Efeito da deficiência de vitamina D na função pulmonar e na modulação autonômica em pacientes idosos com DPOC: Effect of vitamin D deficiency on pulmonary function and autonomic modulation in older COPD patients

Rodrigo Antônio França Barroso; Carlos Alberto Alves Dias-Filho; Leonardo Hesley Ferraz Durans; Carlos José Moraes Dias; Andressa Coelho Ferreira; Christian Emmanuel Torres Cabido; Cristiano Teixeira Mostarda

doi:10.17765/2176-9206.2025v18e13172

Authors

Rodrigo Antônio França Barroso Federal University of Maranhão https://orcid.org/0000-0003-3062-8627
Carlos Alberto Alves Dias-Filho Federal University of Maranhão https://orcid.org/0000-0003-1181-6411
Leonardo Hesley Ferraz Durans Federal University of Maranhão https://orcid.org/0000-0003-1941-1603
Carlos José Moraes Dias Federal University of Maranhão https://orcid.org/0000-0002-0508-0308
Andressa Coelho Ferreira Federal University of Maranhão https://orcid.org/0000-0002-1887-1256
Christian Emmanuel Torres Cabido Federal University of Maranhão https://orcid.org/0000-0002-4800-0128
Cristiano Teixeira Mostarda Federal University of Maranhão https://orcid.org/0000-0002-1305-1697

DOI:

https://doi.org/10.17765/2176-9206.2025v18e13172

Keywords:

COPD, Heart rate variability, Vitamin D

Abstract

The aim was to evaluate the effect of vitamin D deficiency on autonomic modulation and respiratory function in COPD patients. This was a cross-sectional study in which individuals with COPD were selected and divided into two groups: 1) with normal vitamin D levels (NorVD) (n=24), and 2) with vitamin D insufficiency (InsVD) (n=17), and cardiac autonomic modulation and respiratory function were assessed. InsVD individuals showed worse autonomic modulation compared to individuals with normal vitamin D levels, respectively evidenced by lower values in Sample's Entropy (1.53±0.05 vs 1.21±0.1, p=0.01) and Shanon's Entropy (3.61±0.13 vs 3.18±0.13, p=0.01), suggesting greater sympathetic modulation and less parasympathetic modulation. In the evaluation of the frequency and symbolic analysis domains, there was a predominance of sympathetic activity in the InsVD subjects compared to the NorVD subjects, shown, respectively, by the LF (ms2) indices (319±304 vs 158±217, p=0. 05), bare LF (58±19 vs 44±18, p=0.01), bare HF (42.19 vs 56±18, p=0.01), LF/HF (1.9±1.18 vs 1.01±0.65, p=0.01), and 2UV% (13±7 vs 22±11, p=0.01). No changes were observed in hemodynamic variables or respiratory function. This suggests that insufficient vitamin D levels may negatively influence autonomic modulation in COPD patients.

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Author Biographies

Rodrigo Antônio França Barroso, Federal University of Maranhão

Holds a degree in PHYSIOTHERAPY from Faculdade Santa Terezinha (2006). Specialist in Renal Health Care as a physiotherapist through a Multiprofessional Residency in 2016 at the University Hospital of the Federal University of Maranhão. Master's degree in Physical Education from the Federal University of Maranhão in 2019. PhD candidate in Biotechnology at UFMA in 2024. Member of LACORE - UFMA. Professor at Pitágoras College in São Luís, Maranhão, from February 2018 to February 2022. Professor at Uninassau College since February 2021. Professor of the Postgraduate Program in Adult and Pediatric Intensive Care Physiotherapy at NacionalFisio since 2022. Physiotherapist at the Specialized Rehabilitation Center for the Elderly since March 2022. Preceptor at UNDB University Center from June 2022 to July 2023. ICU Physiotherapist at São Domingos Hospital from March 19, 2021 to March 25, 2022. ICU Physiotherapist at Dr. Genesio Rego Hospital since March 11, 2023.

Carlos Alberto Alves Dias-Filho, Federal University of Maranhão

Bachelor's degree in Biomedicine from Estácio de São Luís-MA (2014); Specialist in sports medicine and physical activity from the Municipal University of São Caetano do Sul (USCS); Master's degree in adult and child health (PPGSAC) from the Federal University of Maranhão (UFMA); PhD in Biotechnology in Health from the Northeast Biotechnology Network (RENORBIO-UFMA). He was a professor at Dom Bosco University (UNDB) in the departments of Pharmacy, Biomedicine, and Physiotherapy. He is a professor at Afya Faculty of Medical Sciences of Santa Inês - AFYA. He is a professor at Santa Luzia Faculty of Santa Inês in the departments of Pharmacy and Nursing. Main research areas: Genetics and molecular biology, cardiorenal adaptations and cardiac autonomic modulation in general populations, and health in relation to spirituality.

Leonardo Hesley Ferraz Durans, Federal University of Maranhão

Holds a degree in Physiotherapy from Ceuma University (2020), scholarship recipient in the University for All Program. Master's degree in Adult Health (2023) from the Department of Medicine at the Federal University of Maranhão. Specialist in Exercise Physiology (2024). Postgraduate student in Cardiorespiratory Physiotherapy at Estácio de Sá University. Currently a Physiotherapist at the Djalma Marques Municipal Hospital (Socorrão 1), São Luís/MA; Professor and Supervisor of Community, Outpatient, Ward and ICU Internships for the Physiotherapy Course at the Estácio University Center - São Luís/MA; Member of the Laboratory of Cardiovascular Adaptations to Exercise (LACORE/UFMA), with research in the area of Cardiovascular Physiology, Autonomic Control, Aging, and Diabetes. He was a Scientific Initiator in the 2018-2019 and 2019-2020 cycles with research focused on Non-Communicable Chronic Diseases, Cardiovascular Risk, and Chronic Cardiorespiratory Diseases.

