Smoking reduces vitamin D - many studies

Two pathways are often proposed for how smoking decreases vitamin D:
   1) Smoking decreases Calcium. and Vitamin D is used up in replacing the Calcium
   2) Smoking injures the body, and vitamin D is used up in repairing the body
It appears that taking Vitamin D while smoking will:
   1) Decrease the incidence of the many health problems associated with smoking - even lung cancer
   2) Decrease the desire to smoke (perhaps take fewer smoking breaks?)
   3) Increase breathing capacity
Opinion: If you must smoke, have recently smoked, or are getting 2nd hand smoke:
   take Vitamin D and perhaps Omega-3
    They will extinguish much of the inflammation caused by inhaling tobacco smoke.
Vitamin D should also help people quit smoking   See bottom of page Smoking reduces vitamin D - many studies
   1) Reduces weight gain associated with quitting smoking
   2) Reduces depression associated with quitting smoking

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Highlights in VitaminDWiki

• Low Vitamin D is worse for your health than smoking
• Response to monthly Vitamin D not statistically different in smokers – RCT July 2020
• Smokers helped by Vitamin D (100,000 IU monthly) - RCT Dec 2017
• Smoke Inflammation reduced by vitamin D (COPD in lab) – Sept 2019
• 26 health factors increase the risk of COVID-19 – all are proxies for low vitamin D
  • CDC list of high-risk for COVID-19 includes Smoking
• Each ng extra vitamin D associated with better breathing (and 2X better for smokers) – March 2018
• Breathing by ever-smokers improved by monthly Vitamin D – RCT 2017
• Both parents smoke – child’s vitamin D level was 30 percent lower and worse asthma – May 2018
• Chronic Periodontitis 9.6 times more likely if smoke and have poor Vitamin D Receptor – Aug 2016
• Smoking associated with 9 ng less vitamin D age 40-50 – Nov 2014
• Japanese women 20X more likely to be vitamin D deficient than men, etc. – Many 2013 6.4X more likely to be deficient if smoke
• Probability of T2 diabetes increased almost 3X with smoking and low vitamin D – Oct 2010
• Darker skin smokers have lower levels of vitamin D – Feb 2015
• A smoker costs a company 5816 dollars every year – Aug 2013
• Multiple Sclerosis - low vitamin D, low sun, smoking are the largest modifiable factors – April 2016
• Smokers should stop 1 month before surgery W.H.O. – Jan 2020
• Air pollution, toxins, heavy metals and smoking each result in lower Vitamin D levels – Nov 2018

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78+ studies with SMOKE or SMOKING or SMOKERS or TOBACCO or CIGARETTE in the title

This list is automatically updated

__Web: Pregnancy greater than 16 ng: Smokers only 14%, non-smokers 31% - May 2020
Smoking during pregnancy reduces vitamin D levels in a Finnish birth register cohort
DOI: 10.1017/S1368980018003932   FREE PDF

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Quit smoking - Vitamin D might help

Web-quit - Vitamin D might help

• Smoking Is Way Down in the U.S., but Not for People with Mental Illness
  Scientific American Jan 2018
  30% for those with mental illness (Bipolar, Schizophrenia, etc.) vs only 15% of all Americans
  • Anticipate that Vitamin D would help them decrease/stop smoking - Henry Lahore, founder of VitaminDWiki
• Stop Smoking after fracture to speed up healing - June 2010
• Smoking and Your Bones PDF file from University of Pittsburgh Medical Center
• Breathing Easier with Vitamin D
• Why Smokers Need More Vitamin D Life Extension Foundation, July 2012
• Vitamin D May Delay Deterioration of Smokers' Lungs: Study Yahoo, July 2012
• Vitamin D Can Help the Lungs of Smokers Slideshow,
  Vitamin D reduces depression, weight gain, etc which typically occurs when trying to stop smoking. Vitamin D also makes you feel healthier
• Benefits of Vitamin D3 for Smokers SF Gate, probably early 2013
• Smokers are 3X more likely to suffer from chronic back pain
  but quitting can ease symptoms, Daily Mail Nov 2014
• Smoking can cause permanent damage to DNA HealthDay Sept 2016
  Summary of 16 studies. Smoking alters 7,000 human genes (1/3 of total human), no comment on altering genes in gut, etc,
  Most of the genes recover in 7 years, but some genes still changed 30 years after stopping smoking
• Why is smoking more dangerous for the poorest in society? Dr. Grimes blog post, Oct 2013
  "poor low social class groups have the lowest exposure to the sun and the lowest vitamin D levels"

