Jin Jun, Bian Yuemei, Gu Zhongyun, Lin Maoen
Department of Respiratory Medicine, Hangzhou Ninth People's Hospital, Hangzhou City, Zhejiang Province, China.
Clinical Nutrition Department, Hangzhou Ninth People's Hospital, Hangzhou City, Zhejiang Province, China.
Chronic Obstr Pulm Dis. 2024 Mar 26;11(2):216-228. doi: 10.15326/jcopdf.2023.0457.
This study aimed to investigate dietary fiber (DF) intake with the prevalence of chronic obstructive pulmonary disease (COPD) in the middle-aged and elderly population through analysis of the National Health and Nutrition Examination Survey (NHANES) data.
The study utilized data from 3 cycles of the NHANES database (2007-2012). The exposure variable was DF intake, and the outcome variable was COPD prevalence. Weighted logistic regression was utilized to construct relationship models between the 2 variables. Confounding factors were adjusted, and subgroup analysis was to explore the association of DF intake with COPD. Restricted cubic spline (RCS) analysis investigated the nonlinear relationship between DF intake and COPD. Finally, mediation analysis was performed to determine whether the influence of DF intake on COPD prevalence is mediated through the alteration of white blood cell (WBC) counts.
This study included a total of 7301 eligible participants aged >40 years. The results of the study indicated that an increase in DF intake significantly reduced the prevalence of COPD (odds ratio: 0.98, 95% confidence interval: 0.96-0.99, <0.001), and DF intake was correlated with lung function indicators (e.g., forced expiratory volume in 1 second). Stratified analysis revealed that an increased DF intake significantly reduced the risk of COPD in male individuals, middle-aged individuals (aged 40-59 years), those with a body mass index ≤30 kg/m, individuals with a history of smoking, and alcohol consumers (<0.05). Through RCS analysis exploring the nonlinear association between DF intake and COPD prevalence, the critical threshold for the impact of DF intake on COPD prevalence was 15.10 gm. When DF intake was ≥15.10 g/d, it effectively reduced the prevalence of COPD. Mediation analysis results indicated that the WBC count partially mediated the association between DF intake and COPD, with a mediation proportion of 9.89% (=0.006).
Increased DF intake was linked to decreased prevalence of COPD, particularly in men and middle-aged people. WBC counts may be an important pathway linking DF intake and COPD.
本研究旨在通过分析美国国家健康与营养检查调查（NHANES）数据，探讨膳食纤维（DF）摄入量与中老年人群慢性阻塞性肺疾病（COPD）患病率之间的关系。
本研究利用了NHANES数据库3个周期（2007 - 2012年）的数据。暴露变量为DF摄入量，结局变量为COPD患病率。采用加权逻辑回归构建这两个变量之间的关系模型。对混杂因素进行了调整，并进行亚组分析以探讨DF摄入量与COPD的关联。采用受限立方样条（RCS）分析研究DF摄入量与COPD之间的非线性关系。最后，进行中介分析以确定DF摄入量对COPD患病率的影响是否通过白细胞（WBC）计数的改变介导。
本研究共纳入7301名年龄>40岁的合格参与者。研究结果表明，DF摄入量的增加显著降低了COPD的患病率（优势比：0.98，95%置信区间：0.96 - 0.99，P<0.001），且DF摄入量与肺功能指标（如1秒用力呼气量）相关。分层分析显示，DF摄入量的增加显著降低了男性、中年个体（40 - 59岁）、体重指数≤30 kg/m²的个体、有吸烟史的个体以及饮酒者患COPD的风险（P<0.05）。通过RCS分析探索DF摄入量与COPD患病率之间的非线性关联，DF摄入量对COPD患病率影响的临界阈值为15.10克。当DF摄入量≥15.10克/天时，可有效降低COPD的患病率。中介分析结果表明，WBC计数部分介导了DF摄入量与COPD之间的关联，中介比例为9.89%（P = 0.006）。
DF摄入量的增加与COPD患病率的降低有关，尤其是在男性和中年人中。WBC计数可能是连接DF摄入量与COPD的重要途径。