Carlos José Moraes Dias, Federal University of Maranhão

Doctor of Biotechnology in Health (RENORBIO - UFMA), Master in Adult and Child Health (UFMA), Multiprofessional Residency in Renal Health (HUUFMA), Specialist in Sports Science and Medicine (UFMA) and Bachelor of Physical Education (UFMA). Adjunct Professor at the Federal University of Maranhão - Pinheiro Campus; Coordinator of the League of Renal Diseases in the area of Physical Education (LARE/HUUFMA); Coordinator of the Laboratory of Cardiorenal Adaptations to Physical Exercise (LACE/UFMA). Member of the Ethics Committee on the Use of Animals (CEUA/UFMA). Coordinator of the Physical Education Degree course (UFMA/CAMPUS V, Pinheiro, MA). Member of the faculty of the postgraduate program in Physical Education (PPGEF/UFMA). Has experience in the area of Physical Education (training and physical evaluation in special populations and in high physical performance) and basic research on carvacrol as an antihypertensive, as well as studies focusing on cardiovascular and renal variables in different populations. Studies of evaluation and analysis of cardiovascular variables.

Andressa Coelho Ferreira, Federal University of Maranhão

Bachelor's degree in Biomedicine from Estácio de São Luís University. Postgraduate degree in Quality Management in Health and Laboratory Administration. Master's degree in Adult Health (PPGSAD-UFMA). PhD candidate in Biotechnology (RENORBIO-UFMA). Scientific Initiation: PIBIC (2014-2016) and FAPEMA scholarship recipient (2016-2017 and 2019-2020). Collaborator at the Materials Interfaces Laboratory (CCET-UFMA) working in the development and production of biomaterials (2015-2018). Intern and Trainee at CEDRO Laboratory (2017-2018). Biomedical scientist and technical manager at the Clinical Analysis Laboratory of the Maranhão Institute of Surgery and Endoscopy (2020-2024), performing activities in the area of clinical and pathological analyses, management and laboratory quality control.

Christian Emmanuel Torres Cabido, Federal University of Maranhão

Graduated in Physical Education, Master's and PhD from the Postgraduate Program in Sports Sciences at the Federal University of Minas Gerais, in the Biomechanics (BIOLAB) and Exercise Physiology (LAFISE) laboratories at UFMG. Adjunct Professor in the Department of Physical Education and member of the Postgraduate/Master's Program in Physical Education at the Federal University of Maranhão. Leader of the research group Physical Exercise: Health and Human Performance at the Federal University of Maranhão. Participation in research projects related to strength training methods, jump and flexibility performance, thermoregulation, genetics and sports performance, and muscle damage associated with weight training. Coordinator of the Bachelor's Degree in Physical Education at the Federal University of Maranhão (start: 05/2018 - end: 01/03/2023). The following activities were carried out: Graduation of the first class of the Bachelor's Degree in Physical Education (2018/2); First evaluation by the MEC (Brazilian Ministry of Education), Course Recognition evaluation (2019/1; Concept 4); Two student evaluations through the ENADE exam (concept 5; 2019 and 2021); Two 5-Star ratings in the Guia do Estudante (Student Guide) evaluation (2020 and 2021); Holding of the 1st Seminar on Final Course Projects for the Bachelor's Degree in Physical Education at UFMA (2019/2; with a total of over 100 students attending the 16 final course project defenses).

Cristiano Teixeira Mostarda, Federal University of Maranhão

Holds a degree in Physical Education from Universidade Cidade de São Paulo (2001), a specialization in Physiology (UNIFMU), and a Master's and Doctorate in Sciences from UNIFESP (2002-2006 - Department of Nephrology). Was a tutor in the Multiprofessional Residency program at Hospital Presidente Dutra in São Luís, Maranhão. Has experience in the field of Physiology, with an emphasis on physical training and cardiovascular control, where he conducted several scientific works at the Heart Institute (INCOR/FMUSP). Has experience in tutoring in the Specialization course in Family Health - Mais Médicos Program (Open University of SUS, UNASUS-UFMA, Brazil). Currently, he is an Adjunct Professor at the Federal University of Maranhão (UFMA), where he teaches the subjects of Exercise Physiology and Physical Activity and Aging; He teaches the subjects of Anatomy, First Aid, and Measurement and Evaluation in Physical Education for the PARFOR program (National Plan for the Training of Basic Education Teachers). Professor in the specialization course in Bodybuilding and Sports Medicine at UFMA; Permanent Professor in the Master's Program in Adult and Child Health (UFMA), Permanent Professor and Vice Coordinator of the Postgraduate Program in Physical Education UFMA (PPGEF-UFMA), Permanent Professor in the Postgraduate Program in Biotechnology (RENORBIO - CCBS- UFMA). Professor and advisor at the Center for Prevention of Kidney Disease (Multiprofessional Residency at Hospital Presidente Dutra), Professor at the Center for Cardiopulmonary Rehabilitation (Hospital Presidente Dutra), Coordinator of the Laboratory of Cardiovascular Adaptations to Exercise (LACORE).

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