Abstract
史洪静,蒋家诺,吕筠,陈媛媛,邵子伦,孙点剑一,李立明,余灿清.慢性阻塞性肺疾病患者体力活动水平及影响因素分析的中英比较研究[J].Chinese journal of Epidemiology,2023,44(12):1851-1857
慢性阻塞性肺疾病患者体力活动水平及影响因素分析的中英比较研究
Comparative study on physical activity and its influencing factors in patients with chronic pulmonary obstructive disease between China and the United Kingdom
Received:July 13, 2023  
DOI:10.3760/cma.j.cn112338-20230713-00429
KeyWord: 慢性阻塞性肺疾病  体力活动  影响因素  跨国比较
English Key Word: Chronic obstructive pulmonary disease  Physical activity  Influencing factors  Cross-country comparison
FundProject:国家自然科学基金(82192901,82192904,82192900);国家重点研发计划“精准医学研究”重点专项(2016YFC0900500);中国香港Kadoorie Charitable基金
Author NameAffiliationE-mail
Shi Hongjing Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Jiang Jianuo Institute of Child and Adolescent Health, Peking University/School of Public Health, Peking University, Beijing 100191, China  
Lyu Jun Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China 
 
Chen Yuanyuan Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Shao Zilun Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China  
Sun Dianjianyi Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China 
dsun1@bjmu.edu.cn 
Li Liming Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China 
 
Yu Canqing Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China 
yucanqing@pku.edu.cn 
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Abstract:
      目的 比较中英慢性阻塞性肺疾病(COPD)患者体力活动水平及影响因素差异。方法 利用中国慢性病前瞻性研究和英国生物银行基线调查数据,以一秒率(FEV1/FVC)<70%作为COPD诊断标准,以代谢当量(MET)作为体力活动水平的衡量指标并按性别、年龄分层的MET值三分位数分为低、中、高3级,分别使用多元逐步logistic回归探究体力活动水平与COPD及慢性阻塞性肺疾病全球倡议(GOLD)分级的关系,并进行亚组分析。结果 共纳入506 073名中国成年人和231 884名英国成年人为研究对象。与非COPD人群相比,中英COPD患者低水平体力活动的OR值(95%CI)分别为1.07(1.03~1.10)、1.03(1.01~1.06);GOLD分级与体力活动水平呈负相关,且在中国人群中存在线性趋势(趋势检验P<0.001)。亚组分析显示,中英人群中高龄、受教育年限少、经济水平低、过去吸烟、有呼吸系统疾病史的COPD患者体力活动水平下降的可能性更大。中国农村COPD患者体力活动下降的可能性更大。结论 COPD与体力活动水平呈负相关,且GOLD分级与体力活动水平呈剂量反应关系,应鼓励和促进COPD患者尤其高危人群多进行体力活动。
English Abstract:
      Objective To compare physical activity and its influencing factors in patients with chronic obstructive pulmonary disease (COPD) between China and the United Kingdom.Methods We analyzed baseline data from China Kadoorie Biobank and the United Kingdom Biobank among COPD patients who were diagnosed with a one-second rate (FEV1/FVC) less than 70%. Physical activity level was calculated as metabolic equivalent (MET) and divided into three levels: low, medium, and high, according to tertiles stratified by gender and age. Multiple logistic regression was used to estimate ORs and 95%CIs for COPD and Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade about physical activity level, and subgroup analysis was conducted. Results A total of 506 073 Chinese adults and 231 884 British adults were included. After adjusting for potential confounders, COPD was associated with lower physical activity levels in both Chinese and British COPD patients, with OR (95%CI) of 1.07(1.03-1.10) and 1.03(1.01-1.06) compared with non COPD patients, respectively. The GOLD grade was inversely correlated with physical activity level, particularly in a dose-response manner in the CKB population (trend test P<0.001). The negative relationship was stronger among the elderly, people with less education and lower economic status, and those with a smoking or chronic disease history. Chinese rural COPD patients were at high risk of decline of physical activity. Conclusions Physical activity is inversely related to COPD, with a dose-response connection to GOLD grade. Therefore, physical activity maintenance and improvement should be encouraged and promoted in COPD patients, especially in high-risk groups.
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