ASSESSMENT OF VITAMIN-A STATUS IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE PATIENTS AND HEALTHY SMOKERS

The relation between vitamin A status and the degree of lung airway ob struction was examined in a cross-sectional study of 36 male subjects aged 43-74 y who were assigned to five groups as follows: healthy nons mokers (n = 7), healthy smokers (n = 7), mild chronic obstructive pulm onary disease (COPD-mild) patients (n = 9), COPD-moderate-severe patie nts (n = 7), and COPD-moderate-severe patients with exacerbation (+ex; n = 6). Smoking habits, pulmonary function tests, and energy-protein status were assessed; serum concentrations of retinyl esters, retinol, retinol binding protein, and transthyretin and relative dose response s were measured. In addition, 12 male smokers aged 45-61 y with mild C OPD were randomly assigned to two groups for a longitudinal study: six subjects consumed vitamin A (1000 RE/d; COPD-vitamin A) and six subje cts received placebo for 30 d. Lowered serum retinol concentrations we re found in the COPD-moderate-severe and COPD-moderate-severe + ex gro ups. Measurements of vitamin A status in healthy smokers and in COPD-m ild patients were not different from those in healthy nonsmokers. The improvement of pulmonary function test results after vitamin A supplem entation [mean increase for 1-s forced expiratory volume (FEV(1)) = 22 .9% in the COPD-vitamin A group] may support the assumption of a local (respiratory) vitamin A deficiency in patients with this disease.