Abstract Rationale Oxidative stress and chronic inflammation are central to Chronic Obstructive Pulmonary Disease (COPD)progression, and the antioxidant properties of Vitamin E have been linked to counteracting these processes.Vitamin E, particularly α-tocopherol, protects lung tissue from oxidative damage, yet the relationship between dietary α-tocopherol intake and COPD severity remains understudied. This study aims to evaluate the association between dietary α-tocopherol intake and COPD severity in current smokers, as measured by patient-reported symptoms questionnaires. Methods Current smokers with moderate to severe COPD were enrolled in a randomized controlled trial evaluating the effects of motivational interviewing and the use of air cleaners. Respiratory symptoms and quality of life were assessed using questionnaires including St. George’s Respiratory Questionnaire (SGRQ), the University of California, San Diego Shortness of Breath Questionnaire (UCSD SOBQ), the COPD Assessment Test (CAT), and the Cough and Sputum Assessment Questionnaire (CASAQ). A Food Frequency Questionnaire (FFQ) administered at baseline, 3 months, and 6 months was used to calculate each participant’s average total α-tocopherol intake(including supplements). The association between person-level average α-tocopherol and repeated symptom measures was evaluated using generalized estimating equation (GEE) regression. Negative binomial regression of exacerbation frequency was run on person-level average α-tocopherol, with follow-up days as an offset. Models were adjusted by total calories, BMI, age, gender, race, education, income, pack years, baseline FEV1 % predicted, baseline number of cigarettes smoked, and the treatment assignment for the air cleaner intervention. Results 119 participants were included in the analysis (75 females and 44 males), with a mean (SD) age of 62.9(7.1) years and a mean BMI of 29.0 (8.1). At baseline, participants had a median (IQR) dietary α-tocopherol intake of 14.1 (8.4,21.6) mg. Higher average α-tocopherol levels were associated with better respiratory outcomes, reflected by lower symptom scores on questionnaires including SGRQ (β = -4.4, p = 0.005), UCSD SOBQ (β = -6.9, p= 0.003), CAT (β = -2.1, p = 0.002), and mMRC (β = -0.2, p = 0.027). CASAQ cough and sputum symptoms were also associated with α-tocopherol, and other clinical outcomes showed significant associations or similar trends (Table1). No associations were observed with exacerbation frequency. Sensitivity analyses adjusting for omega-3 intake yielded consistent results. Conclusions Higher average dietary α-tocopherol intake was associated with better respiratory symptoms among current smokers with moderate to severe COPD. These findings suggest that dietary α-tocopherol may play a protective role in respiratory health in this population. This abstract is funded by: National Institute of Health (NIH)/National Institute of Environmental Health Sciences, (NIEHS) R01 ES029512
Schauermann et al. (Fri,) studied this question.