Preserved ratio impaired spirometry (PRISm) was independently associated with higher odds of vitamin D deficiency compared with normal spirometry (OR 1.34; 95% CI 1.04 to 1.74).
Cohort (n=5,177)
Is preserved ratio impaired spirometry (PRISm) associated with vitamin D deficiency in community-dwelling older adults?
In community-dwelling older adults, preserved ratio impaired spirometry (PRISm) is independently associated with lower vitamin D levels and a higher prevalence of vitamin D deficiency compared to normal spirometry.
Effect estimate: OR 1.34 (95% CI 1.04 to 1.74)
Absolute Event Rate: 34% vs 21%
Abstract Rationale Preserved ratio impaired spirometry (PRISm) and vitamin D deficiency are both associated with cardiopulmonary disease and increased mortality. However, the relationship between PRISm and vitamin D deficiency remains poorly understood. We investigated the association between PRISm and vitamin D deficiency and examined factors associated with vitamin D deficiency among individuals with PRISm. Methods We analyzed data from Wave 6 (2012/2013) of the English Longitudinal Study of Ageing (ELSA), a prospective cohort of adults ≥50 years old in England. Pulmonary function was computed using the Global Lung Function Initiative (GLI) equations and categorized as normal spirometry (NS) (FEV1/FVC ≥0.7 and FEV1 ≥80% predicted), PRISm (FEV1/FVC ≥0.7 and FEV1 80% predicted), or airway obstruction (AO) (FEV1/FVC 0.7) based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Serum 25-hydroxyvitamin D 25(OH)D was measured and defined as deficient if 30 nmol/L based on Institute of Medicine guidelines. Multivariable linear and logistic regression assessed associations between pulmonary function categories and 25(OH)D, adjusting for sociodemographic, clinical, behavioral, and seasonal covariates selected a priori. Among participants with PRISm, multivariable logistic regression identified factors associated with vitamin D deficiency. Results Among 5177 participants, 59.8% had NS, 7.8% had PRISm, and 32.5% had AO. Mean serum 25(OH)D levels were 49.8 nmol/L in NS, 42.4 nmol/L in PRISm, and 49.6 nmol/L in AO. Vitamin D deficiency prevalence was 21.0% in NS, 34.0% in PRISm, and 23.3% in AO. In multivariable regression analysis, compared with NS, PRISm was independently associated with lower 25(OH)D levels (adjusted coefficient -2.68, 95% confidence interval -4.91 to -0.45) and higher odds of vitamin D deficiency (adjusted odds ratio 1.34, 95% confidence interval 1.04 to 1.74). Among those with PRISm, factors associated with vitamin D deficiency included current smoking, diabetes, low physical activity, depression, and higher BMI (Figure 1). Protective factors included summer or autumn season (compared with winter), vitamin D supplementation, and self-reported White race. AO was not associated with 25(OH)D levels or vitamin D deficiency. Conclusion Vitamin D deficiency is highly prevalent among individuals with PRISm, affecting over one-third of participants. PRISm is independently associated with lower vitamin D levels and higher odds of vitamin D deficiency compared with NS. Specific modifiable factors such as smoking cessation, sun exposure, and vitamin D supplementation may represent intervention targets. Future studies should evaluate mechanisms linking vitamin D deficiency to clinical outcomes in PRISm and the impact of treating vitamin D deficiency on disease trajectory. This abstract is funded by: ELSA is funded by the National Institute on Aging (R01AG017644), and by UK Government Departments coordinated by the National Institute for Health and Care Research (NIHR).
Ho et al. (Fri,) conducted a cohort in Preserved ratio impaired spirometry (PRISm) (n=5,177). Preserved ratio impaired spirometry (PRISm) vs. Normal spirometry (NS) was evaluated on Vitamin D deficiency (< 30 nmol/L) (OR 1.34, 95% CI 1.04 to 1.74). Preserved ratio impaired spirometry (PRISm) was independently associated with higher odds of vitamin D deficiency compared with normal spirometry (OR 1.34; 95% CI 1.04 to 1.74).