International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Erratum: Evaluation of Clinical Characteristics and Lung Function Trajectories in Young COPD Patients within the General Population [Corrigendum].","authors":"","doi":"10.2147/COPD.S644468","DOIUrl":"https://doi.org/10.2147/COPD.S644468","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/COPD.S579212.].</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"644468"},"PeriodicalIF":4.1,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of Missing Out and Its Association with Respiratory Symptoms in Patients with Chronic Obstructive Pulmonary Disease Who Use Short-Video Platforms.","authors":"Haihong Zhang, Wenjie Zhang, Li Tang, Wenxue Zhang","doi":"10.2147/COPD.S636721","DOIUrl":"10.2147/COPD.S636721","url":null,"abstract":"<p><strong>Purpose: </strong>The pervasive use of short-video platforms has raised concerns about their potential psychological impact, particularly the development of Fear of Missing Out (FoMO). This exploratory cross-sectional study aimed to investigate the association between general FoMO and respiratory symptoms in patients with Chronic Obstructive Pulmonary Disease (COPD) who use short-video platforms.</p><p><strong>Patients and methods: </strong>This exploratory cross-sectional study was conducted between January and April 2025 among 207 patients recruited from respiratory outpatient clinics, pulmonary function laboratories, and rehabilitation departments of three tertiary hospitals in Yinchuan City using convenience sampling. Participants were assessed using the general Chinese Fear of Missing Out Scale (FoMOs) and the Breathlessness, Cough, and Sputum Scale (BCSS). Multiple linear regression was used to evaluate the association between FoMO and respiratory symptoms while adjusting for covariates.</p><p><strong>Results: </strong>Among the 207 patients included, average scores were 12.97 (±5.05) for FoMO and 7.86 (±2.24) for BCSS. In the multivariable model, FoMO (B = 0.079, p = 0.002), underweight BMI (<18.5 kg/m²; B = 1.191, p = 0.024), short-video exposure of 6-8 h/day (B = 1.507, p = 0.008), and anxiety (B = 0.321, p = 0.036) were significantly associated with higher BCSS scores. The model explained 24.2% of the variance in symptom severity <i>(R²</i> = 0.242; adjusted <i>R²</i> = 0.165).</p><p><strong>Conclusion: </strong>Among patients with COPD who used short-form videos, FoMO showed a weak positive correlation with BCSS symptom scores. As this was a cross-sectional study, causal conclusions cannot be drawn, and further longitudinal studies are needed to validate these findings. Nevertheless, these results still suggest that incorporating psychosocial factors into the management of chronic obstructive pulmonary disease holds important potential value.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"636721"},"PeriodicalIF":4.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Obstructive Pulmonary Disease and Multimorbidity: Insights from a National Claims Administrative Database.","authors":"Álvaro Javier Burgos-Cárdenas, Rodolfo J Dennis, Carlos A Torres-Duque, Alejandro Casas, Mauricio Gonzalez-Garcia, Giancarlo Buitrago","doi":"10.2147/COPD.S622073","DOIUrl":"10.2147/COPD.S622073","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the prevalence of diagnosed chronic obstructive pulmonary disease (COPD) and characterize the frequency and distribution of multimorbidity among individuals with and without COPD in Colombia's contributory health system.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional study using administrative healthcare data from the Capitation Unit Sufficiency Database (Unidad de Pago por Capitación, UPC) and the Unique Enrollees Database (Base de Datos Única de Afiliados, BDUA). An electronic algorithm was used to identify individuals with a COPD diagnosis and to estimate diagnosed COPD prevalence among all affiliates during 2018-2019. We also estimated the prevalence of selected health conditions among individuals with and without COPD. Differences between groups were assessed in two steps. First, standardized mean differences (SMDs) were calculated for prevalence estimates. Second, conditions with SMDs of approximately 0.1 or greater were further evaluated using prevalence ratios (PRs) adjusted for sex, region, age, insurer, and prior healthcare service utilization estimated with Poisson regression with robust variance and 95% confidence intervals.</p><p><strong>Results: </strong>The study included 6,865,420 individuals. The nationwide prevalence of diagnosed COPD was 2.21% (95% CI, 2.20-2.22), with the highest prevalence observed in the Central region (2.77%; 95% CI, 2.74-2.79). In adjusted analyses, several conditions were more prevalent among individuals with COPD, including asthma (PR = 3.88; 95% CI, 2.88-5.23), sleep apnea (PR = 2.62; 95% CI, 2.05-3.35), heart failure (PR = 1.89; 95% CI, 1.29-2.78), ischemic heart disease (PR = 1.60; 95% CI, 1.26-2.03), hypertension (PR = 1.08; 95% CI, 1.02-1.15), and osteoporosis (PR = 2.34; 95% CI, 1.52-3.58), among others, were more prevalent among individuals with COPD. Lung cancer (PR = 6.41; 95% CI, 5.89-6.97) and breast cancer (PR = 1.17; 95% CI, 1.08-1.25) were also more prevalent in this population.