Investigation of the Prevalence and Diagnosis of Chronic Obstructive Pulmonary Disease in a Group of Elderly Individuals Residing in an Island Area of Ningbo

Prevalence of non-smoking chronic obstructive pulmonary disease and its risk factors in China: a systematic review and meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disorder in China, impacting a significant proportion of individuals aged > 40 years. In China, the prevalence of and risk factors for COPD among non-smokers remain largely unexplored. In this study, we aimed to determine the prevalence of COPD in non-smokers within the Chinese population and identify potential risk factors associated with COPD in non-smokers.

METHODS

Web of Science, PubMed, Embase, Chinese WanFang, Chinese China National Knowledge Infrastructure, and Weipu databases from inception to August 5, 2024, were searched. Studies reporting the percentage of never-smokers among those diagnosed with COPD and investigations exploring the risk factors associated with COPD in never-smokers in China were examined. Summary proportions and odds ratios (OR), along with their corresponding 95% confidence intervals (95% CI), were measured.

RESULTS

In total, 112 investigations with 491,812 participants were included. The percentage of never-smokers in people with COPD was 41.1% (95% CI: 37.5-44.6%). The prevalence of never-smokers among males diagnosed with COPD was 22.3% (95% CI: 18.8-25.7%), which differed from that among women (81.3%, 95% CI: 75.3-87.2%). The results showed an association between the utilization of biomass fuel and the occurrence of COPD in never-smokers (OR: 1.25, 95% CI: 1.06-1.44). Among never-smokers, the data showed a close association between being underweight (OR: 1.89, 95% CI: 1.78-2.00), tuberculosis history (OR: 1.71, 95% CI: 1.53-1.88) and COPD. Never-smokers living in rural areas or those with low educational status were more susceptible to COPD.

CONCLUSION

This review confirmed the highly different proportions of never-smokers among male and female patients with COPD.

TRIAL REGISTRATION

PROSPERO: CRD42023420786.

Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Users of Primary Health Care Facilities in Morocco

Background

Chronic obstructive pulmonary disease (COPD) is a major public health problem. In Morocco, few studies have focused on COPD in primary health care facilities, whose main mission is prevention. The aim of our work is thus to assess the prevalence of COPD and to study the factors associated with this silent disease among users of health care facilities in Morocco.

Methods

This is a cross-sectional observational study of participants aged 40 and over. Data were collected by questionnaire. Pulmonary function testing was conducted using a spirometer before and after administration of a bronchodilator. COPD was defined as fixed ratio of the post-bronchodilator forced expiratory volume in 1 second / forced vital capacity less than 0.7. Logistic regression models were applied to define factors associated with COPD.

Results

From 550 participants aged 40 and over, we selected only 477 patients with exploitable spirometry results for inclusion in the final analysis. The mean age of participants was 54.91±11.92 years, and the female/male ratio was 1.59. The prevalence of COPD was 6.7% (95% CI; 4.6 to 9.3%), and was higher in men than in women (11.4% vs 3.8%, p=0.002). The prevalence of COPD increased significantly with age, from 3.3% in those aged 40 to 49 to 16.9% in those aged 70 and over (p=0.001). Current smokers had a higher prevalence of COPD than former and never smokers. Age, smoking, asthma diagnosis and childhood hospitalization for lung disease were risk factors associated with the development of COPD. Only 6.25% of participants identified as having COPD had previously been diagnosed with COPD.

Conclusion

COPD remains largely under-diagnosed among primary care consultants in Morocco. Efforts for early detection and promotion of prevention of the main risk factors need to be intensified in order to reduce the burden of this silent pathology on a national scale.

Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a major public health problem. The present study aims to provide a global and regional estimate of the prevalence of COPD based on spirometry according to the two most widely used diagnostic criteria of COPD: fixed ratio (FR) and lower limit of normal (LLN).

METHODS

We conducted a systematic review of the literature according to PRISMA guidelines. MEDLINE, Web of Sciences, and Scopus databases were searched to identify studies on the spirometry-based prevalence of COPD in individuals aged 40 years and older. The meta-analysis was performed using MedCalc 19 software.

