Research On The Association Of Serum Vitamin D With Inflammatory Factors And Lung Function In Asthma-chronic Obstructive Pulmonary Disease Overlap Syndrome Patients

Objective:To investigate the changes of serum levels of vitamin D correlation and clinical significance with the serum total IgE and interleukin-17（IL-17）and transforming growth factor-β1（TGF-β1）and hypersensitive C-reactive protein（hs-CRP）and lung function in asthma-chronic obstructive pulmonary disease overlap syndrome（ACOS）patients,to improve the understanding of ACOS and provide experimental basis for its treatment.Methods:Select Second Department of Respiratory Medicine hospitalized patients in the Affiliated Hospital of Southwest Medical University between April 2016 and April 2017.A total of 46 acute phase of ACOS patients,62 patients with AECOPD and 30 acute onset of bronchial asthma patients were respectively set as group A,B and C.30 health controls were set as group D.Collected The general information with all patients,including age,sex,height,weight,body mass index,Smoking index and allergy.Collected serum separted from fasting venous blood after centrifugation.The levels of serum total IgE,IL-17,TGF-β1 and the levels of25-hydroxyvitamin D which were the main storage form of Vitamin D levels were tested by enzyme-linked immunosorbent assay（ELISA）,hs-CRP was tested by rate nephelometry.FEV₁/FVC%and FEV₁%pred were measured in our hospital.SPSS 19.0 statistical software for data processing and statistical analysis.Results:1.The four groups research object compared with the age,sex,body mass index,Smoking index and allergy,There were no statistically Significantdifference（P>0.05）,they were comparable.2.Theserum25-hydroxyvitamin D levels in four groups were respectively:11.86±5.37ng/ml,12.64±5.76 ng/ml,18.61±10.43 ng/ml,34.33±7.73 ng/ml.The serum25-hydroxyvitamin D levels in acute phase of ACOS,AECOPD and acute onset of bronchial asthma patients were all significantly lower than that of health controls,There were statistically significant difference（P<0.05）,acute phase of ACOS and AECOPD patients were lower than that of acute onset of bronchial asthma patients（P<0.05）,acute phase of ACOS patients were lower than AECOPD patients,There were no statistically significant difference（P>0.05）.3.The levels of serum total IgE,IL-17,TGF-β1 and hs-CRP in group acute phase of ACOS,AECOPD and acute onset of bronchial asthma patients were all significantly higher than those in that group of health controls（all P<0.05）.The serum total IgE level in group acute phaseofACOS（131.21±28.77ng/ml）washigherthangroup AECOPD（116.61±31.65 ng/ml）,But lower than group acute onset of bronchial asthma（151.87±41.51ng/ml）（P<0.05）;Compared with group AECOPD（70.25±27.95pg/ml）,the elevated of serum IL-17 in group acute phase of ACOS（91.58±38.19pg/ml）and group acute onset of bronchial asthma（88.23±37.48pg/ml）patients had significant difference（P<0.05）;The serum TGF-β1 level in group acute phase of ACOS（1.87±0.84ng/ml）was significantly higher than that of group AECOPD（1.48±0.60ng/ml）and group acute onset of bronchial asthma（1.54±0.74 ng/ml）（P<0.05）.There were no statistically significant difference between group AECOPD and group acute onset of bronchial asthma（P>0.05）;The serum hs-CRP level in group acute phase of ACOS（30.71±13.48mg/L）was higher than group acute onset of bronchial asthma（17.28±7.95mg/L）,But lower than group AECOPD（39.62±17.95mg/L）,There were statistically significant difference（P<0.05）.4.The lung function indices:FEV₁/FVC%、FEV₁%pred in group acute phase of ACOS,group AECOPD and group acute onset of bronchial asthma patients were all significantly lower than that of group health controls（P<0.05）.acute phase of ACOS and AECOPD group were lower that of group acute onset of bronchial asthma（P<0.05）,There were no statistically significant difference between group acute phase of ACOS and group AECOPD（P>0.05）.The analysis of Pearson correlation show that the level25-hydroxyvitamin D was negatively correlated with IgE、IL-17、TGF-β1and hs-CRP（r=-0.547、-0.497、-0.374、-0.566,P<0.01）,positively correlated with FEV1/FVC%and FEV₁%pred（r=0.692、0.655,P<0.01）.Conclusion:1.ACOS,COPD and bronchial asthma patients are widespread vitamin D deficiency or inadequate,The serum vitamin D levels in ACOS patients are significantly lower than that COPD and bronchial asthma patients,This suggests ACOS patients are the most significant vitamin D deficiency.2.The serum 25-hydroxyvitamin D of ACOS patients was positively correlated with FEV₁/FVC%and FEV₁%pred,the serum vitamin D levels in ACOS patients may be associated with lung function damage.3.The level25-hydroxyvitamin D of ACOS patients was negatively correlated with Ig E、IL-17、TGF-β1 and hs-CRP,vitamin D may have certain anti-inflammatory effects in ACOS patients.