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ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1544841
Association between compound dietary antioxidant index and all-cause and cancer mortality in patients with chronic obstructive pulmonary disease: results from NHANES 1999 -2018
Provisionally accepted- 1 Zigong First People's Hospital, Zigong, China
- 2 Xiong'an Xuanwu Hospital, Xiong'an New Area, China
- 3 Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, China
- 4 Dazhou Dachuan District People's Hospital (Dazhou Third People's Hospital), Dazhou, China
Objective: Chronic obstructive pulmonary disease (COPD) is one of the most important causes of death in the world, and its core is chronic inflammation. Antioxidants play a positive role in the onset and prognosis of chronic respiratory diseases. In maintaining human health, the composite dietary antioxidant index (CDAI) plays an important function. Therefore, the purpose of the current study was to investigate the relationship between CDAI and all-cause and cancer mortality in individuals with COPD. Methods: A prospective cohort study was conducted by investigating NHANES data between 1999 -2018. The study included people who satisfied the inclusion and exclusion criteria. In this study, the association between CDAI and all-cause and cancer mortality was investigated using weighted Cox regression. The relationship between them is illustrated by drawing constrained cubic spline curves (RCS). Finally, subgroup analysis is used to further verify.The study included 1534 participants. CDAI was associated with COPD patients mortality, and after adjusting for multiple factors, we observed a 5% reduction in the risk of all-cause mortality (HR = 0.95, 95% CI: 0.92-0.97) was associated with a 9% lower risk of cancer mortality for each one-unit increase in CDAI (HR = 0.91, 95% CI: 0.85-0.98). After adjusting for multiple factors, high CDAI was associated with a reduced risk of mortality, with patients in the high CDAI group having 35% lower allcause mortality than those in the low CDAI group (HR = 0.65, 95% CI: 0.50-0.85), the high CDAI group had a 61% lower risk of cancer mortality (HR=0.39,95% CI: 0.23-0.68). Subgroup analysis and sensitivity analysis showed a consistent association between CDAI and COPD mortality. Conclusion: Our study highlights the inverse association between CDAI and all-cause and cancer mortality in patients with COPD. Further prospective studies are needed to confirm the role of CDAI in mortality risk in patients with COPD.
Keywords: COPD, CDAI, All-cause mortality, Cancer mortality, NHANES
Received: 19 Dec 2024; Accepted: 10 Mar 2025.
Copyright: © 2025 Li, Bai, Ge, Fan, Huang and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhiping Deng, Zigong First People's Hospital, Zigong, China
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