Factors influencing the prevalence and death rate of COPD: a pan-database ecological study covering 201 countries and regions from 1990 to 2021.

IF 10 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

EClinicalMedicine Pub Date : 2025-08-01 DOI:10.1016/j.eclinm.2025.103347

Zihui Wang, Wenhan Cao, Zhixuan You, Shaoqiang Li, Mingshan Xue, Haiyang Li, Junfeng Lin, Guannan Cai, Yuqi Chen, Zhiman Liang, Chengtao Zhou, Xiaofang Wu, Guanghui Dong, Nanshan Zhong, Baoqing Sun, Zhangkai J Cheng

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引用次数: 0

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common, heterogeneous disease and may be influenced by diverse factors. However, gaps remain in previous studies regarding the exploration of potential influencing factors. This study aims to investigate the wide range of potential factors influencing COPD based on a pan-database ecological analysis.

Methods: We integrated data from 17 global databases (e.g., the Global Burden of Disease Study) which encompass social, environmental, and health data across various regions. Generalized linear regression was used to analyze the association of cumulative and instant exposures of factors with COPD and to rank their importance. Spearman analysis was used to assess the correlation of various factors with COPD. Heatmaps, scatter plots, and nonclassical multidimensional scaling (i.e., network graph) were employed to visualize the correlations.

Findings: The study aggregated 77 social and environmental factors, 85 lifestyle and dietary factors, 25 physiological indicators, and 28 diseases. In the cumulative exposure analysis, tobacco consumption, atmospheric pollutants (e.g., ozone, CO, and organic matter aerosol), biomass cooking, and climatic conditions (e.g., vapor pressure, solar radiation, and temperature) were found to be associated with COPD prevalence. Additionally, tobacco consumption, social factors (e.g., hunger index, gender inequality index, and education year), and climatic conditions significantly impacted death rates. The results for cumulative exposures were consistent with those for instant exposures. Network graph analysis indicated a positive correlation between COPD and chronic kidney disease, other chronic respiratory diseases, gout, and stroke.

Interpretation: Various factors (e.g., tobacco consumption, atmospheric pollution, biomass cooking, temperature, social factors, and comorbidities) significantly influence COPD. Comprehensive interventions are needed to reduce the disease burden of COPD.

Funding: The Foundation of Guangzhou National Laboratory (SRPG22-018, SRPG22-016), State Key Laboratory of Respiratory Disease (SKLRD-OP-202402), Zhejiang medical health science and technology project (2025KY1245), Multi-Center Clinical Research Project of Guangzhou Medical University (GMUCR2025-02009), and Guangzhou Municipal Science and Technology Bureau (SL2024A04J00706).

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慢性阻塞性肺病患病率和死亡率影响因素：1990 - 2021年覆盖201个国家和地区的泛数据库生态研究

背景：慢性阻塞性肺疾病（COPD）是一种常见的异质性疾病，可能受到多种因素的影响。然而，在探索潜在的影响因素方面，以往的研究仍然存在差距。本研究旨在通过泛数据库生态分析，探讨COPD的广泛潜在影响因素。方法：我们整合了来自17个全球数据库（例如，全球疾病负担研究）的数据，这些数据库涵盖了不同地区的社会、环境和健康数据。采用广义线性回归分析累积和瞬时暴露因素与COPD的关系，并对其重要性进行排序。采用Spearman分析评估各因素与COPD的相关性。使用热图、散点图和非经典多维缩放（即网络图）来可视化相关性。结果：该研究汇总了77个社会和环境因素、85个生活方式和饮食因素、25个生理指标和28种疾病。在累积暴露分析中，发现烟草消费、大气污染物（如臭氧、CO和有机气溶胶）、生物质烹饪和气候条件（如蒸气压、太阳辐射和温度）与COPD患病率相关。此外，烟草消费、社会因素（如饥饿指数、性别不平等指数和教育年份）和气候条件对死亡率有重大影响。累积暴露的结果与即时暴露的结果一致。网络图分析显示COPD与慢性肾脏疾病、其他慢性呼吸系统疾病、痛风和中风呈正相关。解释：各种因素（如烟草消费、大气污染、生物质烹饪、温度、社会因素和合并症）显著影响COPD。需要采取综合干预措施来减轻慢性阻塞性肺病的疾病负担。资助项目：广州国家实验室（SRPG22-018, SRPG22-016），呼吸疾病国家重点实验室（sklrd - p -202402），浙江省医药卫生科技项目（2025KY1245），广州医科大学多中心临床研究项目（GMUCR2025-02009），广州市科技局（SL2024A04J00706）。

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来源期刊

EClinicalMedicine Medicine-Medicine (all)

CiteScore

18.90

自引率

1.30%

发文量

506

审稿时长

22 days

期刊介绍： eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.