</p><p><strong>Conclusion: </strong>Individuals with diagnosed COPD in Colombia's contributory health system had a substantial burden of multimorbidity, particularly respiratory and cardiovascular conditions. These findings support interdisciplinary care models and locally tailored strategies to address regional differences in diagnosed COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"622073"},"PeriodicalIF":4.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Prediction and Causal Forest Analysis of Severe Acute Kidney Injury in ICU Patients with COPD: A MIMIC-IV Study.","authors":"LiFeng Fang, Fei Wang, Junkang Chen, Yulong Zheng","doi":"10.2147/COPD.S611985","DOIUrl":"10.2147/COPD.S611985","url":null,"abstract":"<p><strong>Background: </strong>Severe acute kidney injury (AKI) is frequent in critically ill patients with chronic obstructive pulmonary disease (COPD), but predictive importance does not establish causality.</p><p><strong>Objective: </strong>To model severe AKI (KDIGO stage 3), evaluate temporal robustness at a 24-hour ICU landmark, and explore adjusted exposure-effect estimates.</p><p><strong>Methods: </strong>This retrospective MIMIC-IV v3.1 cohort included 4,705 adults with COPD. The original modeling dataset was split into training (n = 3,294) and testing (n = 1,411) sets. Consensus features from LASSO, Boruta, and random-forest importance informed 15 classifiers; the highest observed test-set AUC was interpreted with SHAP. A 24-hour landmark analysis excluded earlier stage 3 AKI and used pre-landmark predictors for incident stage 3 AKI thereafter. CausalForestDML estimated exploratory adjusted effects of the most recent valid creatinine within 365 days before ICU admission.</p><p><strong>Results: </strong>Severe AKI occurred in 1,085 patients (23.06%). The original six-feature CatBoost model included total ICU length of stay and had an AUC of 0.848 (95% CI, 0.825-0.872); it is interpreted as a retrospective trajectory model. The landmark cohort included 4,171 patients and 841 events. The temporal five-feature AUC was 0.679 (95% CI, 0.641-0.717); without pre-ICU creatinine it was 0.686 (95% CI, 0.648-0.724; paired difference, -0.0067; P = 0.293). The adjusted creatinine risk difference was 0.0547 per 1 mg/dL (95% CI, -0.0021 to 0.1115) and 0.0705 (95% CI, 0.0022-0.1387) after 1st-99th percentile trimming.</p><p><strong>Conclusion: </strong>This study establishes a COPD-specific benchmark showing that a parsimonious model can characterize severe-AKI trajectories and that temporal separation materially changes performance and interpretation. Integrating model comparison, SHAP, adjusted-effect estimation, and landmark validation provides a rigorous framework for distinguishing prognostic importance from causal relevance and defines priorities for external validation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"611985"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Disease Burden and Cost-Effectiveness for Value-Based Prioritisation of COPD Interventions: A Narrative Review.","authors":"Rong Zhang, Lei Yang, Da Jing, Lin Chen","doi":"10.2147/COPD.S629169","DOIUrl":"10.2147/COPD.S629169","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and healthcare expenditure worldwide. Disease burden and economic value are typically evaluated separately, limiting integrated assessment for value-based healthcare and resource allocation. This review integrated COPD burden-reduction potential with the incremental cost-effectiveness ratio (ICER) to prioritise interventions by health impact and economic value.</p><p><strong>Methods: </strong>This narrative review was conducted with reference to the Scale for the Assessment of Narrative Review Articles (SANRA). PubMed, Embase, and the Cochrane Library were searched from inception to August 2026 for evidence on COPD burden, healthcare costs, and intervention economic outcomes. Reporting completeness and methodological quality were assessed using CHEERS 2022, the CHEC-list, and AMSTAR 2, as appropriate. Interventions were synthesised within an integrated disability-adjusted life years (DALYs)-ICER framework.</p><p><strong>Results: </strong>Eighty publications contributed to the synthesis. Acute exacerbations, pulmonary complications, and major comorbidities were the principal drivers of COPD burden and healthcare costs. Smoking cessation and pulmonary rehabilitation showed the most favourable combination of burden-reduction and economic value. Influenza and pneumococcal vaccination showed favourable profiles, although their classification remains provisional because COPD-specific economic evidence is limited. Triple inhaled therapy showed context-dependent economic value across healthcare settings, while long-term azithromycin and long-term oxygen therapy combined with home mechanical ventilation were economically favourable primarily in selected high-risk populations. Ensifentrine and mepolizumab in type 2 COPD demonstrated clinically meaningful benefits but less favourable economic value at the prices evaluated in their source settings. ICS-containing therapy in low-eosinophil, non-exacerbating patients, household air pollution control, and comorbidity-directed interventions could not be formally classified because applicable COPD-specific economic evidence was insufficient.