• Japanese company gives non-smokers 6 days of vacation annually 2017
  • Compensates for not taking smoking breaks
  • “We don’t give punishment for smoking,” Matsushima said. “Instead, we offer a benefit for not smoking.”

reported tobacco craving” and that “omega-3 fats may be of benefit in managing tobacco consumption.”
Having enough vitamin D might allow a person to quit smoking
Slideshare
1 page: How Does Vitamin D Assist Smoking Cessation?
Vitamin D is said to play a crucial role in the stop-smoking process.
It is connected to dwindling rates of many forms of cancer, including lung cancer.
In his book titled: “Quitting Cold: A Guide to Quit Smoking,” Carling Kalicak states that vitamin D is also good for bringing depression and stress to the barest minimum.
These 2 withdrawal symptoms (stress and depression) manifest in the first few days of smoking cessation.
Kalicak further recommends that smokers start consuming vitamin D supplements one to two weeks before dropping off cigarettes.
Hard to quit smoking if low vitamin D - 2016
Evaluation of the relationship between serum vitamin D levels and tobacco use disorder
Tijen Şengezer, Rabia Nazik Yüksel, Tuğba Babacan, Hüseyin Can, Nesrin Dilbaz.

Objective: In recent years; vitamin D, being a steroid hormone with neuroprotective and anti-oxidant effects apart from the effects on musculoskeletal system and endocrine system has been emphasized and studies on the relation of metabolic diseases, malignancies, neuropsychiatric diseases with vitamin D has been performed. A pandemic deficiency of vitamin D is mentioned all around the world. Although it has been reported that there is a relation between tobacco consumption and vitamin D; literature is limited and no data from Turkey regarding to tobacco consumption and vitamin D has been reported.
To evaluate vitamin D levels in individuals admitted to our hospital’s ‘smoking cessation unit’ and accordingly, to investigate the relation of vitamin D levels with tobacco dependence. Methods: Seventy-two cases between ages of 17-69 referring to smoking cessation units were included in our study. Retrospectively, demographic data form the patients’ files, Fagerström Test for Nicotine Dependence (FTND), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) forms were examined and levels of vitamin D were recorded. Whether the parameters conform to the normal distribution or not is evaluated by Kolmogorov-Smirnov test. In statistical analyses; Mann-Whitney U test, Kruskall-Wallis H test, one way ANOVA were applied. p<0.05 level was accepted as statistically significant.

Results: Mean age of the cases was 46.5±12.3 (17-69) years, 36 of them (50%) were female. The average years of smoking was 25.6±12.0 (1-50) years, average daily cigarette use at admission was 21.1±9.7 (2-60), average score of FTND was 6.2±2.4 (1-10). A statistical significance was determined among sex groups by means of vitamin D levels. A low but statistically significant and inverse relation has been observed between vitamin D levels and BDI score. Considering the year of smoking, height, weight, age, score of FTND and BAIQ; no statistical significance has been determined between these variables and vitamin D levels.

