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Li W, Bai J, Ge Y, Fan Y, Huang Q, Deng Z. Association between compound dietary antioxidant index and all-cause and cancer mortality in patients with chronic obstructive pulmonary disease: results from NHANES 1999-2018. Front Med (Lausanne) 2025; 12:1544841. [PMID: 40190581 PMCID: PMC11968349 DOI: 10.3389/fmed.2025.1544841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 03/10/2025] [Indexed: 04/09/2025] Open
Abstract
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. Results The study included 1,534 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 all-cause 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.
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Affiliation(s)
- Wenqiang Li
- Department of Pulmonary and Critical Care Medicine, Zigong First People's Hospital, Zigong, China
| | - Jingshan Bai
- Department of Respiratory Medicine, Xiongan Xuanwu Hospital, Xiong'an, China
| | - Yanlei Ge
- Department of Respiratory Medicine, North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Yuting Fan
- Department of Pulmonary and Critical Care Medicine, Zigong First People's Hospital, Zigong, China
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Qian Huang
- Department of Respiratory Medicine, Dazhou Dachuan District People's Hospital (Dazhou Third People's Hospital), Dazhou, China
| | - Zhiping Deng
- Department of Pulmonary and Critical Care Medicine, Zigong First People's Hospital, Zigong, China
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Polamraju SM, Manochkumar J, Ganeshbabu M, Ramamoorthy S. Unveiling astaxanthin: biotechnological advances, delivery systems and versatile applications in nutraceuticals and cosmetics. Arch Microbiol 2025; 207:45. [PMID: 39869136 DOI: 10.1007/s00203-025-04241-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 01/04/2025] [Accepted: 01/07/2025] [Indexed: 01/28/2025]
Abstract
Astaxanthin (ASX), "king of carotenoids", is a xanthophyll carotenoid that is characterized by a distinct reddish-orange hue, procured from diverse sources including plants, microalgae, fungi, yeast, and lichens. It exhibits potent antioxidant and anti-ageing properties and has been demonstrated to mitigate ultraviolet-induced cellular and DNA damage, enhance immune system function, and improve cardiovascular diseases. Despite its broad utilization across nutraceutical, cosmetic, aquaculture, and pharmaceutical sectors, the large-scale production and application of ASX are constrained by the limited availability of natural sources, low production yields and stringent production requirements. This review provides a comprehensive analysis of ASX applications, emphasizing its dual roles in cosmetic and nutraceutical fields. It integrates insights into the qualitative differences of ASX from various natural sources and assesses biosynthetic pathways across organisms. Advanced biotechnological strategies for industrial-scale production are explored alongside innovative delivery systems, such as emulsions, films, microcapsules, nanoliposomes, and nanoparticles, designed to enhance ASX's bioavailability and functional efficacy. By unifying perspectives on its nutraceutical and cosmetic applications, this review highlights the challenges and advancements in formulation and commercialization. Prospective research directions for optimizing ASX's production and applications are also discussed, providing a roadmap for its future development.
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Affiliation(s)
- Sai Manojna Polamraju
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Janani Manochkumar
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Madhubala Ganeshbabu
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India
| | - Siva Ramamoorthy
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India.
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Jayakanthan M, Manochkumar J, Efferth T, Ramamoorthy S. Lutein, a versatile carotenoid: Insight on neuroprotective potential and recent advances. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 135:156185. [PMID: 39531935 DOI: 10.1016/j.phymed.2024.156185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 10/19/2024] [Accepted: 10/23/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Neurodegenerative diseases (NDDs) are a diverse group of neurological disorders with progressive neuronal loss at specific brain regions, leading to impaired cognitive functioning, loss of neuroplasticity, severe neurological impairment, and dementia. The incidence of neurodegenerative diseases is increasing at an alarming rate with current treatments struggling to barely prolong the inevitable. The desperation to discover a therapeutic agent to treat neurodegenerative diseases and to aid in the process of healthy recovery has opened a gateway into natural pigments. HYPOTHESIS The xanthophyll pigment lutein may bear the potential as a therapeutic agent against NDDs. RESULTS Lutein plays an important role in brain development, cognitive functioning, and improving neuroplasticity. In vitro and in vivo studies revealed the neuroprotective properties of lutein against NDDs such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and cerebral ischemia. The neuroprotective effect of lutein is evidenced by the reduction of free radicals and the simultaneous strengthening of the endogenous antioxidant systems by activating the NRF-2/ERK/AKT pathway. Further, it effectively suppressed mitochondrial aberrations, excitotoxicity, overaccumulation of metals, and its resultant complications. The immunomodulatory activity of lutein prevents neuroinflammation by hindering NF-κB nuclear translocation, regulation of NIK/IKK, PI3K/AKT, MAPK/ERK, JNK pathways, and ICAM-1 downregulation. Lutein also rescued the dysregulated cholinergic system and resolved memory defects. Along with its neuroprotective properties, lutein also improved neuroplasticity by enabling neurogenesis through increased GAP-43, NCAM, and BDNF levels. CONCLUSION Lutein exhibits strong neuroprotective activities against various NDDs. Though the investigations are in the exploratory phase, this review presents the consolidation of scattered evidence of the neuroprotective properties of lutein and urges its further exploration in clinical studies.
