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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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:AimsTo assess the associations of problem drinking with wellbeing and mortality in Chinese men.DesignPopulation-based prospective cohort study.SettingTen diverse areas across China.ParticipantsA total of 210 259 men aged 30-79 years enrolled into China Kadoorie Biobank between 2004 and 2008.MeasurementsSelf-reported alcohol intake and indicators of problem drinking (i.e. drinking in the morning, unable to stop drinking, unable to work due to drinking, negative emotions after drinking, having shakes after stopping drinking) were assessed by questionnaire at baseline, along with stressful life events (e.g. divorce, income loss, violence) and wellbeing-related measures (e.g. life satisfaction, sleep problems, depression, anxiety). Problem drinking was defined as reporting at least one of the drinking problem indicators. Follow-up for mortality and hospitalized events was through linkage to death registries and national health insurance systems. Multivariate logistic regression models assessed cross-sectional relationships between problem drinking and stressful life events/wellbeing. Cox proportional hazards regression models estimated prospective associations of problem drinking with mortality/hospitalized events.FindingsA third of men were current regular drinkers (i.e. drank alcohol at least weekly), 24% of whom reported problem drinking: 8% of all men. Experience of stressful life events in the past 2 years, especially income loss [odds ratio (OR) = 1.86, 95% confidence interval (CI) = 1.45-2.39], was associated with increased problem drinking. Compared with low-risk drinkers (i.e. intake < 200 g/week, no reported problem drinking or habitual heavy drinking episodes), men with problem drinking had poorer self-reported health, poorer life satisfaction and sleep problems, and were more likely to have symptoms of depression and anxiety. Men with two or more problem drinking indicators had an approximately twofold higher risk for all-cause mortality as well as mortality and morbidity from external causes (i.e. injuries), respectively, and 15% higher risk for any hospitalization, compared with low-risk drinkers (all P < 0.01).ConclusionEight per cent of men in China are problem drinkers, and this is associated with significantly increased risk of physical and mental health problems and premature death.

Project description:BackgroundIn China, alcohol consumption has increased significantly in recent decades. Little evidence exists, however, about temporal trends in levels and patterns of alcohol consumption and associated factors in adult populations.MethodsIn 2004-08, the China Kadoorie Biobank recruited ~ 512,000 adults (41% men, mean age 52 years [SD 10.7]) from 10 (5 urban, 5 rural) geographically diverse regions across China, with ~ 25,000 randomly selected participants resurveyed in 2013-14. The self-reported prevalence and patterns (e.g., amount, beverage type, heavy drinking episodes) of alcohol drinking at baseline and resurvey were compared and related to socio-demographic, health and other factors.ResultsAt baseline, 33% of men drank alcohol at least weekly (i.e., current regular), compared to only 2% of women. In men, current regular drinking was more common in urban (38%) than in rural (29%) areas at baseline. Among men, the proportion of current regular drinkers slightly decreased at resurvey (33% baseline vs. 29% resurvey), while the proportion of ex-regular drinkers slightly increased (4% vs. 6%), particularly among older men, with more than half of ex-regular drinkers stopping for health reasons. Among current regular drinkers, the proportion engaging in heavy episodic drinking (i.e., > 60 g/session) increased (30% baseline vs. 35% resurvey) in both rural (29% vs. 33%) and urban (31% vs. 36%) areas, particularly among younger men born in the 1970s (41% vs. 47%). Alcohol intake involved primarily spirits, at both baseline and resurvey. Those engaging in heavy drinking episodes tended to have multiple other health-related risk factors (e.g., regular smoking, low fruit intake, low physical activity and hypertension).ConclusionsAmong Chinese men, the proportion of drinkers engaging in harmful drinking behaviours increased in the past decade, particularly among younger men. Harmful drinking patterns tended to cluster with other unhealthy lifestyles and health-related risk factors.

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).

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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