Abstract
杨梦诗,范习康,苏健,俞浩,陆艳,华钰洁,裴培,吕筠,陶然,周金意,武鸣.苏州队列人群慢性阻塞性肺疾病发病状况及其危险因素研究[J].Chinese journal of Epidemiology,2023,44(6):868-876
苏州队列人群慢性阻塞性肺疾病发病状况及其危险因素研究
Incidence of chronic obstructive pulmonary disease and risk factors in the Suzhou cohort
Received:December 02, 2022  
DOI:10.3760/cma.j.cn112338-20221202-01033
KeyWord: 慢性阻塞性肺疾病  危险因素  前瞻性研究
English Key Word: Chronic obstructive pulmonary disease  Risk factor  Prospective study
FundProject:国家自然科学基金(82192900,81390540,91846303);国家重点研发计划(2016YFC0900500);中国香港Kadoorie Charitable基金;英国Wellcome Trust (202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z);江苏省科技厅社会发展重点项目(BE2019674);苏州市姑苏卫生人才计划培养项目(GSWS2020098)
Author NameAffiliationE-mail
Yang Mengshi Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China  
Fan Xikang Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Su Jian Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Yu Hao Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Lu Yan Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China  
Hua Yujie Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China  
Pei Pei Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China  
Lyu Jun Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China 
 
Tao Ran Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Zhou Jinyi Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Wu Ming Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China 
jswuming@vip.sina.com 
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Abstract:
      目的 了解苏州队列人群慢性阻塞性肺疾病(COPD)的发病状况及人群分布特征,探索其发病的危险因素,为防控COPD提供科学依据。方法 基于中国慢性病前瞻性研究苏州市吴中区项目点数据,剔除基线气流受限及基线调查时自报患有慢性支气管炎/肺气肿/肺心病的个体后,最终纳入分析45 484人。采用Cox比例风险回归模型筛选影响队列人群COPD发病的危险因素并计算风险比(HR)及其95%可信区间(CI),同时分析吸烟在其他危险因素与COPD发病关联中是否存在效应修饰作用。结果 截至2017年12月31日,研究对象中位随访时间为11.12年,随访期间共诊断COPD 524人,COPD的发病密度为105.54/10万人年。多因素Cox比例风险回归分析显示,年龄(HR=3.78,95%CI:3.32~4.30)、曾经吸烟(HR=2.00,95%CI:1.24~3.22)、当前吸烟(<10支/d,HR=2.14,95%CI:1.36~3.35;≥10支/d,HR=2.69,95%CI:1.60~4.54)、有呼吸系统疾病史(HR=2.08,95%CI:1.33~3.26)、每日睡眠时间过长(HR=1.41,95%CI:1.02~1.95)与COPD发病风险增加相关;文化程度为小学及以上(小学/初中,HR=0.65,95%CI:0.52~0.81;高中及以上,HR=0.54,95%CI:0.33~0.87)、每日食用新鲜水果(HR=0.59,95%CI:0.42~0.83)、每周吃辣食(HR=0.71,95%CI:0.53~0.94)与COPD发病风险降低相关。结论 苏州队列人群COPD发病密度处于较低水平,高龄、吸烟、有呼吸系统疾病史、每日睡眠时间过长是苏州队列人群COPD发病的危险因素。
English Abstract:
      Objective To understand the incidence of chronic obstructive pulmonary disease (COPD) in the Suzhou cohort, and explore the risk factors for the development of COPD in Suzhou, and provide a scientific basis for COPD prevention. Methods This study was based on the China Kadoorie Biobank project in Wuzhong District, Suzhou. After excluding individuals with airflow obstruction and self-reported chronic bronchitis, emphysema, or pulmonary heart disease at baseline, 45 484 individuals were finally included in the analysis. Cox proportional risk models were used to analyze risk factors of COPD and calculate hazard ratios and 95% confidence interval (CI) in the Suzhou cohort. The effect modifications of smoking on the association between other risk factors and COPD were evaluated. Results Complete follow-up was available through December 31, 2017. Participants were followed up for a median of 11.12 years, and 524 individuals were diagnosed with COPD during the follow-up period; the incidence was 105.54 per 100 000 person-years. Multivariate Cox proportional risk regression models showed that age (HR=3.78, 95%CI:3.32-4.30), former smoking (HR=2.00, 95%CI:1.24-3.22), current smoking (<10 cigarettes/day, HR=2.14, 95%CI:1.36-3.35;≥10 cigarettes/day, HR=2.69, 95%CI:1.60-4.54), history of respiratory disease (HR=2.08, 95%CI:1.33-3.26), daily sleep duration ≥10 hours (HR=1.41, 95%CI:1.02-1.95) were associated with increased risk of COPD. However, education level of primary school and above (primary or junior high school, HR=0.65, 95%CI:0.52-0.81; high school and above, HR=0.54, 95%CI:0.33-0.87), consuming fresh fruit daily (HR=0.59, 95%CI:0.42-0.83) and consuming spicy food weekly (HR=0.71, 95%CI:0.53-0.94) were associated with reduced risk of COPD. Conclusions The incidence of COPD is low in Suzhou. Older age, smoking, history of respiratory disease, and long sleep duration were risk factors for the development of COPD in the Suzhou cohort.
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