Department of Clinical Biochemistry.
The Copenhagen General Population Study, and.
Am J Respir Crit Care Med. 2020 Mar 15;201(6):671-680. doi: 10.1164/rccm.201908-1644OC.
Identification of younger adults at high risk of developing chronic obstructive pulmonary disease (COPD) could lead to implementation of preventive measures before disease onset and halt progression. To investigate the prevalence, characteristics, and prognosis of individuals with early COPD in the general population. We investigated 105,630 randomly chosen adults from a Danish contemporary population-based cohort. Early COPD was defined as FEV/FVC less than the lower limit of normal in individuals under 50 years of age with 10 pack-years or greater of tobacco consumption. Among 8,064 individuals under 50 years of age with 10 pack-years or greater of tobacco consumption, 1,175 (15%) had early COPD, of whom 58% were current smokers. Individuals with early COPD more often had chronic respiratory symptoms, severe lung function impairment, asthma, and a history with bronchitis/pneumonia. During the 14.4-year follow-up, we observed 117 acute hospitalizations with obstructive lung disease, 227 acute hospitalizations with pneumonia, and 185 deaths among the 8,064 younger adults. Compared with individuals without COPD, those with early COPD had multivariable adjusted hazard ratios of 6.42 (95% confidence interval, 3.39-12.2) for acute obstructive lung disease hospitalizations, 2.03 (1.43-2.88) for acute pneumonia hospitalizations, and 1.79 (1.28-2.52) for all-cause mortality. Among individuals under 50 years of age and 10 pack-years or greater of tobacco consumption from the general population, 15% fulfill criteria of early COPD. Individuals with early COPD more often have chronic respiratory symptoms and severe lung function impairment, and an increased risk of acute respiratory hospitalizations and early death.
在一般人群中，识别有发展为慢性阻塞性肺疾病（COPD）风险的年轻人可能会导致在疾病发作前实施预防措施，并阻止其进展。本研究旨在调查一般人群中早期 COPD 患者的患病率、特征和预后。我们调查了来自丹麦当代人群为基础的队列中的 105630 名随机成年人。将年龄在 50 岁以下且有 10 包年吸烟史的个体中，FEV/FVC 低于正常值下限定义为早期 COPD。在 8064 名年龄在 50 岁以下且有 10 包年吸烟史的个体中，有 1175 名（15%）患有早期 COPD，其中 58%为当前吸烟者。早期 COPD 患者更常出现慢性呼吸道症状、严重的肺功能损害、哮喘和支气管炎/肺炎病史。在 14.4 年的随访期间，我们观察到在 8064 名年轻成年人中，有 117 例因阻塞性肺病急性住院，227 例因肺炎急性住院，185 例死亡。与无 COPD 患者相比，患有早期 COPD 的患者因急性阻塞性肺病住院的多变量校正风险比为 6.42（95%置信区间，3.39-12.2），因急性肺炎住院的风险比为 2.03（1.43-2.88），全因死亡率的风险比为 1.79（1.28-2.52）。在一般人群中年龄在 50 岁以下且有 10 包年吸烟史的个体中，15%符合早期 COPD 的标准。早期 COPD 患者常伴有慢性呼吸道症状和严重的肺功能损害，且发生急性呼吸道住院和早期死亡的风险增加。
