Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients

BackgroundFew studies have investigated the effects of both dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) on mortality in patients with Chronic Obstructive Pulmonary Disease (COPD). Our research aimed to explore the associations between the two indicators with all-c...

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Main Authors: Sue Zhao, Yingjie Su, Hongzhong Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1514430/full
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author Sue Zhao
Yingjie Su
Hongzhong Yang
author_facet Sue Zhao
Yingjie Su
Hongzhong Yang
author_sort Sue Zhao
collection DOAJ
description BackgroundFew studies have investigated the effects of both dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) on mortality in patients with Chronic Obstructive Pulmonary Disease (COPD). Our research aimed to explore the associations between the two indicators with all-cause mortality in COPD patients.MethodsWe conducted a prospective cohort analysis based on data from the six cycles of the National Health and Nutrition Examination Survey (NHANES) dataset from 2007 to 2018. Multivariate Cox proportional hazard models were used to analyze the effects of DII and CDAI on all-cause mortality in COPD. We employed restricted cubic spline (RCS) analysis to examine the dose–response relationship between two indicators and all-cause mortality, used threshold effect analysis to determine the inflection point, and conducted subgroup analysis and interaction tests to verify the stability of the results.ResultsA total of 1,457 COPD patients aged over 40 were enrolled in the study. The median follow-up time was 76.8 months. The multivariate Cox proportional hazards model showed that increased DII was associated with an increase in all-cause mortality (HR (95% CI): 1.11(1.04, 1.18), p = 0.002). In contrast, CDAI was negatively correlated with all-cause mortality (HR (95% CI): 0.95(0.91, 0.99), p = 0.01). The RCS analysis showed a nonlinear correlation between DII or CDAI and all-cause mortality. The maximum pro-inflammatory inflection point of DII was 2.32, while the antioxidant threshold of CDAI is −0.12. Subgroup analyses indicated that the relationship between exposure variables and all-cause mortality was stable in most populations.ConclusionReducing the pro-inflammatory diet or increasing the antioxidant diet can reduce all-cause mortality in COPD patients.
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spelling doaj-art-09ed345aaaff45b0b826b32f5e7df18a2025-01-21T05:43:10ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011210.3389/fnut.2025.15144301514430Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patientsSue Zhao0Yingjie Su1Hongzhong Yang2Department of Pulmonary and Critical Care Medicine, Changsha Central Hospital, Changsha, ChinaChangsha Central Hospital, Changsha, ChinaDepartment of Pulmonary and Critical Care Medicine, Changsha Central Hospital, Changsha, ChinaBackgroundFew studies have investigated the effects of both dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) on mortality in patients with Chronic Obstructive Pulmonary Disease (COPD). Our research aimed to explore the associations between the two indicators with all-cause mortality in COPD patients.MethodsWe conducted a prospective cohort analysis based on data from the six cycles of the National Health and Nutrition Examination Survey (NHANES) dataset from 2007 to 2018. Multivariate Cox proportional hazard models were used to analyze the effects of DII and CDAI on all-cause mortality in COPD. We employed restricted cubic spline (RCS) analysis to examine the dose–response relationship between two indicators and all-cause mortality, used threshold effect analysis to determine the inflection point, and conducted subgroup analysis and interaction tests to verify the stability of the results.ResultsA total of 1,457 COPD patients aged over 40 were enrolled in the study. The median follow-up time was 76.8 months. The multivariate Cox proportional hazards model showed that increased DII was associated with an increase in all-cause mortality (HR (95% CI): 1.11(1.04, 1.18), p = 0.002). In contrast, CDAI was negatively correlated with all-cause mortality (HR (95% CI): 0.95(0.91, 0.99), p = 0.01). The RCS analysis showed a nonlinear correlation between DII or CDAI and all-cause mortality. The maximum pro-inflammatory inflection point of DII was 2.32, while the antioxidant threshold of CDAI is −0.12. Subgroup analyses indicated that the relationship between exposure variables and all-cause mortality was stable in most populations.ConclusionReducing the pro-inflammatory diet or increasing the antioxidant diet can reduce all-cause mortality in COPD patients.https://www.frontiersin.org/articles/10.3389/fnut.2025.1514430/fullchronic obstructive pulmonary diseasedietary inflammatory indexcomposite dietary antioxidant indexmortalityNHANES
spellingShingle Sue Zhao
Yingjie Su
Hongzhong Yang
Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
Frontiers in Nutrition
chronic obstructive pulmonary disease
dietary inflammatory index
composite dietary antioxidant index
mortality
NHANES
title Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
title_full Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
title_fullStr Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
title_full_unstemmed Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
title_short Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients
title_sort associations of dietary inflammation index and composite dietary antioxidant index with all cause mortality in copd patients
topic chronic obstructive pulmonary disease
dietary inflammatory index
composite dietary antioxidant index
mortality
NHANES
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1514430/full
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AT hongzhongyang associationsofdietaryinflammationindexandcompositedietaryantioxidantindexwithallcausemortalityincopdpatients