The role of vitamin D in bone metabolism is well established, but recent epidemiologic and basic science studies suggest that vitamin D related pathways are involved in the determination of pulmonary function, risk of infection, and respiratory health, all factors influencing morbidity and mortality in chronic SCI. These observations regarding vitamin D are highly significant as vitamin D deficiency and insufficiency is common in chronic spinal cord injury. Previous research conducted at VA Boston in persons with chronic SCI has demonstrated that longitudinal decline in pulmonary function and chest illness risk are not attributable to level and severity of injury, but to other potentially modifiable factors. The VA Boston SCI research program has conducted epidemiologic studies focused on identifying factors responsible for pulmonary function decline and pulmonary-related illness in chronic SCI. In a cohort of 330 persons with chronic SCI, it is proposed to longitudinally assess the relationship between vitamin D levels with pulmonary function and the risk of future chest illness. Understanding these adverse effects of lower vitamin D levels is particularly important in SCI because of the increased risk of pulmonary-related diseases and infection. Our approach is efficient because it will take advantage of a large SCI cohort enrolled in an ongoing longitudinal health study. The demonstration of an association between pulmonary function decline and an increased risk of chest illness with lower levels of vitamin D would result in a clinical trial assessing the potential benefits of vitamin D supplementation that would potentially identify an approach to disease prevention in SCI.

Public Health Relevance

The role of vitamin D as a determinant of bone health is well established. However, recent studies suggest that vitamin D is involved in the determination of pulmonary function, risk of infection, and respiratory health, all factors influencing the health of persons with chronic SC. Previous research conducted at VA Boston has demonstrated that decline in pulmonary function and respiratory illness in persons with chronic SCI is not attributable to level and severity of injury, but to potentially modifiable factors. In persons with SCI, the relationship between lower vitamin D levels with pulmonary function decline and chest illness rates will be assessed. The demonstration of an association with lower levels of vitamin D would result in the study of the benefits of supplementation in persons with chronic SCI and influence the clinical approach to vitamin D supplementation.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Non-HHS Research Projects (I01)
Project #
1I01RX000792-01A2
Application #
8593481
Study Section
RR&D Translational Program (RRDA)
Project Start
2013-10-01
Project End
2017-09-30
Budget Start
2013-10-01
Budget End
2017-09-30
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
VA Boston Health Care System
Department
Type
DUNS #
034432265
City
Boston
State
MA
Country
United States
Zip Code
02130