Urine volatile organic compounds in predicting chronic obstructive pulmonary disease risk in a national observational study

<i>Background</i>: chronic obstructive pulmonary disease (COPD) is a common respiratory disease caused by genetic and environmental factors, but the contribution of urine volatile organic compounds (VOCs) to the risk of COPD remains unclear. This study aims to use the NHANES data to explore the potential value of urine VOCs in predicting COPD. <i>Methods</i>: an epidemiological study including 782 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2018 was performed to evaluate the association between urine VOCs and COPD. Receiver operating characteristic (ROC) and the area under the ROC curve (AUC) analysis were used to evaluate the diagnostic performance of urine VOCs on COPD. <i>Results</i>: seven urine VOCs were associated with an increased risk of COPD [odds ratio (OR>1; <i>p</i> < 0.05)]. The dose-response relationship was also statistically significant between them. Meanwhile, urine VOCs can lead to the occurrence of COPD through the inflammatory effects. The area under the ROC curves for the combined urine VOC models as a predictor for COPD was 0.90. <i>Conclusions</i>: association between urine VOCs and an increased risk of COPD was found in the NHANES data. Inflammatory factors play an important role in the association of urine VOCs and COPD. In addition, urine VOCs could be useful in predicting COPD risk. More studies are needed to elucidate the mechanisms and clinical application values underlying the association between urine VOCs and COPD.