Yang Bumhee, Jang Hyo Jun, Chung Sung Jun, Yoo Seung-Jin, Kim Taehee, Kim Sun-Hyung, Shin Yoon Mi, Kang Hyung Koo, Kim Jung Soo, Choi Hayoung, Lee Hyun
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Thoracic and Cardiovascular Surgery, Hanyang University College of Medicine, Seoul, Korea.
Ann Transl Med. 2020 Nov;8(21):1350. doi: 10.21037/atm-20-4873.
Many important clinical features of bronchiectasis have been reported. However, the factors were evaluated using a specific disease cohort. Thus, clinical factors associated with bronchiectasis have not been well assessed in comparison to the general population. The aim of this study was to evaluate the factors associated with bronchiectasis using a national representative database.
We conducted a cross-sectional study using data from the Korean National Health and Nutrition Examination Survey 2007-2009. To evaluate factors associated with bronchiectasis, a multivariable logistic analysis was used with adjustment for demographic and socioeconomic factors.
In the present study, the prevalence of bronchiectasis was 0.4%. Compared with subjects without bronchiectasis, subjects with bronchiectasis were older (55.1 44.4 years, P<0.001) and had lower body mass index (BMI) (23.2 24.2 kg/m, P<0.001). The proportions of low family income (70.5% 40.2%, P<0.001) and low educational level (less than high school) (85.3% 70.6%, P=0.041) were higher in subjects with bronchiectasis than in subjects without bronchiectasis. Regarding comorbidities, subjects with bronchiectasis were more likely to have asthma (17.8% 2.9%, P<0.001), previous history of pulmonary tuberculosis (TB) (43.5% 5.0%, P<0.001), osteoporosis (19.1% 7.8%, P=0.002), and depression (9.3% 3.0%, P=0.015) compared with subjects without bronchiectasis. In addition, subjects with bronchiectasis had more respiratory symptoms and poorer quality of life measured using the EuroQoL five dimensions questionnaire (EQ-5D) index (0.87 0.93, P<0.001) than subjects without bronchiectasis. In multivariable logistic regression analysis, low family income (adjusted odds ratio, OR =3.83, 95% confidence interval, CI: 1.46-10.03), asthma (adjusted OR =3.73, 95% CI: 1.29-10.79), pulmonary TB (adjusted OR =7.88, 95% CI: 2.65-23.39), and the presence of airflow limitation (adjusted OR =2.98, 95% CI: 1.01-8.98) were independently associated with bronchiectasis.
Subjects with bronchiectasis suffered from more respiratory symptoms with limited physical activity and poorer quality of life than the general population. Factors independently associated with bronchiectasis were lower family income and comorbid pulmonary conditions, such as previous pulmonary TB, asthma, and airflow limitation.
支气管扩张的许多重要临床特征已被报道。然而，这些因素是通过特定疾病队列进行评估的。因此，与一般人群相比，支气管扩张相关的临床因素尚未得到充分评估。本研究的目的是使用全国代表性数据库评估支气管扩张相关因素。
我们利用2007 - 2009年韩国国家健康与营养检查调查的数据进行了一项横断面研究。为评估支气管扩张相关因素，采用多变量逻辑分析，并对人口统计学和社会经济因素进行了调整。
在本研究中，支气管扩张的患病率为0.4%。与无支气管扩张的受试者相比，支气管扩张患者年龄更大（55.1岁对44.4岁，P<0.001），体重指数（BMI）更低（23.2对24.2kg/m²，P<0.001）。支气管扩张患者中低家庭收入（70.5%对40.2%，P<0.001）和低教育水平（高中以下）（85.3%对70.6%，P = 0.041）的比例高于无支气管扩张的受试者。关于合并症，与无支气管扩张的受试者相比，支气管扩张患者更易患哮喘（17.8%对2.9%，P<0.001）、既往肺结核（TB）病史（43.5%对5.0%，P<0.001）、骨质疏松（19.1%对7.8%，P = 0.002）和抑郁症（9.3%对3.0%，P = 0.015）。此外，与无支气管扩张的受试者相比，支气管扩张患者有更多的呼吸道症状，且使用欧洲五维健康量表（EQ - 5D）指数测量的生活质量更差（0.87对0.93，P<0.001）。在多变量逻辑回归分析中，低家庭收入（调整后的优势比，OR = 3.83，95%置信区间，CI：1.46 - 10.03）、哮喘（调整后的OR = 3.73，95%CI：1.29 - 10.79）、肺结核（调整后的OR = 7.88，95%CI：2.6—— 23.39）和气流受限的存在（调整后的OR = 2.98，95%CI：1.01 - 8.98）与支气管扩张独立相关。
与一般人群相比，支气管扩张患者有更多的呼吸道症状，身体活动受限，生活质量更差。与支气管扩张独立相关的因素是家庭收入较低以及合并肺部疾病，如既往肺结核、哮喘和气流受限。
