ArticleRespiratory research2022
Serum antioxidant vitamins and respiratory morbidity and mortality: a pooled analysis.
Article in Respiratory research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 36 citations in OpenAlex.
- Research on the Mechanism of Natural Products Acting on Chronic Obstructive Pulmonary Disease.Food science & nutrition · 2026Review
- Genetically Raised Circulating Levels of Dietary Antioxidants and the Association With Respiratory Health in High-Risk Populations.Canadian respiratory journal · 2026Article
- Association between carotene intake and hospital-acquired pneumonia in elderly men: a cross-sectional study.Aging clinical and experimental research · 2025Article
- Dietary Antioxidant Intake and Sleep Quality: Combined Effects on Chronic Obstructive Pulmonary Disease in NHANES 2005-2008 and Mendelian Randomization Analysis.Food science & nutrition · 2025Article
- The Community Prevalence of Vitamin C Deficiency and Inadequacy-How Does Australia Compare With Other Nations? A Scoping Review.Health science reports · 2025Review
- Exploring the link between nutritional status and total antioxidant status in patients with severe asthma: a cross-sectional study.BMC pulmonary medicine · 2025Article
- Nutritional Support of Chronic Obstructive Pulmonary Disease.Nutrients · 2025Review
- A case report of severe organophosphate poisoning and aspiration pneumonitis treated with exchange blood transfusion.Oxford medical case reports · 2025Article
- Association between compound dietary antioxidant index and all-cause and cancer mortality in patients with chronic obstructive pulmonary disease: results from NHANES 1999-2018.Frontiers in medicine · 2025Article
- Dietary antioxidant nutrients intake and pneumonia mortality in Japanese men and women: the Japan Public Health Center-Based Prospective Study.Environmental health and preventive medicine · 2025Article
- The association between serum vitamin C levels and respiratory infections in children and adolescents.Frontiers in nutrition · 2025Article
- L-ascorbate Alleviates Chronic Obstructive Pulmonary Disease through the EGF/PI3K/AKT Signaling Axis.Current medicinal chemistry · 2025Article
- Association of systemic immune-inflammatory index with all-cause and cancer mortality in Americans aged 60 years and older.Frontiers in aging · 2025Article
- Modulating oxidative stress: a reliable strategy for coping with community-acquired pneumonia in older adults.Frontiers in medicine · 2025Review
- Composite dietary antioxidant index, chronic respiratory disease, and all-cause mortality: National Health and Nutrition Examination Survey, 2003-2018.European journal of nutrition · 2024Article
- Association between rheumatoid arthritis and serum vitamin C levels in Adults: Based on the National health and Nutrition Examination survey database.Preventive medicine reports · 2024Article
- Article
- Association between serum carotenoids and bacterial vaginosis infection among American women.BMC infectious diseases · 2024Article
- Association of dietary patterns with chronic respiratory health among U.S. adults.Frontiers in immunology · 2024Article
- Prenatal exposure to replacement flame retardants and organophosphate esters and childhood adverse respiratory outcomes.Environmental research · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOxidative stress plays a key role in the pathogenesis of respiratory diseases; however, studies on antioxidant vitamins and respiratory outcomes have been conflicting. We evaluated whether lower serum levels of vitamins A, C, D, and E are associated with respiratory morbidity and mortality in the U.S. adult population.
methodsWe conducted a pooled analysis of data from the 1988-1994 and 1999-2006 National Health and Nutrition Examination Survey (participants aged ≥ 20 years). We estimated covariate-adjusted odds ratios (aOR) per interquartile decrease in each serum vitamin level to quantify associations with respiratory morbidity, and covariate-adjusted hazard ratios (aHR) to quantify associations with respiratory mortality assessed prospectively through 2015. Vitamin supplementation and smoking were evaluated as potential effect modifiers.
resultsLower serum vitamin C increased the odds of wheeze among all participants (overall aOR: 1.08, 95% CI: 1.01-1.16). Among smokers, lower serum α-tocopherol vitamin E increased the odds of wheeze (aOR: 1.11, 95% CI: 1.04-1.19) and chronic bronchitis/emphysema (aOR: 1.13, 95% CI: 1.03-1.24). Conversely, lower serum γ-tocopherol vitamin E was associated with lower odds of wheeze and chronic bronchitis/emphysema (overall aORs: 0.85, 95% CI: 0.79-0.92 and 0.85, 95% CI: 0.76-0.95, respectively). Lower serum vitamin C was associated with increased chronic lower respiratory disease (CLRD) mortality in all participants (overall aHR: 1.27, 95% CI: 1.07-1.51), whereas lower serum 25-hydroxyvitamin D (25-OHD) tended to increase mortality from CLRD and influenza/pneumonia among smokers (aHR range: 1.33-1.75). Mortality from influenza/ pneumonia increased with decreasing serum vitamin A levels in all participants (overall aHR: 1.21, 95% CI: 0.99-1.48). In pooled analysis, vitamin C deficiency and 25-OHD insufficiency were associated with mortality from influenza/pneumonia, increasing mortality risk up to twofold.
conclusionsOur analysis of nationally representative data on over 34,000 participants showed that lower serum levels of vitamins A, C, D, and α-tocopherol vitamin E are associated with increased respiratory morbidity and/or mortality in U.S. adults. The results underscore the importance of antioxidant vitamins in respiratory health.
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