Conclusion: Tobacco use has a relation with low levels of 25(OH)D. Although the mechanisms regarding to tobacco consumption and vitamin D deficiency are not enlightened yet; the evaluation of vitamin D levels in the routine examination of tobacco consumers, replacement of vitamin D if there is any deficiency and their exposure to daylight will be beneficial considering the neuroprotective and anti-oxidant effects of vitamin D.
 Download the PDF from VitaminDWiki

 

Blacks have harder time quitting smoking - perhaps due to low vitamin D
http://www.empowher.com/skin-hair-amp-nails/content/why-skin-color-may-affect-nicotine-dependence? 2009?

VitaminDWiki - Vitamin D might help

• If smoke, try Vitamin D - reduce damage or help quit - 2012
• Vitamin D prevents smoke lung damage in mice (If you must smoke, take vitamin D) – Nov 2019

Many people are depressed after quitting smoking - Vitamin D can help

• Smoking Cessation - Depression Wikipedia 2019
  "... nicotine addiction causes a down-regulation of the production of dopamine and other stimulatory neurotransmitters as the brain attempts to compensate for the artificial stimulation caused by smoking."

Depression category listing has 267 items along with related searches

Intervention of Vitamin D for Depression

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A $20 tax on each pack would just pay for the additional costs imposed on society

240 Billion cigarettes sold a year in the US in 2016
Additional US costs due to smoking = $300 Billion health, productivity

Tobacco is a leading cause of many premature deaths

World Heatlh Organization

Lesson Planet

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The many ways that smoking results in death (as well as shorter life) - 2015

 PDF

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Black women smokers have the lowest vitamin D levels – Feb 2020

History of Tobacco, Vitamin D and Women
Int J Vitam Nutr Res, 1-6 2020 Feb 24, DOI: 10.1024/0300-9831/a000640
Kiano Reza Manavi 1, Brenda Pauline Alston-Mills 2, Marvin Paul Thompson 3
Tobacco usage kills more than 8 million people a year. Approximately 7 million of those deaths are the result of direct tobacco use, while approximately 1.2 million are the result of non-smokers being exposed to second-hand smoke. About 200 million of the world's one billion smokers are women and usage among women is increasing in some countries. Nicotine from smoking tobacco, specifically its metabolite cotinine, has negative effects on human health causing lung cancer, COPD and non-respiratory problems. Over a billion people worldwide are Vitamin D deficient or insufficient, which is prevalent across all age-groups, geographic regions, and sunlight. With the discovery of Vitamin D in 1919, a new chapter in the prevention of rickets was introduced opening the door to its therapeutic properties for other diseases. Since 1919, there have been many clinical and epidemiolocal studies performed globally on the effect of the vitamin on prevention of other diseases, including but not limited to, cancer, autoimmune disorders, cardiovascular diseases, and osteoporosis. Exposure to environmental tobacco smoke has been associated with reduced levels of Vitamin D in the bloodstream and sinus tissues. Manavi et al. (2015) demonstrated that among three smoking categories (heavy, light, and non-smokers),

• black female heavy smokers have lower vitamin D (13.374 ng/ml), than
• Hispanic (19.213 ng/ml) or
• white (24.929 ng/ml)

females are correlating to higher levels of cotinine. Therefore, blood serum concentrations of cotinine contribute to decreased Vitamin D concentrations in addition to other factors such as gender and ethnicity.

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40% less likely to have tobacco-related cancer if > 30 ng of vitamin D - Oct 2015

Prospective associations between vitamin D status, vitamin D-related gene polymorphisms, and risk of tobacco-related cancers.
Am J Clin Nutr. 2015 Oct 7. pii: ajcn110510
Deschasaux M1, Souberbielle JC2, Latino-Martel P3, Sutton A4, Charnaux N4, Druesne-Pecollo N3, Galan P3, Hercberg S5, Le Clerc S6, Kesse-Guyot E3, Ezzedine K7, Touvier M3.

BACKGROUND:
Experimental evidence has suggested that vitamin D may be protective against tobacco-related cancers through the inhibition of the formation of tumors induced by tobacco carcinogens. To our knowledge, only one previous epidemiologic study investigated the association between vitamin D status and tobacco-related cancer risk, and no study has focused on vitamin D-related gene polymorphisms.

