Glucosamine use, smoking and risk of incident chronic obstructive pulmonary disease: a large prospective cohort study

Chronic inflammation exerts pleiotropic effects in the aetiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40-69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HR) as well as 95 % CI for the risk of incident COPD. During a median follow-up of 8 center dot 96 years (interquartile range 8 center dot 29-9 center dot 53 years), 9016 new-onset events of COPD were documented. We found that the regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0 center dot 80 (95 % CI, 0 center dot 75, 0 center dot 85; P < 0 center dot 001). When subgroup analyses were performed by smoking status, the adjusted HR for the association of regular glucosamine use with incident COPD were 0 center dot 84 (0 center dot 73, 0 center dot 96), 0 center dot 84 (0 center dot 77, 0 center dot 92) and 0 center dot 71 (0 center dot 62, 0 center dot 80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (P (for interaction) = 0 center dot 078). Incident COPD could be reduced by 14 % to 84 % through a combination of regular glucosamine use and smoking cessation.