</p><p><strong>Conclusion: </strong>Integrating burden-reduction potential with ICER-based cost-effectiveness provides a conceptual framework for prioritising COPD interventions by health impact and economic value, while highlighting priorities for COPD-specific economic evaluation and future validation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"629169"},"PeriodicalIF":4.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Utility of Lower Limb Muscle Ultrasound for Sarcopenia in COPD Patients.","authors":"Jing Huang, Fei Guo, Li Jiang, Jierong Quan, Lu Yu, Xiao Nie, Huaicong Long","doi":"10.2147/COPD.S612655","DOIUrl":"10.2147/COPD.S612655","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia is a common but underdiagnosed extrapulmonary complication in patients with chronic obstructive pulmonary disease (COPD) and contributes to poor clinical outcomes. This study aimed to investigate the screening utility of rectus femoris cross-sectional area (RFCSA), femoral muscle thickness (FMT), and quadriceps femoris muscle thickness (QFMT) for sarcopenia in COPD patients.</p><p><strong>Patients and methods: </strong>This single-center cross-sectional study enrolled 61 COPD patients. According to the sarcopenia criteria, patients were classified into sarcopenia group (n=24) and non-sarcopenia group (n=37). All participants underwent pulmonary function tests, grip strength measurement, 6-meter walk test, 5-repetition sit-to-stand test, and bioelectrical impedance analysis. QFMT, FMT, and RFCSA were measured by a single experienced sonographer using a standardized protocol. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed.</p><p><strong>Results: </strong>The proportion of participants with sarcopenia in this COPD cohort was 39.34% (24/61). All ultrasound parameters were significantly reduced in the sarcopenia group: QFMT (2.28 cm vs 2.57 cm, p<0.001), FMT (1.30±0.21 cm vs 1.43±0.23 cm, p=0.033), and RFCSA (4.25±0.75 cm² vs 4.72±0.75 cm², p=0.019). Multivariable logistic regression adjusting for age, sex, BMI, and FEV₁% pred confirmed QFMT as an independent factor of sarcopenia (OR=0.121, 95% CI: 0.021-0.697, p=0.018). ROC analysis revealed that QFMT had the highest AUC among single parameters (AUC=0.767, 95% CI: 0.642-0.866). At the optimal cut-off of 2.833 cm, QFMT showed a sensitivity of 100% and specificity of 43.24%. When QFMT, FMT, and RFCSA were combined, the AUC was 0.777 (95% CI: 0.652-0.874), with a sensitivity of 50% and specificity of 94.59%, representing only a marginal improvement over QFMT alone (p=0.711 by DeLong test).</p><p><strong>Conclusion: </strong>Lower limb muscle ultrasound parameters, particularly QFMT, are significantly reduced in COPD patients with sarcopenia. Ultrasound appears promising as a screening tool but requires validation in larger, prospective, multicenter studies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"612655"},"PeriodicalIF":4.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the Follow-Up of Patients with COPD in Daily Practice: Results from a Spanish Delphi Consensus (\"The SEGUIPOC Study\").","authors":"Bernardino Alcázar-Navarrete, Marc Miravitlles, Juan Antonio Riesco, Juan José Soler-Cataluña","doi":"10.2147/COPD.S610382","DOIUrl":"10.2147/COPD.S610382","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a consensus document on how to follow-up patients with COPD in clinical practice in Spain.</p><p><strong>Methods: </strong>A qualitative, three-round Delphi survey was conducted in the framework of Spanish pneumologists attending COPD patients in routine daily practice. Participants completed a 35-item questionnaire on how to follow-up COPD patients, according to four sections: 1) assessment of the patient's clinical conditions, 2) therapeutical interventions, 3) frequency of follow-up visits, and 4) healthcare pathways. Consensus was defined if more than 70% of participants agree.</p><p><strong>Results: </strong>A total of 155 specialists in respiratory medicine (53% men; mean age 47 years) participated in the study (69% with more than 10 years of professional practice). More than 80% of participants agreed on the use of clinical practice guidelines but 81.9% considered that recommendations on follow-up should be more explicit. Assessment of lung function (FEV1), dyspnea, and exacerbations were the clinical variables that reached a higher level of consensus. Dyspnea values were reported as the main indicator to assess increased bronchodilation, and exacerbations were the most important to assess the use of inhaled corticosteroids. Follow-up of low-risk patients should be performed in the primary care setting, and patients should be visited every 12 months, whereas high‑risk patients should be monitored by pneumologists and including nursing visits.</p><p><strong>Conclusion: </strong>The participants agree that the guidelines should include more specific indications to define the follow-up of the COPD patient, and there is lack of evidence in many aspects. There is consensus on the importance of care to coordinate with nursing and primary care, but the protocols to follow and the working tasks for each healthcare setting remain unclear.