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美国西班牙裔/拉丁裔个体中早期慢性阻塞性肺疾病的流行情况及人群归因风险。

Prevalence and Population Attributable Risk for Early Chronic Obstructive Pulmonary Disease in U.S. Hispanic/Latino Individuals.

机构信息

Department of Anesthesiology, Perioperative, and Pain Medicine.

Division of Sleep Medicine, and.

出版信息

Ann Am Thorac Soc. 2022 Mar;19(3):363-371. doi: 10.1513/AnnalsATS.202103-253OC.

Abstract

In predominantly White populations, early chronic obstructive pulmonary disease (COPD) (i.e., COPD in people aged <50 yr) has been linked to higher hospitalization rates and mortality; however, the prevalence, risk factors, and population attributable risk (PAR) of early COPD remain to be determined in non-White populations. We aimed to examine the prevalence, risk factors, and PARs of early COPD among Hispanic/Latino individuals, the largest U.S. minority group. We used baseline data from the Hispanic Community Health Study/Study of Latinos, a population-based probability sample of 16,415 Hispanic/Latino individuals aged 18-74 years. Participants aged <50 years were included ( = 7,323). Early COPD was defined as a forced expiratory volume in 1 second to forced vital capacity ratio less than the lower limit of normal. We used survey logistic regression analysis to identify risk factors and estimate the prevalence of early COPD. PARs of the risk factors identified were estimated. A total of 524 participants met the criteria for early COPD, yielding a sex- and age-adjusted prevalence of 7.6% (95% confidence interval [CI], 6.8-8.6). Asthma (odds ratio [OR], 3.37; 95% CI, 2.57-4.41), smoking status (ever vs. never; OR, 1.65; 95% CI, 1.24-2.20), and chronic sinusitis (OR, 1.71; 95% CI, 1.09-2.66) were associated with increased odds of early COPD. Immigrants versus U.S.-born individuals have lower odds of early COPD (age at immigration <15 yr and living in the United States <10 yr; OR, 0.94; 95% CI, 0.39-2.27; age at immigration <15 yr and living in the United States ⩾10 yr; OR, 0.55; 95% CI, 0.37-0.84; age at immigration ⩾15 yr and living in the United States <10 yr; OR, 0.86; 95% CI, 0.57-1.30; and age at immigration ⩾15 yr and living in the United States ⩾10 yr; OR, 0.63; 95% CI, 0.42-0.95). Among smokers, pack-years was not associated with early COPD (5-9.9 vs. <5 pack-years; OR, 1.04; 95% CI, 0.59-1.82; ⩾10 vs. <5 pack-years; OR, 1.20; 95% CI, 0.74-1.94). The mean PAR for asthma, smoking status, and chronic sinusitis was 26.3% (95% CI, 22.1-30.3), 22.4% (95% CI, 17.4-27.1), and 6.9% (95% CI, 4.3-9.4), respectively. Among U.S. Hispanic/Latino individuals, asthma is one of the most important risk factors for early COPD, followed by smoking and chronic sinusitis. Immigrants appear to have a lower risk of early COPD than U.S.-born Hispanic/Latino individuals.

摘要

在以白种人为主的人群中,早期慢性阻塞性肺疾病(COPD)(即 50 岁以下人群的 COPD)与更高的住院率和死亡率有关;然而,非白种人群中早期 COPD 的患病率、风险因素和人群归因风险(PAR)仍有待确定。我们旨在研究西班牙裔/拉丁裔人群中早期 COPD 的患病率、风险因素和 PAR,西班牙裔/拉丁裔是美国最大的少数族裔群体。我们使用了西班牙裔社区健康研究/拉丁裔研究的基线数据,这是一项基于人群的概率抽样研究,共纳入了 16415 名年龄在 18-74 岁的西班牙裔/拉丁裔个体。纳入了年龄<50 岁的参与者(n=7323)。早期 COPD 定义为 1 秒用力呼气量与用力肺活量的比值低于正常下限。我们使用调查逻辑回归分析来确定风险因素并估计早期 COPD 的患病率。估计了确定的风险因素的 PAR。共有 524 名参与者符合早期 COPD 的标准,得出了性别和年龄调整后的患病率为 7.6%(95%置信区间[CI],6.8-8.6)。哮喘(比值比[OR],3.37;95%CI,2.57-4.41)、吸烟状况(曾经吸烟 vs. 从不吸烟;OR,1.65;95%CI,1.24-2.20)和慢性鼻窦炎(OR,1.71;95%CI,1.09-2.66)与早期 COPD 的发生几率增加有关。移民与土生土长的美国人相比,早期 COPD 的发病风险较低(移民年龄<15 岁且在美国居住时间<10 年;OR,0.94;95%CI,0.39-2.27;移民年龄<15 岁且在美国居住时间 ⩾10 年;OR,0.55;95%CI,0.37-0.84;移民年龄 ⩾15 岁且在美国居住时间<10 年;OR,0.86;95%CI,0.57-1.30;移民年龄 ⩾15 岁且在美国居住时间 ⩾10 年;OR,0.63;95%CI,0.42-0.95)。在吸烟者中,吸烟年限与早期 COPD 无关(5-9.9 年 vs. <5 年;OR,1.04;95%CI,0.59-1.82; ⩾10 年 vs. <5 年;OR,1.20;95%CI,0.74-1.94)。哮喘、吸烟状况和慢性鼻窦炎的平均 PAR 分别为 26.3%(95%CI,22.1-30.3)、22.4%(95%CI,17.4-27.1)和 6.9%(95%CI,4.3-9.4)。在美国的西班牙裔/拉丁裔人群中,哮喘是早期 COPD 的最重要风险因素之一,其次是吸烟和慢性鼻窦炎。与土生土长的西班牙裔/拉丁裔美国人相比,移民似乎患早期 COPD 的风险较低。

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