Mechanism of High Dosage Vitamin D Supplementation on The Lung Function and Quality of Life of Stable COPD Patients

Abstract

Background: Oxidative stress results from the amplification mechanism of COPD, which leads to decreased lung function and the quality of life of the sufferers. Vitamin D has a function in reducing oxidative stress levels through several mechanisms, which can be revealed by analyzing several biomarkers to determine the role of vitamin D on lung function and the quality of life of stable COPD patients. Methods: The subjects included GOLD 2 and 3 stable COPD patients who had 25(OH)D levels of < 32 ng/ml and were receiving bronchodilator Indacaterol maleate therapy. The biomarkers examined included Nrf2, HDAC2, MDA, MMP-9, pulmonary function tests 6MWT, and QOL. The patients in the control and treatment groups were administered with vitamin D at a dose of 1,000 and 5,000 IU, respectively, for three months. Results: The administration of vitamin D to the patients in the control and treatment groups can significantly reduce oxidative stress, as evidenced by reduced MDA (p-value < 0.01) and MMP-9 levels (p-value < 0.01). Vitamin D affects exercise tolerance, as evidenced by 6MWT (p-value = 0.01). Vitamin D affects the quality of life, as evidenced by 6MWT (p-value = 0.01). Vitamin D affects Nrf2 levels (p-value = 0.08) and HDAC2 (p-value = 0.01). Conclusion: The pathway analysis through the study of the Nrf2, HDAC2, MMP-9, and MDA levels does not prove that vitamin D can prevent decreased lung function and quality of life in patients with stable COPD. Key words: Oxidative Stress, COPD, Vitamin D, Nrf2, HDAC2, MDA, MMP-9, FEV1, FVC, FEF25-75, 6MWT, QOL