Park So Young, Kim Jung Hyun, Kim Hyo Jung, Seo Bomi, Kwon Oh Young, Chang Hun Soo, Kwon Hyouk Soo, Kim Tae Bum, Kim Ho, Park Choon Sik, Moon Hee Bom, Cho You Sook
Department of Allergy and Respiratory Medicine, Konkuk University Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Allergy Asthma Immunol Res. 2018 Jul;10(4):387-396. doi: 10.4168/aair.2018.10.4.387.
The prevalence and burden of asthma is increasing worldwide. In this study, we analyzed 3 different Korean national health survey datasets to determine the general features of adult asthma in Korea and to obtain basic information that would support future strategies for better management of adult asthma.
The surveys used in this study included the Korea National Health and Nutrition Examination Survey (KNHANES), Korea Community Health Survey (KCHS) and National Health Insurance Service-National Sample Cohort (NHIS-NSC). We investigated annual asthma prevalence, evaluating the rate and risk factors of asthma exacerbation by age and sex, and clinical data of 1,832 patients with asthma who were registered in the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) were analyzed to elucidate risk factors for asthma exacerbation. We also analyzed another asthma cohort and added it as replication data.
In the KNHANES database, annual asthma prevalence rates varied from 1.2% to 3.1%. In the KCHS database, overall prevalence increased, with significant regional differences (1.6%-2.1%). The NHIS-NSC indicated a gradual increase in annual asthma prevalence from 4.5% to 6.2%. Interestingly, all 3 surveys indicated the highest prevalence of asthma among elderly women. In addition, elderly women with asthma had a significantly higher risk of asthma exacerbation (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.19-2.93; P=0.006). Approximately 11% of patients were classified as having severe asthma. An asthma cohort analysis identified female sex, low baseline pulmonary function, longer treatment duration, high variability in pulmonary function and significant changes in Asthma Control Test scores as risk factors for asthma exacerbation.
The prevalence of asthma in Korea is consistently high among elderly and female populations. These results should lay the foundation for strategies for effective asthma prevention and management; elderly female patients with asthma should receive particular attention.
全球哮喘的患病率和负担正在上升。在本研究中，我们分析了3个不同的韩国国民健康调查数据集，以确定韩国成人哮喘的一般特征，并获取有助于未来更好管理成人哮喘策略的基础信息。
本研究使用的调查包括韩国国民健康与营养检查调查（KNHANES）、韩国社区健康调查（KCHS）和国家健康保险服务-全国样本队列（NHIS-NSC）。我们调查了年度哮喘患病率，按年龄和性别评估哮喘加重的发生率和危险因素，并分析了韩国成人哮喘实际情况与演变队列（COREA）中登记的1832例哮喘患者的临床数据，以阐明哮喘加重的危险因素。我们还分析了另一个哮喘队列并将其作为重复数据添加。
在KNHANES数据库中，年度哮喘患病率从1.2%到3.1%不等。在KCHS数据库中，总体患病率上升，存在显著的地区差异（1.6%-2.1%）。NHIS-NSC显示年度哮喘患病率从4.5%逐渐上升至6.2%。有趣的是，所有3项调查均表明老年女性哮喘患病率最高。此外，老年哮喘女性哮喘加重的风险显著更高（优势比[OR]，1.87；95%置信区间[CI]，1.19-2.93；P=0.006）。约11%的患者被归类为重度哮喘。一项哮喘队列分析确定女性、低基线肺功能、较长治疗时间、肺功能高变异性以及哮喘控制测试分数的显著变化为哮喘加重的危险因素。
韩国老年和女性人群中哮喘患病率持续较高。这些结果应为有效的哮喘预防和管理策略奠定基础；老年哮喘女性患者应受到特别关注。