OBJECTIVE:
Our objective was to prospectively study the association between plasma 25-hydroxyvitamin D [25(OH)D] concentrations, vitamin D-related gene polymorphisms, and risk of tobacco-related cancers.

DESIGN:
A total of 209 tobacco-related cancers were diagnosed within the SU.VI.MAX (Supplémentation en vitamines et minéraux antioxidants) cohort (1994-2007) and were matched with 418 controls as part of a nested case-control study. Tobacco-related cancers (i.e., cancers for which tobacco is one of the risk factors) included several sites in the respiratory, digestive, reproductive, and urinary systems. Total plasma 25(OH)D was assessed with the use of an electrochemoluminescent assay. Polymorphisms were determined with the use of a TaqMan assay. Conditional logistic regression models were computed.

RESULTS:
A 25(OH)D concentration ≥30 ng/mL was associated with reduced risk of tobacco-related cancers (OR for ≥30 vs. <30 ng/mL: 0.59; 95% CI 0.35, 0.99; P = 0.046). This association was observed in former and current smokers (OR for ≥30 vs. <30 ng/mL: 0.43; 95% CI: 0.23, 0.84; P = 0.01) but not in never-smokers (P = 0.8). The vitamin D receptor (VDR) FokI AA genotype and retinoid X receptor (RXR) rs7861779 TT genotype were associated with increased risk of tobacco-related cancers [OR for homozygous mutant type (MT) vs. wild type (WT): 1.87; 95% CI: 1.08, 3.23; P-trend = 0.02; OR for heterozygous type (HT) plus MT vs. WT: 1.60; 95% CI: 1.07, 2.38; P = 0.02].

CONCLUSIONS:
In this prospective study, high vitamin D status [25(OH)D concentration ≥30 ng/mL] was associated with decreased risk of tobacco-related cancers, especially in smokers. These results, which are supported by mechanistic plausibility, suggest that vitamin D may contribute to the prevention of tobacco-induced cancers in smokers and deserve additional investigation. The SU.VI.MAX trial was registered at clinicaltrials.gov as NCT00272428.
Study was cited 20 times as of April 2024
Google Scholar
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Vitamin D deficiency in South Europe: effect of smoking and aging

Eugenia Cutillas-Marco1,*, Amparo Fuertes-Prosper2, William B. Grant3, Maria Morales-Suárez-Varela4,5
Photodermatology, Photoimmunology & Photomedicine; Volume 28, Issue 3, pages 159–161, June 2012

From the conclusion: Smoking was associated with an increased risk of hypovitaminosis D (odds ratio, 1.8; 95% confidence interval, 1.00–3.35).

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2297 medical studies mentioned Smoking and Vitamin D - Oct 2024

• Pubmed search for (smoking) AND "vitamin d" in title or abstract

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Vitamin D deficiency, Smoking, and Lung Function in the Normative Aging Study; 2012

Measurements and Main Results: In the overall cohort, there was no significant effect of vitamin D deficiency on lung function nor on lung function decline.
In both cross-sectional and longitudinal multivariable models there was effect modification by vitamin D status on the association between smoking and lung function.
Cross-sectional analysis revealed lower lung function in current smokers with vitamin D deficiency (FEV1, FVC, and FEV1/FVC, p? 0.0002) and longitudinal analysis showed more rapid rates of decline in FEV1 (p=0.023) per pack-year of smoking in subjects with vitamin D deficiency as compared to subjects who were vitamin D sufficient.

Conclusions: Vitamin D deficiency was associated with lower lung function and more rapid lung function decline in smokers over 20 years in this longitudinal cohort of elderly men. This suggests that vitamin D sufficiency may have a protective effect against the damaging effects of smoking on lung function. Future studies should seek to confirm this finding in the context of smoking and other exposures that affect lung function.

Why is vitamin D beneficial when quitting smoking?