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Affiliation(s)
- Megha Jayakanthan
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Janani Manochkumar
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, 55128, Mainz, Germany
| | - Siva Ramamoorthy
- School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India.
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Ranogajec A, Ilić A, Benko Meštrović S, Rumbak I. Effect of Phytochemical-Rich Food Intake on Respiratory and Muscle Function in Middle-Aged Patients with COPD: A Cross-Sectional Study. Nutrients 2024; 16:3962. [PMID: 39599748 PMCID: PMC11597668 DOI: 10.3390/nu16223962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/15/2024] [Accepted: 11/18/2024] [Indexed: 11/29/2024] Open
Abstract
Background: It is known that the consumption of single phytochemicals improves respiratory function in chronic obstructive pulmonary disease (COPD) patients. Since phytochemicals have a synergistic effect on health, a more comprehensive analysis is needed. The aim of this study was to estimate the intake of phytochemicals using the dietary phytochemical index (DPI) and assess their association with respiratory function, inspiratory muscle strength and function, and peripheral muscle strength. Methods: This study was conducted at the Special Hospital for Pulmonary Diseases in Zagreb (September 2023 to May 2024). The DPI was assessed using three 24 h recalls from 71 COPD patients (66.5 ± 8.4 years; 53.5% men). Anthropometric measurements, respiratory function, inspiratory muscle function and strength, and peripheral muscle strength were assessed during pulmonary rehabilitation following standard protocols. Results: Patients were divided into DPI tertiles with mean values of 7.3 ± 3.0, 16.0 ± 3.0, and 32.2 ± 8.8, respectively. After controlling for confounding factors, a significant association was found between DPI tertiles and FEV1 (p-trend < 0.001), FVC (p-trend = 0.002), FEV1/FVC (p-trend < 0.001), MIP (p-trend = 0.012), and MSUE (p-trend = 0.002). In addition, an inverse association was found between DPI tertiles and diaphragm thickness during inhalation (p-trend = 0.012) and exhalation (p-trend = 0.013). Conclusions: This study suggests that a higher intake of phytochemicals could be beneficial in dietary interventions for COPD therapy. Future prospective studies are needed to confirm these findings.
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Affiliation(s)
- Alda Ranogajec
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia; (A.R.); (S.B.M.)
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia;
| | - Ana Ilić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia;
| | - Snježana Benko Meštrović
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia; (A.R.); (S.B.M.)
- Physiotherapy Department, University of North, Jurja Križanića 31b, 42000 Varaždin, Croatia
| | - Ivana Rumbak
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia;
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Tian Z, Li X, Han Y, Zhang X. The association between the composite dietary antioxidant index and asthma in US children aged 3-18 years: a cross-sectional study from NHANES. Sci Rep 2024; 14:17204. [PMID: 39060352 PMCID: PMC11282223 DOI: 10.1038/s41598-024-67702-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
The association between composite dietary antioxidant index (CDAI) and asthma remains unclear. Our study aimed to investigate the association of CDAI with asthma in children aged 3-18 years in the United States. Cross-sectional analyses were carried out on 18,118 children aged 3-18 years old. Data was obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2020. The Composite Dietary Antioxidant Index (CDAI) was measured by assessing the consumption of six dietary antioxidants (vitamin A, vitamin C, vitamin E, zinc, selenium and carotenoids). The association between CDAI and asthma was explored using multivariate weighted logistic regression, subgroup analyses, and sensitivity analyses. Among the 18,118 participants, 2045 (11.3%) reported a diagnosis of asthma by a healthcare provider. In both the crude and adjusted models, the odds ratios (ORs) for asthma with CDAI were not significant. Specifically, in the fully adjusted model, the OR for T2 was 0.98 (95% CI 0.83, 1.17) and the OR for T3 was 1.00 (95% CI 0.76, 1.31). Subgroup analyses by sex, age and BMI category also showed no significant associations. Sensitivity analyses, including weighted logistic multivariate analyses adjusting for family history of asthma, confirmed the absence of a significant association between CDAI and asthma. Our study showed no significant association between CDAI and asthma in children and adolescents.
