Dataset Information

Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey.

ABSTRACT: BACKGROUND:The prevalence of chronic obstructive pulmonary disease (COPD) in Anhui Province of eastern China remain uncertain. The present study provides the first estimate of the prevalence and risk factors of COPD in Anhui. METHODS:A population-based survey was conducted in a representative sample of population aged 40?years or older in 2015. COPD was diagnosed based on 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. RESULTS:A total of 2770 participants had reliable post-bronchodilator results and were included in the final analysis. The overall prevalence of COPD was 9.8% (95% CI: 8.2, 11.7). Prevalence was higher in men (14.8, 95% CI: 12.6, 17.2) than it was in women (5.2, 95% CI: 3.1, 8.7). Among adults with COPD, 45.0% (95% CI: 39.1, 51.0) had moderate or severe disease (GOLD stage II-IV), 0.7% (95% CI: 0.2, 2.9) reported that they had a previous pulmonary function test, and only 0.4% (95% CI: 0.1, 2.6) knew their diagnosis of COPD. Risk factors for COPD included older age (OR 1.06, 95% CI: 1.04, 1.08), male sex (OR 2.01, 95% CI: 1.22, 3.33), current smoking status (OR 2.63, 95% CI: 1.86, 3.73), primary school or lower education (OR 1.61, 95% CI: 1.12, 2.31), family history of lung disease (OR 1.50, 95% CI: 1.17, 1.93), and indoor exposure to coal for cooking or heating (OR 1.55, 95% CI: 1.11, 2.15). In addition, people in north region has a significantly higher risk for developing COPD than people in south region of Anhui (OR 1.98, 95% CI:1.44, 2.71). CONCLUSIONS:COPD is prevalent in Anhui and the prevalence is highest in north region. Strategies aiming at prevention, early detection and treatment of COPD are urgently needed to reduce COPD-related burden.

SUBMITTER: Zha Z

PROVIDER: S-EPMC6542059 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey.

Zha Zhenqiu Z Leng Ruixue R Xu Wei W Bao Heling H Chen Yeji Y Fang Liwen L Liu Zhirong Z Ye Dongqing D Ye Dongqing D

BMC pulmonary medicine 20190529 1

<h4>Background</h4>The prevalence of chronic obstructive pulmonary disease (COPD) in Anhui Province of eastern China remain uncertain. The present study provides the first estimate of the prevalence and risk factors of COPD in Anhui.<h4>Methods</h4>A population-based survey was conducted in a representative sample of population aged 40 years or older in 2015. COPD was diagnosed based on 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.<h4>Results</h4>A total of 2770 pa ...[more]

PMID: 31142295

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Project description:BackgroundChronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD.MethodsA cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.ResultsThe mean age of the 2421 participants was 56.63 ± 9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%-13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43-0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49-0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index.ConclusionsEducation, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.

Project description:BackgroundSecondary polycythemia is associated with cigarette smoking and chronic obstructive pulmonary disease (COPD). However, the prevalence of polycythemia in COPD and the contributing risk factors for polycythemia in COPD have not been extensively studied.MethodsWe analyzed the presence of secondary polycythemia in current and former smokers with moderate to very severe COPD at the five-year follow-up visit in the observational COPDGene study. We used logistic regression to evaluate the association of polycythemia with age, sex, race, altitude, current smoking status, spirometry, diffusing capacity for carbon monoxide (DLCO), quantitative chest CT measurements (including emphysema, airway wall thickness, and pulmonary artery to aorta diameter ratio), resting hypoxemia, exercise-induced hypoxemia, and long-term oxygen therapy.ResultsIn a total of 1928 COPDGene participants with moderate to very severe COPD, secondary polycythemia was found in 97 (9.2%) male and 31 (3.5%) female participants. In a multivariable logistic model, severe resting hypoxemia (OR 3.50, 95% CI 1.41-8.66), impaired DLCO (OR 1.28 for each 10-percent decrease in DLCO % predicted, CI 1.09-1.49), male sex (OR 3.60, CI 2.20-5.90), non-Hispanic white race (OR 3.33, CI 1.71-6.50), current smoking (OR 2.55, CI 1.49-4.38), and enrollment in the Denver clinical center (OR 4.42, CI 2.38-8.21) were associated with higher risk for polycythemia. In addition, continuous (OR 0.13, CI 0.05-0.35) and nocturnal (OR 0.46, CI 0.21-0.97) supplemental oxygen were associated with lower risk for polycythemia. Results were similar after excluding participants with anemia and participants enrolled at the Denver clinical center.ConclusionsIn a large cohort of individuals with moderate to very severe COPD, male sex, current smoking, enrollment at the Denver clinical center, impaired DLCO, and severe hypoxemia were associated with increased risk for secondary polycythemia. Continuous or nocturnal supplemental oxygen use were associated with decreased risk for polycythemia.

Project description:Chronic obstructive pulmonary disease (COPD) is set to become the third most frequent cause of death and also the third largest cause of global morbidity by 2020. In China, where the population is aging rapidly, COPD has become one of the leading causes of disability and a large economic burden. An epidemiological assessment of the COPD in China is required, with a focus on the number of cases living with disease, main determinants of the disease and time trends.We systematically searched large Chinese bibliographic databases and English databases to identify spirometry-based epidemiological studies of the prevalence of COPD in China diagnosed according to GOLD criteria. We estimated age- and gender-specific prevalence of COPD using a multilevel mixed-effect logistic regression. We also presented the time trends of COPD between 1990 and 2010 by age, gender and setting (urban vs rural).In 1990, the prevalence of COPD ranged from 0.49% (95% CI?=?0.29-0.85) in <20 years group to 20.95% (95% CI?=?14.04-27.04) in>?=?80 years group, and the crude prevalence for China was 2.70% (95% CI?=?1.86-3.51). In 2010, the prevalence in <20 years was 0.55% (95% CI?=?0.37-1.04) and in>?=?80 years was 22.89% (95% CI?=?18.13-28.96), with the crude prevalence for China of 3.84% (95% CI?=?3.30-4.77). The COPD prevalence in males was about two-fold higher than in females, and it increased with increasing age. Between 1990-2010, the total number of Chinese people living with COPD increased by 66.73%, from 30.90 million (95% CI?=?21.28-40.02) in 1990 to 51.52 million (95% CI?=?44.26-63.93) in 2010. This increase was most striking in middle age, and greater in females than in males from 30 years up to 64 years. Our estimates, which used an independent approach to acquiring data and development of analytical methods, and were based on a more complete data set, are remarkably similar to those produced recently by the GBD 2013 collaboration, differing by only about 5% in the estimated number of COPD cases in 1990 and by 1% in 2010.COPD is a highly prevalent disease in China and its importance is growing steadily. The number of people living with COPD has increased substantially between 1990 and 2010. COPD is more frequent in males and in rural areas. Optimised primary and secondary prevention and treatment is urgently needed to counter this growing trend. Improved epidemiological studies will be required to assist development of more effective strategies of prevention and treatment of COPD in China in the next decade and beyond.

Dataset Information

Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey.

Publications

Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey.

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