Mirabelli Maria C, Beavers Suzanne F, Chatterjee Arjun B
Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-60, Atlanta, GA, 30341, USA,
Lung. 2014 Oct;192(5):693-700. doi: 10.1007/s00408-014-9609-2. Epub 2014 Jun 21.
Despite the considerable overlap of asthma and chronic obstructive pulmonary disease (COPD), the extent to which the two diagnoses are the manifestations of the same disease remains unresolved. We conducted these analyses to evaluate the role of active asthma in the prevalence of physician-diagnosed COPD.
From 2006 through 2010, 74,209 adults aged 18-99 years and with a history of asthma participated in the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey and responded to interview-administered questionnaires via telephone. We used publicly available data from 71,639 (97%) participants to identify respondents with and without active manifestations of asthma and self-reported, physician-diagnosed COPD. We generated population-weighted estimates of physician-diagnosed COPD prevalence and conducted linear regression to estimate associations between active asthma status and the prevalence of COPD among current smokers, former smokers, and lifetime nonsmokers separately.
Physician-diagnosed COPD was reported in an estimated 29% of the population with any history of asthma, including both active and inactive asthma. Age-specific prevalences of physician-diagnosed COPD were consistently higher among adults with active asthma than adults without active asthma. Compared to inactive asthma, active asthma was associated with an 8.3% [95% confidence interval (CI) 6.1, 10.5] higher prevalence of physician-diagnosed COPD among lifetime nonsmokers, a 20.6% (95% CI 18.0, 23.3) higher prevalence among former smokers, and a 26.7% (95% CI 22.5, 30.9) higher prevalence among current smokers.
Among adults with a history of asthma, active manifestations of asthma may play an important role in the epidemiology of COPD.
尽管哮喘与慢性阻塞性肺疾病（COPD）有相当多的重叠之处，但这两种诊断是否为同一疾病的表现，目前仍未明确。我们进行了这些分析，以评估活动性哮喘在医生诊断的COPD患病率中的作用。
2006年至2010年期间，74209名年龄在18 - 99岁且有哮喘病史的成年人参加了行为危险因素监测系统（BRFSS）哮喘回访调查，并通过电话回答了访谈式问卷。我们使用来自71639名（97%）参与者的公开数据，确定有或无哮喘活动表现以及自我报告的、医生诊断的COPD的受访者。我们生成了医生诊断的COPD患病率的人群加权估计值，并进行线性回归，分别估计当前吸烟者、既往吸烟者和终生不吸烟者中活动性哮喘状态与COPD患病率之间的关联。
据报告，在有任何哮喘病史（包括活动性和非活动性哮喘）的人群中，约29%被医生诊断为COPD。在有活动性哮喘的成年人中，医生诊断的COPD的年龄特异性患病率始终高于无活动性哮喘的成年人。与非活动性哮喘相比，活动性哮喘与终生不吸烟者中医生诊断的COPD患病率高8.3% [95%置信区间（CI）6.1, 10.5]、既往吸烟者中患病率高20.6%（95% CI 18.0, 23.3）以及当前吸烟者中患病率高26.7%（95% CI 22.5, 30.9）相关。
在有哮喘病史的成年人中，哮喘的活动表现可能在COPD的流行病学中起重要作用。
