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Improvement of Lung Function by Micronutrient Supplementation in Patients with COPD: A Systematic Review and Meta-Analysis.

  • 2024-04-01
  • Nutrients 16(7)
    • Mingxin Li
    • Liangjie Zhao
    • Chenchen Hu
    • Yue Li
    • Yang Yang
    • Xiaoqi Zhang
    • Quanguo Li
    • Aiguo Ma
    • Jing Cai

Study Design

Type
Meta-Analysis
Sample size
n = 43
Population
patients with chronic obstructive pulmonary disease (COPD)
Methods
Systematic review and meta-analysis of RCTs; PubMed, Cochrane Library, and Web of Science searched from creation to February 2024; meta-analysis of micronutrient supplementation alone or complex on lung function
  • Rigorous Journal

Background

A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive pulmonary disease (COPD), micronutrient supplementation might have the beneficial health effects in those patients. This systematic review and meta-analysis aimed to demonstrate the impact of micronutrient supplementation on the lung function of patients with COPD.

Methods

The PubMed, Cochrane Library, and Web of Science databases were searched from their corresponding creation until February 2024. Search terms included 'chronic obstructive pulmonary disease', 'COPD', 'micronutrients', 'dietary supplements', 'vitamins', 'minerals', and 'randomized controlled trials'. Meta-analysis was performed to evaluate the effects of micronutrient supplementation alone or complex on lung function in patients with COPD.

Results

A total of 43 RCTs fulfilled the inclusion criteria of this study. Meta-analysis revealed that vitamin D supplementation could significantly improve FEV1% (WMDdifferences between baseline and post-intervention (de): 6.39, 95% CI: 4.59, 8.18, p < 0.01; WMDpost-intervention indicators (af): 7.55, 95% CI: 5.86, 9.24, p < 0.01) and FEV1/FVC% (WMDde: 6.88, 95%CI: 2.11, 11.65, WMDaf: 7.64, 95% CI: 3.18, 12.10, p < 0.001), decrease the odds of acute exacerbations, and improve the level of T-cell subsets, including CD3+%, CD4+%, CD8+%, and CD4+/CD8+% (all p < 0.01). The effects of compound nutrients intervention were effective in improving FEV1% (WMDde: 8.38, 95%CI: 1.89, 14.87, WMDaf: 7.07, 95%CI: -0.34, 14.48) and FEV1/FVC% (WMDde: 7.58, 95% CI: 4.86, 10.29, WMDaf: 6.00, 95% CI: 3.19, 8.81). However, vitamin C and vitamin E supplementation alone had no significant effects on lung function (p > 0.05).

Conclusions

Micronutrient supplementation, such as vitamin D alone and compound nutrients, has improved effect on the lung function of patients with COPD. Therefore, proper supplementation with micronutrients would be beneficial to stabilize the condition and restore ventilation function for COPD patients.

Research Insights

  • Vitamin C→Improved Lung Function

    vitamin C and vitamin E supplementation alone had no significant effects on lung function (p > 0.05)

    Effect
    Neutral
    Effect size
    Small
  • Vitamin D→Improved CD4+/CD8+ Ratio

    improve the level of T-cell subsets, including CD3+%, CD4+%, CD8+%, and CD4+/CD8+% (all p < 0.01)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin D→Improved CD8+ Cell Percentage

    improve the level of T-cell subsets, including CD3+%, CD4+%, CD8+%, and CD4+/CD8+% (all p < 0.01)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin D→Improved FEV1 Percentage

    vitamin D supplementation could significantly improve FEV1% (WMD_differences between baseline and post-intervention (de): 6.39, 95% CI: 4.59, 8.18, p < 0.01; WMD_post-intervention indicators (af): 7.55, 95% CI: 5.86, 9.24, p < 0.01)

    Effect
    Beneficial
    Effect size
    Moderate
  • Vitamin D→Improved FEV1/FVC Ratio

    vitamin D supplementation could significantly improve ... FEV1/FVC% (WMD_de: 6.88, 95%CI: 2.11, 11.65, WMD_af: 7.64, 95% CI: 3.18, 12.10, p < 0.001)

    Effect
    Beneficial
    Effect size
    Moderate
  • Vitamin D→Increased CD4+ T Cell Count

    improve the level of T-cell subsets, including CD3+%, CD4+%, CD8+%, and CD4+/CD8+% (all p < 0.01)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin D→Reduced Acute Exacerbation Rate

    vitamin D supplementation could significantly improve ... decrease the odds of acute exacerbations

    Effect
    Beneficial
    Effect size
    Moderate
  • Vitamin E→Improved Lung Function

    vitamin C and vitamin E supplementation alone had no significant effects on lung function (p > 0.05)

    Effect
    Neutral
    Effect size
    Small
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