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Affiliation(s)
- Zhenyu Tian
- State Key Laboratory for Innovation and Transformation of Luobing Theory; Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Xiaoying Li
- Department of Neonatal, Children's Hospital Affiliated to Shandong University/Jinan Children's Hospital, No. 23976 Huaiyin District, Jinan, 250022, Shandong, People's Republic of China
| | - Yujie Han
- Department of Neonatal, Children's Hospital Affiliated to Shandong University/Jinan Children's Hospital, No. 23976 Huaiyin District, Jinan, 250022, Shandong, People's Republic of China.
| | - Xiaolan Zhang
- Department of Pediatrics, Third People's Hospital of Liaocheng, No. 62, Weiyu Road, Liaocheng, Shandong, People's Republic of China.
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Huang Q, Peng Z, Li S, Nan W, He B. Association between carotenoids and the prevalence of chronic obstructive pulmonary disease in the United States. Heart Lung 2024; 65:93-100. [PMID: 38457968 DOI: 10.1016/j.hrtlng.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Previous studies mainly concentrated on examining the correlation between single carotenoids and Chronic obstructive pulmonary disease (COPD). However, these findings have been inconsistent. OBJECTIVES This study aimed to evaluate both the individual and overall associations of carotenoids with the prevalence of COPD. METHODS This study comprised 2,939 participants chosen from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The logistic regression, quantile-based G-computation regression (qgcomp), and Bayesian kernel machine regression (BKMR) models were employed to explore the association between carotenoids and the prevalence of COPD. Mediation analyses were also conducted to explore the underlying mechanism of carotenoids on COPD. RESULTS Individuals diagnosed with COPD had significantly lower serum carotenoid concentrations than those without COPD. We found a negative relationship between combined carotenoids and the prevalence of COPD, and lutein and zeaxanthin and alpha cryptoxanthin were identified as the main contributors to this negative association. Moreover, eosinophil acted as a mediator in the relationship between lutein and zeaxanthin, alpha cryptoxanthin, and the prevalence of COPD, with mediating proportions of 2.75 % and 3.67 %. CONCLUSION A negative association was observed between combined carotenoids and COPD prevalence, with lutein and zeaxanthin, and alpha cryptoxanthin identified as the main contributors. Eosinophils could potentially mediate the association between carotenoids and COPD.
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Affiliation(s)
- Qiong Huang
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhenyu Peng
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Siqi Li
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Wenbin Nan
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Baimei He
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
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Hua Z, Liu N, Yan X. Research progress on the pharmacological activity, biosynthetic pathways, and biosynthesis of crocins. Beilstein J Org Chem 2024; 20:741-752. [PMID: 38633914 PMCID: PMC11022409 DOI: 10.3762/bjoc.20.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Crocins are water-soluble apocarotenoids isolated from the flowers of crocus and gardenia. They exhibit various pharmacological effects, including neuroprotection, anti-inflammatory properties, hepatorenal protection, and anticancer activity. They are often used as coloring and seasoning agents. Due to the limited content of crocins in plants and the high cost of chemical synthesis, the supply of crocins is insufficient to meet current demand. The biosynthetic pathways for crocins have been elucidated to date, which allows the heterologous production of these valuable compounds in microorganisms by fermentation. This review article provides a comprehensive overview of the chemistry, pharmacological activity, biosynthetic pathways, and heterologous production of crocins, aiming to lay the foundation for the large-scale production of these valuable natural products by using engineered microbial cell factories.
