inflammatory markers and bone status in patients with obstructive airway diseases

• Main Authors: Yueh-Ling, 李月玲
• Other Authors: Yi-Chin Lin
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/26439410520918762777

碩士 === 中山醫學大學 === 營養學研究所 === 100 === Obstructive airway diseases include asthma and chronic obstructive pulmonary disease (COPD). Glucocorticoid steroids are commonly prescribed for patients with these two types of diseases, and long-term use of the medications have been found to increase the risk for osteoporosis. In addition, systemic chronic inflammation is not uncommon in patients with COPD. There has been evidence that several inflammatory factors (CRP, TNF-α, IL-1β and IL-6) enhance osteoclastic activity and bone resorption, and inhibit osteogenesis on the other hand, thus increase the risk for osteoporosis and fractures in these patients. The current study is therefore conducted to investigate whether intervention with calcium and vitamin D influence the inflammatory response and bone health status of patients with obstructive airway diseases using glucocorticoid steroids. Patients with obstructive airway diseases using glucocorticoid steroids were recruited from outpatient clinic of chest medicine in Chung Shan Medical University Hospital, Taichung. The subjects were randomly assigned to either experimental (n=39) or placebo group (n=40). Daily dose of supplementation was calcium 550 mg plus 200 IU of vitamin D. The duration of intervention was one year. Data were collected baseline and at the sixth and the twelfth month post- intervention, including the medical history, anthropometric measurements, lung function measurements, bone mass measurements and assessment of activity capacity. Fasting, venous blood samples were collected and were analyzed for serum levels of 25 - hydroxyvitamin D, parathyroid hormone, markers for bone resorption (cross-linked carboxy-terminal telopeptide of type I collagen , ICTP) and bone formation (osteocalcin, OST) as well as inflammatory markers, including hs-CRP (high sensitivity C-reactive protein),IL-6 (Interleukin-6), and hs-TNF-α (high-sensitivity tumor necrosis factor-alpha). The results show that in the experimental group, there was a downward trend in percent change in body fat and a trend toward increase in percent change in lean mass six- and twelve months post-intervention, respectively, whereas the trend appeared to be downward in the placebo group. Compared to the placebo group, there were upward trends in percent changes in bone mineral content and bone mineral density at most sites in the experimental group, and there appeared to be a relatively slower rate of bone loss, though the differences were statistically insignificant. Despite the insignificant differences in percent changes in the inflammatory markers between the two groups, there appeared to be a downward trend in the serum level of IL-6 in the experimental group. In addition, although there were trends toward increases in serum levels of hsCRP and hs-TNF- α, the trend appeared to be milder in the experimental group than in the placebo group. The results of our study show that calcium and vitamin D intervention may slow the rate of bone loss and ameliorate inflammation in patients with obstructive airway diseases. Higher dosage and/or longer duration of supplementation may be required to observe more significant effects.