Vitamin D has a wide range of health benefits, including being associated with lower rates of cancer.
This beneficial vitamin has also been proven to have mental health benefits, such as stress reduction.
Anybody who has attempted to quit smoking is able to tell you the importance of reducing stress during the process.

DID YOU KNOW (Magnesium)?

Magnesium supplements are sometimes recommended for those trying to quit smoking.
Taking magnesium helps ease anxiety and reduce intense nicotine cravings.

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Smoking increases risk of mental illness by 2.5X - Aug 2023

Cigarettes Ignite the Risk of Mental Illness

• "The research, based on data from 350,000 individuals from the UK Biobank, shows that smoking increases the risk of hospitalization for mental illness by 250%."

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Smoking’s Toll on Health Is Even Worse Than Previously Thought, a Study Finds - Feb 2015

New York Times (nothing about vitamin D)

• Previously 500,000 deaths/year from 21 diseases
  cancers of the esophagus, stomach, colon, liver, pancreas, larynx, lung, bladder, kidney, cervix, lip and oral cavity; acute myeloid leukemia;
  diabetes; heart disease; stroke; atherosclerosis; aortic aneurysm; other artery diseases; chronic lung disease; pneumonia; influenza; and tuberculosis.
• Study added 60,000 deaths/year infection, kidney disease, intestinal disease caused by inadequate blood flow, and heart and lung ailments not previously attributed to tobacco.
• Smokers on average, they die more than a decade before nonsmokers
• Smokers were also six times more likely to die from a rare illness caused by insufficient blood flow to the intestines.
  • No such attachment on this page

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Smoking costs global economy over $1 trillion every year - WHO Jan 2017

Newstalk (nothing about Vitamin D)

• "Not only do cigarettes cause six million annual deaths – and rising – they hit healthcare and productivity hard around the world..."
• "A new study by the World Health Organisation (WHO) and the US National Cancer Institute estimates that roughly $269 billion in tax revenues was taken in 2013/14. This figure only takes care of roughly one-quarter of the expense of healthcare and lost productivity."

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Active form of vitamin D actually counteracts the effects of cigarette smoke in th lab - March 2015

1α, 25-hydroxy vitamin D3 counteracts the effects of cigarette smoke in airway epithelial cells
Cellular Immunology, doi:10.1016/j.cellimm.2015.03.004
Ruhui Zhanga, Haijin Zhaoa, Hangming Donga, Fei Zoub, Shaoxi Caia, ,
a Department of Respiratory, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
b School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
Received 5 December 2014, Revised 18 February 2015, Accepted 13 March 2015, Available online 18 March 2015

Cigarette smoke extracts (CSE) alter calpain-1 expression via ERK signaling pathway in bronchial epithelial cells. 1α, 25-dihydroxy vitamin D3 (1,25D3) inhibits cigarette smoke-induced epithelial barrier disruption.

This study was aimed to explore whether the 1,25D3 counteracted the CSE effects in a human bronchial epithelial cell line (16HBE). In particular, transepithelial electrical resistance (TER) and permeability, expression and distribution of E-cadherin and β-catenin, calpain-1 expression, and ERK phosphorylation were assessed in the CSE-stimulated 16HBE cells. The CSE induced the ERK phosphorylation, improved the calpain-1 expression, increased the distribution anomalies and the cleaving of E-cadherin and β-catenin, and resulted in the TER reduction and the permeability increase. The 1,25D3 reduced these pathological changes. The 1,25D3 mediated effects were associated with a reduced ERK phosphorylation.

In conclusion, the present study provides compelling evidence that the 1,25D3 may be considered a possible valid therapeutic option in controlling the cigarette smoke-induced epithelial barrier disruption.

