Plasma Vitamin D, Past Chest Illness, and Risk of Future Chest Illness in Chronic Spinal Cord Injury (SCI): A Longitudinal Observational Study
Spinal Cord, 2020 Jan 16, PMID: 31949283 DOI: 10.1038/s41393-019-0409-7
Kristopher Clark 1, Rebekah L Goldstein 2, Jaime E Hart 3, Merilee Teylan 2, Antonio A Lazzari 1 4, David R Gagnon 5, Carlos G Tun 6, Eric Garshick 7 8
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Study design: Observational study.
Objective: Assess associations between vitamin D levels and other risk factors on future chest illness in a chronic spinal cord injury (SCI) cohort.
Setting: Veterans Affairs Boston and the Boston, MA community.
Methods: Between August 2009 and August 2017, 253 participants with chronic SCI were followed over a median of 3.2 years (up to 7.4 years) with two to four visits a median of 1.7 years apart. At each visit, plasma 25-hydroxyvitamin D level was obtained, spirometry performed, and a respiratory questionnaire assessing chest illnesses since last visit was completed. Repeated measures negative binomial regression was used to assess chest illness risk longitudinally.
Results: At entry, 25% had deficient vitamin D levels (<20 nanograms/milliliter (ng/ml)), 52% were insufficient (20 to <30 ng/ml), and 23% were sufficient (≥30 ng/ml). Over 545 study visits, chest illnesses (n = 106) were reported by 60 participants. In multivariable models (including previous chest illness history), deficient vitamin D levels (compared with those with sufficient levels) were associated with future chest illness though with wide confidence limits (relative risk (RR) = 1.36, 95% confidence intervals (CI) = 0.74, 2.47).
The strongest association with chest illness during the follow-up period was in persons who reported pneumonia/bronchitis after injury and a chest illness in the three years before study entry (RR = 7.62; 95% CI = 3.70, 15.71).
Conclusion: Assessed prospectively in chronic SCI, there was a suggestive association between deficient vitamin D levels and future chest illness. Past chest illness history was also strongly associated with future chest illness.Spinal Cord Injured persons were 7.6 X more likely to get pneumonia if low vitamin D – Jan 2020
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