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Affiliation(s)
- Zhongwei Hua
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Tuanbo New Town, Jinghai District, Tianjin 301617, China
| | - Nan Liu
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Tuanbo New Town, Jinghai District, Tianjin 301617, China
| | - Xiaohui Yan
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Tuanbo New Town, Jinghai District, Tianjin 301617, China
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Wang S, Teng H, Zhang L, Wu L. Association between dietary antioxidant intakes and chronic respiratory diseases in adults. World Allergy Organ J 2024; 17:100851. [PMID: 38259299 PMCID: PMC10801335 DOI: 10.1016/j.waojou.2023.100851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Background Chronic respiratory diseases (CRDs) pose a significant global health burden. Antioxidant-rich diets have been associated with improved lung health, but the specific relationship with CRDs remains unclear. Methods This study examined the relationship between dietary antioxidant intakes and CRDs using data from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). Information on dietary antioxidant intakes, including vitamins A, C, and E, zinc, selenium, and carotenoid, were collected from the 2 24-h recall interviews to calculate composite dietary antioxidant index (CDAI). CRDs were determined based on self-reported physician diagnoses. To examine the relationship between CDAI and CRDs, multivariate logistic regression was used. To study potential non-linear correlations within these associations, restricted cubic spline (RCS) regression was performed. Results The study involved 40 557 individuals. The median CDAI was -0.09 (-2.05, 2.25). We discovered those who were in the fourth quartile of CDAI scores had a 19% lower prevalence than those in the first quartile (OR = 0.81 [0.72-0.91], Ptrend < 0.01) after adjusting for all relevant covariates. The fourth quartile of CDAI was linked with a lower prevalence of emphysema (OR = 0.57 [0.40-0.81], Ptrend < 0.01) and chronic bronchitis (OR = 0.74 [0.62-0.88], Ptrend < 0.01). RCS regression showed that CDAI was non-linearly related to the prevalence of CRDs, with inflection points of 3.20 (P for non-linearity <0.01). The stratified analysis did not identify variables that significantly affected the results. Conclusion Higher dietary antioxidant intakes were related with a lower prevalence of CRDs (particularly emphysema and chronic bronchitis) in general adults.
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Affiliation(s)
- Shidong Wang
- Department of Respiratory Medicine, Shaoxing Second Hospital, Shaoxing, 312000, PR China
| | - Hong Teng
- Department of Respiratory Medicine, Shaoxing Second Hospital, Shaoxing, 312000, PR China
| | - Lin Zhang
- Department of Respiratory and Critical Care Medicine, The Affiliated Cangnan Hospital of Wenzhou Medical University, Cangnan, Zhejiang, 325800, PR China
| | - Liang Wu
- Department of Respiratory and Critical Care Medicine, The Affiliated Cangnan Hospital of Wenzhou Medical University, Cangnan, Zhejiang, 325800, PR China
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Zheng L, Yu X, Xia Z, Guo Y, Dai Y. The Associations Between Serum Vitamins and Carotenoids with Chronic Obstructive Pulmonary Disease: Results from the NHANES. Int J Chron Obstruct Pulmon Dis 2023; 18:2985-2997. [PMID: 38107596 PMCID: PMC10725645 DOI: 10.2147/copd.s432995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose Vitamins and carotenoids are essential in preventing and treating chronic obstructive pulmonary disease (COPD). This study investigated the associations between serum vitamins, carotenoids, and COPD in adults aged ≥ 40 years in the United States. Methods We selected 3487 participants aged ≥40 from the NHANES (2017-2018) and used demographic analysis, sensitivity tests, and different weighted multivariate regression models to investigate the relationship between serum vitamins, carotenoids, and COPD. Results Subjects in the highest tertile of serum vitamin C, vitamin E (α-tocopherol), α-carotene, trans-β-carotene, and cis-β-carotene had a 50%, 35%, 51%, 54%, and 51% lower risk of COPD than those in the lowest tertile (P for trend: P=0.0005, <0.0001, 0.0054, 0.0066, and 0.0049). Unfortunately, no significant correlation was found for serum vitamin D levels. Conclusion Our analysis of nationally representative data from 3487 participants showed that serum levels of vitamin C, vitamin E (α-tocopherol), α-carotene, and β-carotene were negatively associated with the incidence of COPD in adults over 40 years of age in the US The findings highlighted the importance of antioxidant vitamins and carotenoids in respiratory health, while the data showed no significant correlation between vitamin D (25-OHD) and the incidence of COPD.
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Affiliation(s)
- Lei Zheng
- Respiratory Department, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Xiaofei Yu
- Respiratory Department, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Zehai Xia
- Respiratory Department, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Yehao Guo
- Postgraduate Training Base Department, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China
| | - Yifan Dai
- Respiratory Department, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, People’s Republic of China
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