L-Shaped Association Between Dietary Copper Intake and Chronic Obstructive Pulmonary Disease Among American Adults: Findings From the National Health and Nutrition Examination Survey 1999–2018 - 19/08/25
Abstract |
Background |
Copper plays a vital role in human physiological functions. However, limited epidemiologic evidence exists for an association between dietary copper intake and chronic obstructive pulmonary disease (COPD).
Objectives |
This study aimed to assess the association between dietary copper intake and COPD in American adults.
Design |
This cross-sectional study used data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018.
Participants/setting |
Following the inclusion criteria, data from a total of 39 644 adults aged 20 and older were included in this study, out of which 3159 individuals had been diagnosed with COPD by a health care provider.
Main outcome measures |
Dietary data were obtained through 24-hour dietary recall, and COPD diagnosis information was derived from a standardized medical condition questionnaire.
Statistical analyses performed |
Multivariable logistic regression analysis was conducted to explore the association between dietary copper intake and COPD. To assess the dose–response relationship, a 3-piecewise restricted cubic spline analysis was employed. Potential thresholds were identified with a 2-piecewise logistic regression model. Subgroup analysis was performed to assess heterogeneity and explore potential interactions.
Results |
Compared with individuals in the lowest tertile of dietary copper intake (T1, <0.89 mg/day), those in the highest tertile (T3, > 1.35 mg/day) had an adjusted odds ratio (OR) of 0.79 for COPD (95% confidence interval [CI], 0.68–0.92, P = .002). The relationship between dietary copper intake and COPD followed a nonlinear L-shaped curve ( P < .001). Threshold analysis found a statistically significant inverse association between dietary copper intake and the odds of COPD for intakes < 1.5 mg/day but no significant association for intakes ≥ 1.5 mg/day. Subgroup analysis indicated an interaction effect with age.
Conclusions |
An L-shaped inverse association was observed between dietary copper intake and COPD in US adults, at a threshold of approximately 1.5 mg/day, with an observed age interaction.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic obstructive pulmonary disease, Dietary copper intake, L-shaped, Threshold analysis, Interaction effect
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| Supplementary materials: Table 4 , Table 5 , Table 6 and Table 7 and Figure 4 are available at www.jandonline.org |
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| STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. |
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| FUNDING/SUPPORT This research was supported by the Chongqing Natural Science Foundation of China (cstc2022ycjh-bgzxm0051), Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University , and was also funded by the Scientific Research Project of Banan District, Chongqing. |
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| ACKNOWLEDGEMENT The authors thank the participants and staff of NHANES for their valuable contributions. They also thank Jie Liu from the Department of Vascular and Endovascular Surgery at the Chinese PLA General Hospital for his support and insightful feedback, and likewise appreciate the assistance provided by Haoxian Tang from Shantou University Medical College in Shantou, China. The authors confirm that they have received permission from Jie Liu and Haoxian Tang to include their names in this acknowledgement. |
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| AUTHOR CONTRIBUTIONS C. F. and J. S. designed and conducted the research. M. H. analyzed the data. C. F. was responsible for software and visualization. J. L. and Y. H. drafted the manuscript. D. J. and J. L. were responsible for obtaining funding. D. J. primarily took charge of finalizing the content. All authors read and approved the final manuscript. Each author made significant contributions to the conception, design, data analysis, and interpretation of the study results. Additionally, all authors critically reviewed and revised the manuscript for important intellectual content and provided final approval of the version to be published. |
Vol 125 - N° 9
P. 1275 - septembre 2025 Retour au numéro
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