Leng Shuguang, Picchi Maria A, Tesfaigzi Yohannes, Wu Guodong, Gauderman W James, Xu Fadi, Gilliland Frank D, Belinsky Steven A
The Lung Cancer Program, Lovelace Respiratory Research Institute.
Cancer Control Research Program, University of New Mexico Comprehensive Cancer Center.
Int J Chron Obstruct Pulmon Dis. 2017 Oct 30;12:3171-3181. doi: 10.2147/COPD.S142237. eCollection 2017.
COPD is the third leading cause of death in the United States. Cigarette smoking accelerates the age-related forced expiratory volume in 1 s (FEV) decline, an important determinant for the genesis of COPD. Hispanic smokers have lower COPD prevalence and FEV decline than non-Hispanic whites (NHWs).
A nutritional epidemiological study was conducted in the Lovelace Smokers cohort (LSC; n=1,829) and the Veterans Smokers cohort (n=508) to identify dietary nutrients (n=139) associated with average FEV and its decline and to assess whether nutrient intakes could explain ethnic disparity in FEV decline between Hispanics and NHW smokers.
Nutrients discovered and replicated to be significantly associated with better average FEV included magnesium, folate, niacin, vitamins A and D, eicosenoic fatty acid (20:1n9), eicosapentaenoic acid (20:5n3), docosapentaenoic acid (DPA; 22:5n3), docosahexaenoic acid (22:6n3), and fiber. In addition, greater intakes of eicosenoic fatty acid and DPA were associated with slower FEV decline in the LSC. Among omega 3 polyunsaturated fatty acids, DPA is the most potent nutrient associated with better average FEV and slower FEV decline. Adverse effect of continuous current smoking on FEV decline was completely negated in LSC members with high DPA intake (>20 mg/day). Slower FEV decline in Hispanics compared to NHWs may be due to the greater protection of eicosenoic fatty acid and DPA for FEV decline rather than greater intake of protective nutrients in this ethnic group.
The protective nutrients for the preservation of FEV in ever smokers could lay foundation for designing individualized nutritional intervention targeting "optimal physiological levels" in human to improve lung function in ever smokers. Ethnic disparity in FEV decline may be explained by difference in magnitude of protection of dietary intakes of eicosenoic fatty acid and DPA between Hispanics and NHWs.
慢性阻塞性肺疾病（COPD）是美国第三大死因。吸烟会加速与年龄相关的1秒用力呼气量（FEV）下降，这是COPD发病的一个重要决定因素。西班牙裔吸烟者的COPD患病率和FEV下降幅度低于非西班牙裔白人（NHW）。
在洛夫莱斯吸烟者队列（LSC；n = 1829）和退伍军人吸烟者队列（n = 508）中进行了一项营养流行病学研究，以确定与平均FEV及其下降相关的膳食营养素（n = 139），并评估营养素摄入量是否可以解释西班牙裔和NHW吸烟者在FEV下降方面的种族差异。
发现并重复验证与更好的平均FEV显著相关的营养素包括镁、叶酸、烟酸、维生素A和D、二十碳烯酸（20:1n9）、二十碳五烯酸（20:5n3）、二十二碳五烯酸（DPA；22:5n3）、二十二碳六烯酸（22:6n3）和纤维。此外，在LSC中，二十碳烯酸和DPA摄入量增加与FEV下降较慢有关。在ω-3多不饱和脂肪酸中，DPA是与更好的平均FEV和较慢的FEV下降相关的最有效营养素。在高DPA摄入量（>20毫克/天）的LSC成员中，持续吸烟对FEV下降的不良影响被完全抵消。与NHW相比，西班牙裔FEV下降较慢可能是由于二十碳烯酸和DPA对FEV下降的保护作用更强，而不是该种族群体摄入了更多的保护性营养素。
长期吸烟者中保存FEV的保护性营养素可为设计针对人体“最佳生理水平”的个性化营养干预措施奠定基础，以改善长期吸烟者的肺功能。西班牙裔和NHW在FEV下降方面的种族差异可能是由于两者在膳食中二十碳烯酸和DPA摄入量的保护程度不同所致。