RESULTS

In total, 42 of the 3393 studies reviewed were eligible for inclusion. The overall prevalence of COPD in people aged 40 years and older was 12.64% (95% CI 10.75%-14.65%) and 7.38% (95% CI 5.47% - 9.55%) based on FR and LLN criteria, respectively. By gender, men had a higher prevalence of COPD compared to women (15.47%; 95% CI 12.22%-19.02% for men versus 8.79%; 95% CI 6.94%-10.82% for women). Using the LLN criteria, the prevalence of COPD in both sexes was almost identical (8.67%; 95% CI 8.44%- 8.90% for men and 8.00%; 95% CI 6.42% - 9.73% for women). We reported a high prevalence of COPD among smokers and the elderly by both definitions of airway obstruction. Regional prevalence estimates using the FR definition indicate that the highest COPD prevalence was recorded in the Americas and the lowest was recorded in the Eastern Mediterranean region. Using the LLN definition, the highest prevalence was recorded in the Southeast Asian region and the lowest prevalence was recorded in the American region. The most common COPD stage was stage II, with a prevalence of 50.46%. The results indicate a huge lack of prevalence data in the African and Eastern Mediterranean region. The results were given using a random-effect model due to the high heterogeneity between studies.

CONCLUSION

Results show that the prevalence of COPD differs according to the diagnostic criteria used. In addition, management and prevention strategies targeting risk factors for COPD are certainly needed to reduce the global burden of this chronic respiratory disease.

Serum lactate dehydrogenase is associated with impaired lung function: NHANES 2011-2012

BACKGROUND

Serum lactate dehydrogenase levels reflect disease status in a variety of organs, but its role in indicating pulmonary function is not yet clear. Therefore, this study explored the correlation between pulmonary function and serum lactate dehydrogenase, and investigated thresholds for changes in pulmonary function indicators in the total population as well as in different strata of the population.

METHODS

Based on data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 (n = 3453), univariate and stratified analyses were performed to investigate factors associated with pulmonary function, and multiple regression analysis was used to further investigate the specific relationship with serum lactate dehydrogenase. Smoothed curve fitting, threshold effect and saturation effect analysis were used to explore the threshold level of serum lactate dehydrogenase at the onset of changes in pulmonary function indicators.

RESULTS

Adjusted smoothed curve fit plots showed a linear relationship between serum lactate dehydrogenase levels and forced vital capacity and forced expiratory volume in one second: for each 1 U/L increase in serum lactate dehydrogenase levels, forced vital capacity decreased by 1.24 mL (95% CI = -2.05, -0.42, P = 0.0030) and forced expiratory volume in one second by 1.11 mL (95% CI = -1.82, -0.39, P = 0.0025).

CONCLUSIONS

Serum lactate dehydrogenase was negatively and linearly correlated with pulmonary function indices in the total population analyzed. Based on the total population and different population stratifications, this study determined the threshold values of serum lactate dehydrogenase at the onset of decline of pulmonary function in different populations. This provides a new serological monitoring indicator for patients suffering from respiratory diseases and has implications for patients with possible clinical impairment of pulmonary function. However, our cross-sectional study was not able to determine a causal relationship between these two factors, and further research is needed.

A population-based survey of the prevalence and risk factors of chronic obstructive pulmonary disease in Shanxi Province, China

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease which can cause organ damage and even death. For the first time, the prevalence and risk factors of COPD in Shanxi Province (China) were evaluated in this study.

METHODS

A population-based survey was conducted in 2015 based on the Shanxi Province population (age ≥ 20). COPD was diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard (2017).

RESULTS

A total of 5636 participants with reliable post-bronchodilator results were selected. The prevalence of spirometry-defined COPD among the population (age ≥ 20) was 6.4% (95% CI 5.8-7.1) and was more prevalent in men (9.7%, 95% CI 8.6-10.9) than women (3.9%, 95% CI 3.2-4.6). The multivariate-adjusted analysis demonstrated that sex, age, education, smoking, chronic cough during childhood (age ≤ 14), and a family history of parents with respiratory diseases were related to the prevalence of COPD risk. On the contrary, among rural residents living with smokers, a history of pneumonia or bronchitis during childhood, BMI, use of biomass energy, prolonged exposure to particulate matter 2.5, and a family history of parents with respiratory diseases did not show a significant correlation to COPD.

CONCLUSIONS

We have identified a high prevalence of COPD and its determinants in Shanxi province. The prevention of COPD and its early detection is a health priority in this province.