Dataset Information

Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB).

ABSTRACT:

Background

Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors.

Methods

We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004-2008. Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-measured lung function. The prevalence of AFO was analysed by region, age, socioeconomic status, body mass index (BMI) and smoking history and compared with the prevalence of self-reported physician-diagnosed chronic bronchitis or emphysema (CB/E) and its symptoms.

Findings

The prevalence of AFO was 7.3% in men (range 2.5-18.2%) and 6.4% in women (1.5-18.5%). Higher prevalence of AFO was associated with older age (p<0.0001), lower income (p<0.0001), poor education (p<0.001), living in rural regions (p<0.001), those who started smoking before the age of 20 years (p<0.001) and low BMI (p<0.001). Compared with self-reported diagnosis of CB/E, 88.8% of AFO was underdiagnosed; underdiagnosis proportion was highest in 30-39-year olds (96.7%) compared with the 70+ age group (81.1%), in women (90.7%), in urban areas (89.4%), in people earning 5K-10 K ¥ monthly (90.3%) and in those with middle or high school education (92.6%).

Interpretation

In China, the burden of AFO based on spirometry was high and significantly greater than that estimated based on self-reported physician-diagnosed CB/E, especially in rural areas, reflecting major issues with diagnosis of AFO that will impact disease treatment and management.

SUBMITTER: Kurmi OP

PROVIDER: S-EPMC4212802 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB).

Kurmi Om P OP Li Liming L Smith Margaret M Augustyn Mareli M Chen Junshi J Collins Rory R Guo Yu Y Han Yabin Y Qin Jingxin J Xu Guanqun G Wang Jian J Bian Zheng Z Zhou Gang G Davis Kourtney K Peto Richard R Chen Zhenming Z Li Liming L Chen Zhengming Z Chen Junshi J Collins Rory R Peto Richard R Chen Zhengming Z Lancaster Garry G Yang Xiaoming X Williams Alex A Smith Margaret M Yang Ling L Chang Yumei Y Millwood Iona I Chen Yiping Y Lewington Sarah S Sansome Sam S Walters Robin R Kurmi Om O Guo Yu Y Bian Zheng Z Hou Can C Tan Yunlong Y Wang Zheng Z Cai Xin X Zhou Huiyan H Chen Xuguan X Pang Zengchang Z Li Shanpeng S Wang Shaojie S Lv Silu S Zhao Zhonghou Z Liu Shumei S Pang Zhigang Z Yang Liqiu L He Hui H Yu Bo B Wang Shanqing S Wang Hongmei H Chen Chunxing C Zheng Xiangyang X Hu Xiaoshu X Zhou Minghao M Wu Ming M Tao Ran R Wang Yeyuan Y Hu Yihe Y Ma Liangcai L Zhou Renxian R Tang Zhenzhu Z Chen Naying N Huang Ying Y Li Mingqiang M Gan Zhigao Z Meng Jinhuai J Qin Jingxin J Wu Xianping X Zhang Ningmei N Luo Guojin G Que Xiangsan X Chen Xiaofang X Ge Pengfei P Ren Xiaolan X Dong Caixia C Zhang Hui H Mao Enke E Li Zhongxiao Z Zhou Gang G Feng Shixian S Gao Yulian Y He Tianyou T Jiang Li L Sun Huarong H Yu Min M Su Danting D Lu Feng F Qian Yijian Y Shi Kunxiang K Han Yabin Y Chen Lingli L Li Guangchun G Liu Huilin H Yin Li L Xiong Youping Y Tan Zhongwen Z Jia Weifang W

BMJ open respiratory research 20140509 1

<h4>Background</h4>Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors.<h4>Methods</h4>We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004-2008. Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-meas ...[more]

PMID: 25478177

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Project description:Short versions of qualitative and quantitative food frequency questionnaires (FFQs) are widely used to assess usual food intake. However, fewer studies evaluated their relative validity and reproducibility in the Chinese population. This study compared 12-day 24-h dietary recalls with qualitative and quantitative FFQs designed by the China Kadoorie Biobank (CKB) study to assess the relative validity. Two FFQs were administered in the second and third seasons and compared to evaluate the reproducibility. Statistical tests included Spearman correlation coefficients, weighted kappa, and cross-classification. A total of 432 participants were eligible after stratifying by age, sex, and four regions. In the validation of qualitative FFQ, adjusted Spearman coefficients were between 0.23 and 0.59, and weighted kappa coefficients ranged from 0.61 to 0.88, except for fresh vegetables. The percentage of correct classification was highest in fresh vegetables and lowest in fresh fruit, but the percentages of extreme classification were below 3.0%. Corresponding Spearman and kappa coefficients for the reproducibility were 0.17-0.56 and 0.62-0.90. Furthermore, the correct classification constituted between 35.6 and 93.3% of all participants. Regarding the relative validity of the quantitative FFQ, Spearman coefficients ranged from 0.14 to 0.69 in addition to dried vegetables and carbonated soft drinks. For items with more than two-thirds of total participants consumed, weighted kappa coefficients were from 0.57 to 0.79; correct classification percentages were between 34.6% and 67.5%. Spearman and kappa coefficients for the reproducibility of the quantitative FFQ were 0.15-0.71 and 0.60-0.86, respectively; correct classification percentages varied from 47.8% to 71.6%. Most food items from the qualitative FFQ showed acceptable or even good relative validity and reproducibility in the CKB study. Likewise, major food items in the quantitative FFQ were valid and reproducible, but poor performances of dried vegetables and carbonated soft drinks indicated the need for modification and validation in future research.

Dataset Information

Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB).

Background

Methods

Findings

Interpretation

Publications

Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB).

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