Epidemiology, Biostatistics and Prevention Institute, and.
Department of Mathematics, University of Zurich, Zurich, Switzerland.
Ann Am Thorac Soc. 2020 Apr;17(4):457-465. doi: 10.1513/AnnalsATS.201907-542OC.
Most studies determining the prevalence of airway obstruction are limited to short time periods. Because temporal trends of obstruction in populations are largely unknown, we determined the prevalence of airway obstruction over 20 years in yearly general population samples in Switzerland between 1993 and 2012. We analyzed data of 85,789 participants aged 35 years and older who provided spirometric measurements as part of the LuftiBus lung function campaign. We linked data from the 2003-2012 period to the Swiss National Cohort to adjust for annual population differences. Spirometry was performed without bronchodilation, according to American Thoracic Society guidelines. We used Global Lung Initiative (GLI) and Hankinson reference equations to identify obstruction. Obstruction prevalence increased between 1993 and 2012 from 6.1% (95% confidence interval [CI], 5.5 to 6.7) to 15.6% (95% CI, 13.8 to 17.3) based on GLI estimates and from 5.3% (95% CI, 4.7 to 5.9) to 15.4% (95% CI, 13.6 to 17.1) based on Hankinson estimates. When adjusted for participant demographics, air pollutant and occupational exposures, altitude, and season, the prevalence ratios of obstruction were 1.54 (95% CI, 1.22 to 1.93) and 1.65 (95% CI, 1.33 to 2.04) for GLI- and Hankinson-defined airway obstruction, respectively, for 2012 compared with 2003. Though prebronchodilator measurements likely overestimate the prevalence of airway obstruction in absolute terms compared with post-bronchodilator measurements, we found an increase in airway obstruction prevalence. Even with adjustment for several well-known risk factors for obstruction to make the populations across the years more comparable, we still saw a statistically significant increase in prevalence over this time period.
大多数确定气道阻塞患病率的研究都仅限于短期。由于人群中阻塞的时间趋势在很大程度上是未知的，我们在 1993 年至 2012 年间，在瑞士每年的一般人群样本中确定了 20 多年来气道阻塞的患病率。我们分析了作为 LuftiBus 肺功能运动一部分提供肺活量测定的 85789 名年龄在 35 岁及以上的参与者的数据。我们将 2003-2012 年期间的数据与瑞士国家队列相关联，以调整每年的人口差异。肺活量测定是根据美国胸科学会指南，在未使用支气管扩张剂的情况下进行的。我们使用全球肺倡议（GLI）和汉金森参考方程来确定阻塞。根据 GLI 估计，1993 年至 2012 年，阻塞的患病率从 6.1%（95%置信区间[CI]，5.5 至 6.7）增加到 15.6%（95% CI，13.8 至 17.3），根据汉金森的估计，从 5.3%（95% CI，4.7 至 5.9）增加到 15.4%（95% CI，13.6 至 17.1）。根据参与者人口统计学数据、空气污染物和职业暴露、海拔和季节进行调整后，GLI 和汉金森定义的气道阻塞的患病率比分别为 1.54（95%CI，1.22 至 1.93）和 1.65（95%CI，1.33 至 2.04）。尽管与支气管扩张剂后测量相比，预支气管扩张剂测量可能会高估气道阻塞的绝对患病率，但我们发现气道阻塞的患病率有所增加。即使考虑到几个已知的阻塞危险因素来使多年来的人群更具可比性，我们仍然看到在此期间患病率呈统计学显著上升。