PDF is available free at Sci-Hub   10.1016/j.cellimm.2015.03.004

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Smokers with impaired lung function were 2.4 X more likely to have level of vitamin D < 20 ng

Serum 25-hydroxyvitamin D level, smoking and lung function in adults: the HUNT Study. May 2015

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Mice exposed to smoke for weeks, mice with low Vitamin D got many lung problems - Sept 2015

Vitamin D deficiency exacerbates COPD-like characteristics in the lungs of cigarette smoke-exposed mice

Vitamin D deficient diet	<100 IU/kg	17–20 ng/ml.
Control diet	1000 IU/kg	75–90 ng/ml

Mice exposed to the smoke were second-generation mice on the diet
From Background
Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by a progressive expiratory airflow limitation and is associated with chronic inflammation in the airways and lung parenchyma . In the majority of cases, this inflammatory response in COPD is initiated by long-term exposure to cigarette smoke (CS), which triggers a series of events that damage the airways and terminal airspaces, leading to lung function decline and emphysema.

A great many charts and microphotographs in the PDF
Details and PDF on VitaminDWiki

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A UK region no longer will provide surgery to smokers or very obese (BMI>40)

No surgery for smokers or the obese: Policy in UK stirs debate Oct 2017

• Hertfordshire, which has population of more than 1.1. million.
• The time frame for improving health is set at nine months for the obese in particular; those with a body mass index over 40 must reduce the number by 15% over that time period, and those with a BMI over 30 are given a target of 10%.
• The target for smokers is eight weeks or more without a cigarette — with a breath test to prove it.

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More tobacco cancer if lower level of vitamin D - 2013

Low Plasma 25-Hydroxyvitamin D and Risk of Tobacco-Related Cancer
 Download the PDF from VitaminDWiki

Note - this is an association of >9,000 Dutch people
There is a possibility that a smoker who increases their vitamin D levels will have less tabacco-related cancer
Google Scholar found 72 studies that referenced this paper as of April 2018 - example titles
Molecular link between vitamin D and cancer prevention - 2013
Vitamin D and cancer risk and mortality: state of the science, gaps, and challenges - 2017
Circulating 25-hydroxyvitamin D and lung cancer risk and survival: A dose–response meta-analysis of prospective cohort studies - 2017

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Smokers with > 30 ng level of vitamin D had 0.43 the risk of getting tobacco-related cancer - Nov 2015

Prospective associations between vitamin D status, vitamin D-related gene polymorphisms, and risk of tobacco-related cancers.
 Download the PDF from VitaminDWiki
Google found 11 citations of this study by Jan 2021

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High percentage of males on the planet still smoke

>30% in Russia, Indonesia. China, Bangladesh, Bolivia, etc.

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Many people gain weight after quitting smoking - Vitamin D can help

• Smoking cessation Wikipedia 2019
  "Giving up smoking is associated with an average weight gain of 4–5 kilograms (8.8–11.0 lb) after 12 months,
    most of which occurs within the first three months of quitting."
• Less weight gain by senior women if vitamin D levels over 30 ng – Kaiser Dec 2012
• Low-calorie diets mimicked by Vitamin D – Dec 2016

Note: My mother smoked most of her life and died of lung cancer.
She had tried several times to quit the addiction.
Every time she tried quitting she gained too much weight, so went back to smoking.
Henry Lahore, founder of VitaminDWiki

Note: Your Vitamin D levels must be > 30 ng to be of any benefit.
You cannot just stop smoking and start taking 4,000 IU of vitamin D and expect any help in stopping smoking.
Must either start taking 4,000-5,000 IU two months BEFORE stopping smoking OR start with a loading dose when stopping

"It took more than 7,000 studies ... before the first Surgeon General report against smoking was finally released in the 1960s"
Then it took the AMA another 10 years to agree with the Surgeon General

Note: The founder of VitaminDWiki has been exploring multiple ways to add Vitamin D to cigarette filters such that the warm air would vaporize the vitamin D. Thus ZERO extra effort would be needed by the smoker to increase their vitamin D levels

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Second-hand smoke studies funded by big tobacco were 88X more likely to not find a problem

