Effects Of Vitamin D On Serum Levels Of TNF-α、IL-6 And Pulmonary Function In Patients With Chronic Obstructive Pulmonary Disease At Stable Stage

Objective: Through exogenous vitamin D supplementation in patients with stable chronic obstructive pulmonary disease,observe the inflammatory factors in the body: tumor necrosis factor-α（TNF-α）was observed.And interleukin-6（IL-6）and the forced expiratory volume in one second（FEV₁）and the first second forced expiratory volume as a percentage of the predicted value（FEV₁%）changes to investigate the effects of vitamin D on chronic airway inflammation and pulmonary function in patients with stable COPD.Methods: Eighty patients with COPD stable patients who were admitted to the Department of Respiratory Medicine of the Second Affiliated Hospital of Hunan Normal University from October 2017 to October 2018,and those hospitalized with active treatment for stable COPD patients（FEV₁/FVC<70% and 30% ≤ FEV₁% <80%）,divided into 2 groups: conventional treatment group（group A）and Vitamin D intervention group（group B）.In addition,40 patients in the same period of the physical examination center of our hospital were selected as the control group.Group C).Record basic information for all subjects: gender,age,duration of illness,age of smoke,and their height.Group A should be treated routinely: bronchodilator（Budesonide Formoterol powder inhaler 164.5ug / time Inhalation 2 / day + theophylline controlled release tablets 0.1g / time Oral after meals 2 / day）;Group B: conventional treatment + vitamin D3 800 IU / oral or 1 / day;both treatment time is 8 weeks.Group C was not treated as a control.In group A and group B,early fasting venous blood was taken before treatment and 8 weeks after treatment,while group C subjects received early morning fasting venous blood on the day of physical examination.All specimens were sent to our laboratory for enzyme-linked immunosorbent assay（ELISA）.The method was to detect 25（OH）D,TNF-α and IL-6 levels,respectively.Pulmonary function tests were performed before the start of treatment and after 8 weeks of treatment in group A and group B,and pulmonary function tests were performed in group C at the time of physical examination.Results: 1.The levels of serum 25（OH）D in group A and group B were significantly lower than those in group C（P<0.01）.There was no significant difference in the level of 25（OH）D between groups A and B before treatment（P>0.05）.The level of 25（OH）D in the group was not significantly different from that before treatment（P>0.05）.The level of 25（OH）D in group B was significantly higher than that before treatment（P<0.01）.2.Serum TNF-α and IL-6 levels were significantly higher in group A and group B than in group C（P<0.01）.There was no significant difference in serum TNF-α and IL-6 between groups A and B before treatment（P>0.05）.After treatment,serum TNF-α and IL-6 decreased in the A and B groups,but decreased significantly in the B group（P<0.05）.3.The pre-treatment FEV₁ and FEV₁% in group A and group B were significantly lower than those in group C（P<0.01）.There was no significant difference in FEV₁ and FEV₁% between groups A and B before treatment（P>0.05）.Both FEV₁ and FEV₁% were improved,and the improvement of lung function in group B was better than that in group A（P <0.05）.4.Serum 25（OH）D was negatively correlated with TNF-α and IL-6,and positively correlated with FEV₁ and FEV₁%.TNF-α and IL-6 were negatively correlated with pulmonary function indexes FEV₁ and FEV₁%（P <0.01）.Conclusion: Chronic inflammatory response still exists in patients with stable COPD;vitamin D may reduce the levels of TNF-α and IL-6 in patients with stable COPD,thereby reducing the inflammatory response in the body and may improve lung function to some extent.