Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Division of Respiratory Medicine, Department of Medical Oncology and Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan.
Respir Res. 2021 Jan 6;22(1):6. doi: 10.1186/s12931-020-01601-y.
Chronic sputum production in the general population is historically associated with clinical indices including male sex and smoking history. However, its relationship with gastroesophageal reflux disease (GERD), which may prove an underlying factor in sputum production, is unclear. We aimed to clarify factors associated with sputum production in the general population in cross-sectional and longitudinal manners.
In the Nagahama study, a community-based cohort study, 9804 subjects were recruited between 2008 and 2010 (baseline assessment), 8293 of whom were followed from 2013 to 2015 (follow-up assessment). This study contained a self-completed questionnaire which included medical history, assessment of sputum production, and a frequency scale for symptoms of GERD. A Frequency Scale for Symptoms of Gastroesophageal Reflux Disease score of ≥ 8 was defined as GERD. In addition to the frequency of sputum production at each assessment, frequency of persistent sputum production defined as sputum production at both assessments was examined.
Frequency of sputum production was 32.0% at baseline and 34.5% at follow-up. Multivariable analysis demonstrated that sputum production at baseline was significantly associated with GERD [odds ratio (OR), 1.92; 95% confidence interval (CI) 1.73-2.13] and post-nasal drip (PND) (OR, 2.40; 95% CI 2.15-2.68), independent of other known factors such as older age, male sex and smoking history. These associations between sputum production and GERD or PND were also observed at follow-up. In longitudinal analysis, 19.4% had persistent sputum production and 12.3% had transient sputum production, i.e., at baseline only. Multivariable analysis for risk of persistence of sputum production revealed that persistent sputum production was associated with GERD and PND, in addition to the known risk factors listed above. The proportion of subjects with GERD at both assessments was highest among subjects with persistent sputum production.
Cross-sectional and longitudinal analysis demonstrated an association in the general population between sputum production and GERD, as well as PND, independent of known risk factors. The presence of GERD should be assessed in patients complaining of sputum production.
在一般人群中，慢性咳痰与包括男性性别和吸烟史在内的临床指标历史上有关。然而，它与胃食管反流病（GERD）的关系尚不清楚，而 GERD 可能是咳痰的潜在因素。我们旨在以横断面和纵向方式阐明一般人群中与咳痰有关的因素。
在长滨研究中，这是一项基于社区的队列研究，在 2008 年至 2010 年之间招募了 9804 名受试者（基线评估），其中 8293 名受试者从 2013 年至 2015 年进行了随访（随访评估）。本研究包含一份自填问卷，其中包括病史、咳痰评估和胃食管反流病症状频率量表。GERD 的定义为症状频率量表评分≥8。除了每次评估时的咳痰频率外，还检查了定义为两次评估时均有咳痰的持续性咳痰频率。
基线时咳痰频率为 32.0%，随访时为 34.5%。多变量分析表明，基线时的咳痰与 GERD[比值比（OR），1.92；95%置信区间（CI）1.73-2.13]和后鼻滴注（PND）（OR，2.40；95%CI 2.15-2.68）显著相关，独立于年龄较大、男性性别和吸烟史等其他已知因素。在随访时也观察到了咳痰与 GERD 或 PND 之间的这些关联。在纵向分析中，19.4%有持续性咳痰，12.3%有短暂性咳痰，即仅在基线时。多变量分析表明，持续性咳痰与 GERD 和 PND 以及上述已知危险因素有关。在持续性咳痰的受试者中，两次评估均有 GERD 的受试者比例最高。
横断面和纵向分析表明，在一般人群中，咳痰与 GERD 以及 PND 之间存在关联，而与已知的危险因素无关。在有咳痰的患者中应评估 GERD 的存在。