Dr. Greger April 2021

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Lower vitamin D levels in mother and neaonate if 2nd-hand smoke - Aug 2022

Comparison of Vitamin D Levels and Related Factors in Pregnant Women and Neonates Exposed to Second-Hand Smoke
Cureus . 2022 Aug 23;14(8):e28287. doi: 10.7759/cureus.28287.
Süleyman Yıldız 1 , Ömer Tammo 2

Introduction: Exposure to second-hand smoke, a significant public health issue today, may lead to various health problems, especially in pregnant women and their infants. Low vitamin D levels during pregnancy may lead to preeclampsia and gestational diabetes in the mother, while it may cause low birth weight and respiratory problems in the infant.

Method: The study group consisted of 42 mothers, who smoked regularly, and their infants and 45 mothers (passive smokers), who were regularly exposed to second-hand smoke in their home environment, although they did not smoke, and their infants. Meanwhile, the control group consisted of 46 healthy mothers, who did not smoke and were not exposed to second-hand smoke at home, and their infants with similar gestational age and birth weight. Blood samples were taken as two different samples, from the mother and the baby, and 25-hydroxyvitamin D (25(OH)D) and related blood parameters were studied and compared statistically.

Results: 25(OH)D, calcium, and magnesium levels of mothers who smoked were significantly lower than those who were exposed to second-hand smoke and those who did not. Moreover, the vitamin D levels of mothers and babies exposed to second-hand smoke in the non-smoker group were significantly lower than mothers and babies who were not exposed to second-hand smoke. In the babies of these three groups, a significant decrease was observed only in vitamin D levels.

Conclusion: The present study shows that pregnant women and their infants exposed to second-hand smoke have lower vitamin D levels. Hence, more emphasis should be put on vitamin D monitoring and supplementation to prevent severe health problems in pregnant women and their infants exposed to tobacco smoke. Further studies are needed to assess the associated risks for maternal and fetal health as well as possible long-term implications for the infant.
 Download the PDF from VitaminDWiki

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Faster decline in lung function when smokers had low vitamin D – April 2021

Vitamin D deficiency and lung function decline in healthy individuals: A large longitudinal observation study
Respir Med. 2021 Apr 20;182:106395. doi: 10.1016/j.rmed.2021.106395
Kyung-Min Ahn 1, Sun-Sin Kim 2, Suh-Young Lee 1, So-Hee Lee 2, Heung-Woo Park 3

Aim: A reliable evidence from a comprehensive large-scale study supporting associations between serum vitamin D (25-hydroxyvitamin D) level (SVDL) and lung function decline (LFD) in healthy individuals has been unavailable. Using a well-established health screening database, we assessed the associations between SVDL and LFDs, measured as the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio.

Methods: Serial SVDL and lung function data were analyzed using linear mixed models, which were performed in smokers and non-smokers separately. Vitamin D-deficient individuals (VDDs) were defined when their SVDLs were consistently lower than 20 ng/mL at all measurements.

Results: A total of 1371 individuals were analyzed. The mean FEV1 decline rates of VDDs and vitamin D-normal individuals (VDNs) in smokers were -33.35 mL/year (95% CI: 39.44 to -27.26 mL/year) and -15.61 mL/year (95% CI: 27.29 to -4.21 mL/year) respectively, over a mean of 6.29 years of observation with statistical significance (P < 0.001). However, there was no significant differences observed between decline rates of FEV1 in non-smokers. Similarly, FVC decline rates of VDDs were significantly greater than those of VDNs only in smokers (P < 0.001). However, FEV1/FVC ratio decline rates showed no significant difference between VDDs and VDNs regardless of their smoking status.

Conclusions: Consistently low SVDLs predicted more rapid FEV1 and FVC declines in smokers. However, FEV1/FVC decline rate was not associated with SVDL. SVDL may be used to identify healthy smoking individuals at high risk for accelerated LFD.

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