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老年人哮喘研究:职业性致喘物、高体重指数和吸烟影响的综合分析

The study for asthma in older adults: a combined analysis of the effects of occupational asthmagens, high body-mass index and smoking.

作者信息

Wang Jia-Qi, Liang Yuan-Yu, Zhao Zhong-Xue, Xie Wei, Sun Wan-Ning, Zou Ji-Yu, Lv Xiao-Dong, He Youfu, Pang Li-Jian

机构信息

The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China.

Department of Pulmonology II, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China.

出版信息

Front Public Health. 2025 Jul 23;13:1625623. doi: 10.3389/fpubh.2025.1625623. eCollection 2025.

Abstract

BACKGROUND

Asthma remains a significant public health challenge globally, particularly among older adults who face diagnostic complexity, atypical symptom profiles, and frequent comorbidities. Despite global advances in asthma control, little attention has been paid to the evolving composition and geographic disparity of modifiable risk factors in this age group.

METHODS

We utilized data from the Global Burden of Disease Study 2021 to evaluate the long-term trends (1990-2021) in asthma burden attributable to high body-mass index (BMI), smoking, and occupational asthmagens among adults aged 60 years and older. Key metrics included age-standardized mortality rates (ASMR), age-standardized DALY rates (ASDR), and estimated annual percentage change (EAPC). Stratified analyses were conducted across Socio-demographic Index (SDI) quintiles, gender, and detailed 5-year age subgroups (60-64 to ≥95 years) to assess disparities across socioeconomic development, gender, and aging patterns, with additional stratification by geographic region.

RESULTS

From 1990 to 2021, asthma burden attributable to smoking and occupational asthmagens among older adults declined globally, while high BMI-related burden increased in several middle and low SDI regions. In terms of attribution proportion, the proportion of asthma deaths attributable to high BMI increased from 10.89 to 14.4%, with this upward trend being particularly pronounced in high SDI regions. Occupational asthmagens-related burden showed limited decline and remained elevated in low SDI regions. Gender-stratified analysis showed that the risk burden of smoking was higher in older men in Asia, whereas the high BMI-related burden was higher in women in more developed regions.

CONCLUSION

This study demonstrates a structural shift in the composition of asthma risk factors among older adults, with high BMI emerging as a dominant contributor amid declining traditional behavioral risks such as smoking. There are significant differences among regions, age groups and genders. Targeted, region-specific strategies are essential to address these evolving risks and reduce inequities in asthma burden among aging populations.

摘要

背景

哮喘仍然是全球重大的公共卫生挑战,尤其是在面临诊断复杂性、非典型症状谱和频繁合并症的老年人中。尽管全球在哮喘控制方面取得了进展,但对于该年龄组中可改变风险因素的不断变化的构成和地理差异关注甚少。

方法

我们利用了《2021年全球疾病负担研究》的数据,以评估60岁及以上成年人中因高体重指数(BMI)、吸烟和职业性致喘物导致的哮喘负担的长期趋势(1990 - 2021年)。关键指标包括年龄标准化死亡率(ASMR)、年龄标准化伤残调整生命年率(ASDR)和估计年度百分比变化(EAPC)。通过社会人口指数(SDI)五分位数、性别和详细的5岁年龄亚组(60 - 64岁至≥95岁)进行分层分析,以评估社会经济发展、性别和老龄化模式方面的差异,并按地理区域进行额外分层。

结果

从1990年到2021年,全球老年人中因吸烟和职业性致喘物导致的哮喘负担有所下降,而在几个中低SDI地区,与高BMI相关的负担有所增加。就归因比例而言,因高BMI导致的哮喘死亡比例从10.89%增至14.4%,这一上升趋势在高SDI地区尤为明显。与职业性致喘物相关的负担下降有限,在低SDI地区仍然很高。性别分层分析表明,亚洲老年男性吸烟的风险负担较高,而在较发达地区,女性与高BMI相关的负担较高。

结论

本研究表明老年人哮喘风险因素构成发生了结构性转变,在吸烟等传统行为风险下降的情况下,高BMI成为主要因素。不同地区、年龄组和性别之间存在显著差异。针对性的、因地制宜的策略对于应对这些不断变化的风险以及减少老年人群哮喘负担的不平等至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64e2/12325056/5c9fb5a8819f/fpubh-13-1625623-g001.jpg

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