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Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

 Hye Jung Park  ;  Min Kwang Byun  ;  Hyung Jung Kim  ;  Jae Yeol Kim  ;  Yu-Il Kim  ;  Kwang-Ha Yoo  ;  Eun Mi Chun  ;  Ji Ye Jung  ;  Sang Haak Lee  ;  Chul Min Ahn 
 International Journal of Chronic Obstructive Pulmonary Disease, Vol.11 : 2721-2728, 2016 
Journal Title
 International Journal of Chronic Obstructive Pulmonary Disease 
Issue Date
Adult ; Aged ; Ascorbic Acid/administration & dosage* ; Chi-Square Distribution ; Diet* ; Female ; Health Status ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Protective Factors ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/prevention & control* ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Time Factors
chronic obstructive lung disease ; nutrition ; risk factor ; smoking ; vitamin C
BACKGROUND: Vitamin C, as an antioxidant, has recently been suggested to provide protection against COPD; however, only few national cohort studies have investigated these effects. We aimed to confirm the protective effects of vitamin C against COPD in Korean patients. PATIENTS AND METHODS: We analyzed the data of 3,283 adults aged ≥40 years (representing 23,541,704 subjects) who underwent pulmonary function tests and responded to questionnaires on smoking history and vitamin C intake, with stratification variables and sampling weight designated by the Korea 2012 National Health and Nutrition Examination Survey. RESULTS: Among all the subjects, 512 (representing 3,459,679 subjects; 15.6%) were diagnosed as having COPD based on pulmonary function test results. Male gender, old age, residence in suburban/rural regions, low household income, low educational level, an occupation in agriculture or fisheries, and heavy smoking were significantly associated with COPD. Low intake of nutrients, including potassium, vitamin A, carotene, retinol, and vitamin C, was significantly associated with COPD. The prevalence of COPD in heavy smokers with the lowest quartile (Q1, <48.50 mg; 63.0%) and low-middle quartile (Q2, 48.50-84.38 mg; 56.4%) of vitamin C intake was significantly higher than that in subjects with the high-middle quartile (Q3, 84.38-141.63 mg; 29.5%) and highest quartile (Q4, >141.63 mg; 32.6%) of vitamin C intake (P=0.015). In multivariate analysis, male gender, old age, heavy smoking, and a low intake of vitamin C were significant independent risk factors for COPD. A significant reduction of 76.7% in COPD risk was observed with a Q3 vitamin C intake compared to Q1 vitamin C intake (odds ratio, 0.233; 95% confidence interval, 0.094-0.576) in heavy smokers. CONCLUSION: This large-scale national study suggests that dietary vitamin C provides protection against COPD, independent of smoking history, in the general Korean population.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김형중(Kim, Hyung Jung) ORCID logo https://orcid.org/0000-0003-2498-0683
박혜정(Park, Hye Jung) ORCID logo https://orcid.org/0000-0002-1862-1003
변민광(Byun, Min Kwang) ORCID logo https://orcid.org/0000-0003-1525-1745
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