الفهرس 
Review COPDOnly 14 pages are availabe for public view
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Abstract
Chronic Obstructive Pulmonary Disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients.
AECOPD is associated with increased risk of short-term mortality and impaired respiratory health status. Exacerbations are also costly, making prevention of it an important goal of COPD management .
Vitamin D refers to a group of fat-soluble secosteroids responsible for enhancing intestinal absorption of calcium, iron, magnesium, phosphate and zinc. In humans, the most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol). Cholecalciferol and ergocalciferol can be ingested from the diet and from supplements. The body can also synthesize vitamin D (specifically cholecalciferol) in the skin, from cholesterol, when sun exposure is adequate (hence its nickname, the ”sunshine vitamin”).
Vitamin D deficiency contributes to the pathophysiology of COPD through its effects on airway smooth muscle and lung remodelation by its actions on fibroblast proliferation, collagen synthesis and modulation of matrix metalloproteinase levels.
The aim of the current study was to assess the serum level of vitamin D in chronic obstructive pulmonary disease patients and its relation to disease severity and body mass index.
The present study was conducted upon 60 COPD Patients,who presented at our Abbassia chest hospital.
Patients classified into three groups ::
Mild COPD group (20 patients)
Moderate COPD group (20 patients)
Severe COPD group (20patients)
Patients with Other pulmonary disorders, History of malignancy or ischaemic heart disease, Inflammatory process elsewhere in the body, Patients on oral or injectable supplementation with vitamin D or with Other causes of Vitamin D deficiency are excluded .
In the current study there was no statistical significant difference between the studied groups regarding Sex, age, sun exposure and occupation
As regard skin grade, there was no statistical significant difference between the studied groups but There were significant negative correlations between vitamin-D level and skin grade in different study groups (as vitamin D levels decrease with increasing in grade of skin ) .
As regard BMI, it ranged from normal to overweight and obese in all groups . there was no statistical significant difference between them but There were significant negative correlations between vitamin-D level and BMI in different study groups (as vitamin D levels decrease with increasing in BMI) .
In the current study as regard smoking there was patients are current smoking , ex-smoker and never smoking and there was no significant difference between studied groubs regarding Smoking
In the current study, there was high prevalence of 25 (OH) vitamin D deficiency in COPD patients. There was statistical significant difference between the studied groups as regard 25(OH) vitamin D level. Vitamin-D was significantly lowest in severe group, followed by moderate group and highest in mild group with no significant difference between mild and moderate groups .
There were significant positive correlations between vitamin-D level and pulmonary functions in different study groups ( as vitamin D levels increase with increasing in pulmonary function values ) which mean negative correlation between serum level of vitamin D and gold spirometric classification
In the current study exacerbation frequencies are increased with severity and Vitamin-D was significantly lower among cases with frequent exacerbations and In differentiation between study groups, Vitamin-D ≤ 22.5 and Vitamin-D≤9.0 had moderate diagnostic characteristics but had significantly low diagnostic performance in differentiating moderate from Mild and differentiating severe from moderate .