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"610382"},"PeriodicalIF":4.1,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential Green and Blue Space, the Natural Environment, Genetic Susceptibility, and Incident COPD.","authors":"Yuntian Chen, Yuxin Zou, Chang Liu, Yuqing Lv, Qiyun Tu, Haiyang Zhang, Manyi Pan, Lifeng Yan, Tianyu Zhou, Baopeng Liu, Xiahui Ge, Huaqi Guo, Weining Xiong","doi":"10.2147/COPD.S627458","DOIUrl":"https://doi.org/10.2147/COPD.S627458","url":null,"abstract":"<p><strong>Background: </strong>Although cigarette smoking is the predominant risk factor for chronic obstructive pulmonary disease (COPD), environmental exposures and genetic susceptibility also contribute to disease risk, yet their joint effects remain unclear. We therefore prospectively examined the associations of residential green and blue space and the natural environment (GBN) with incident COPD across levels of genetic susceptibility.</p><p><strong>Methods: </strong>This population-based prospective cohort study included 385,502 UK Biobank participants. Residential GBN exposures within 300 m and 1000 m buffers were assessed. Genetic susceptibility was quantified using a polygenic risk score based on COPD-associated variants identified in a genome-wide association study. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between GBN exposures, genetic risk, and incident COPD. Gene-environment interactions were evaluated on multiplicative and additive scales.</p><p><strong>Results: </strong>Higher exposure to green space and the natural environment was associated with a lower risk of COPD (green space: HR = 0.87 [95% CI, 0.83-0.92], natural environment: HR = 0.83 [95% CI, 0.78-0.87] for the 1000 m buffer). Associations with blue space were weak and inconsistent. The natural environment exposure was inversely associated with COPD risk across genetic risk strata, with no significant multiplicative or additive interactions observed.</p><p><strong>Conclusion: </strong>Greater residential exposure to green space and the natural environment was associated with lower COPD risk, with no evidence that genetic susceptibility modified these associations, highlighting the potential role of environmental interventions in COPD prevention.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"627458"},"PeriodicalIF":4.1,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Concerns Regarding the Causal Relationship Between Methotrexate and COPD: The Missing Confounding by Indication [Response to Letter].","authors":"Ying-Xing Xiang, Fang-Shu Zou, Mei-Feng Shi, Qiang Xu","doi":"10.2147/COPD.S646536","DOIUrl":"10.2147/COPD.S646536","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"646536"},"PeriodicalIF":4.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Dietary Fiber Intake and COPD: A Two-Stage Epidemiological and Clinical Cohort Study.","authors":"Xunwei Tu, Long Huang, Zhengwei Chen, Sheng Lin","doi":"10.2147/COPD.S607608","DOIUrl":"https://doi.org/10.2147/COPD.S607608","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. This study aims to investigate the associations of dietary fiber intake with COPD, systemic inflammatory markers, and circulating lipopolysaccharide (LPS).</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) 2013-2018 were analyzed. Dietary fiber intake was evaluated as the primary exposure, whereas dietary protein and carbohydrate intakes were included as dietary comparators. White blood cell (WBC), neutrophil, and lymphocyte counts were assessed as inflammatory markers in exploratory mediation analyses, and COPD status was the primary outcome. Multivariable logistic regression, mediation, stratified, and sensitivity analyses were conducted. In parallel, a retrospective clinical cohort of 331 participants (158 COPD patients and 173 non-COPD controls) was evaluated to compare dietary patterns, lung function, systemic inflammatory markers, and serum LPS levels.</p><p><strong>Results: </strong>In the NHANES analysis, higher energy-adjusted dietary fiber intake was associated with lower COPD prevalence after adjustment for major confounders. In contrast, dietary protein and carbohydrate intakes showed no significant associations with COPD. WBC and neutrophil counts showed statistically significant but modest indirect associations, accounting for approximately 1.36% and 4.22%, respectively, of the observed association between dietary fiber intake and COPD. In the clinical cohort, among participants with COPD, higher dietary fiber intake was associated with lower levels of inflammatory markers and circulating LPS. Higher levels of these markers and LPS were associated with lower FEV₁% predicted.</p><p><strong>Conclusion: </strong>Higher dietary fiber intake was associated with lower COPD prevalence and reduced levels of systemic inflammatory markers and circulating LPS. These observational findings do not establish causal relationships or mediating pathways. Prospective longitudinal studies and intervention trials are needed to clarify the causal relationships and underlying mechanisms.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"607608"},"PeriodicalIF":4.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}