International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Prevalence and Prognostic Significance of Systemic Inflammation Index and Diet Quality in Patients with Chronic Obstructive Pulmonary Disease: Evidence from the Cohort Study of NHANES 2007-2018.","authors":"Yu Han, Yutao Wu, Yihao Li, Huilin Xia, Zhihao Cai, Li Qiao, Xiaomeng Zhang, Zibei Chang, Peng Huang, Jianqing Wu, Bo Chen","doi":"10.2147/COPD.S536178","DOIUrl":"10.2147/COPD.S536178","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Previous studies have explored the relationship between different dietary patterns, systemic inflammation index (SII)and the risk of COPD. However, the joint effects and interactions between SII and HEI-2015 in COPD have not been fully investigated. This study aimed to explore the relationships between COPD and SII and HEI-2015.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Surveys (NHANES) were utilized.Univariate and multivariate logistic regression analyzed the associations between SII and HEI-2015 with COPD. Restricted cubic spline (RCS) model analyzed the relationship between SII and HEI-2015 and COPD.Use the area enclosed under the ROC curve (AUC) to represent its predicted value. Interaction indices and subgroup analyses were performed. The Kaplan-Meier curve was used to evaluate the impact on mortality of COPD patients.</p><p><strong>Results: </strong>This study included 10,898 participants.After adjusting,logistic regression analysis showed that higher SII (OR=1.03, 95% CI: 1.01-1.05) were associated with an increased risk of COPD, while higher HEI-2015 (OR=0.97, 95% CI: 0.96-0.99) reduced the risk.The RCS model observed a non-linear relationship between SII and HEI-2015 and COPD risk. Additionally, ROC showed a more significant advantage in predicting COPD prevalence (AUC=0.68). Interaction analysis indicated that SII and HEI-2015 might be independent influencing factors for COPD risk. Kaplan-Meier survival curves showed a lower all-cause mortality rate among in the group with high SII and low HEI-2015 (p < 0.0001).</p><p><strong>Conclusion: </strong>The results of this study indicate that a higher SII level and a lower HEI-2015 are associated with COPD risk. COPD patients with higher SII levels combined with lower HEI - 2015 levels have a higher all-cause death risk.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3093-3109"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Chronic Obstructive Pulmonary Disease Management and Treatment Patterns in General Medicine: Results From the ASTER Study in Italy.","authors":"Gino Genga, Umberto Alecci, Miriam Vighini, Carmen Stabile, Donato Cinquepalmi, Barbara Grassi, Riccardo Pistelli","doi":"10.2147/COPD.S517556","DOIUrl":"10.2147/COPD.S517556","url":null,"abstract":"<p><strong>Purpose: </strong>The ASTER study described the management of chronic obstructive pulmonary disease (COPD) by general practitioners (GPs) in Italy, focusing on the treatment patterns and clinical outcomes of patients over 6 months.</p><p><strong>Patients and methods: </strong>This multicenter prospective cohort study included patients aged 40-80 years with spirometry-confirmed COPD, post-bronchodilator FEV₁ ≥50% of predicted value, and ≤1 exacerbation in the previous year. Eligible patients had a COPD assessment test (CAT) score of ≥10 and, according to the prescription limits for GPs before Note 99, they could have been treated in the last 3 months before enrollment exclusively with a short or long acting bronchodilator or an corticosteroid/long-acting beta₂-agonist ICS/LABA. Patients were evaluated at enrollment, 3 months, and 6 months, with data collected on treatment, exacerbations, patient-reported outcomes (CAT and mMRC scores), and lung function.</p><p><strong>Results: </strong>Overall, 385 patients were enrolled, and 344 (89.4%) met the study criteria, of which 332 (96.5%) completed the study. The cohort included patients with mild to moderate COPD, predominantly males (61.9%), and current/former smokers (91%). At baseline, ongoing treatments included LAMA (20.9%), ICS/LABA (13.7%), and LABA (2.9%). However, 62.5% of patients were not treated. By 6 months, only 10.2% of patients were not receiving any treatment and 55.4% were treated with a LABA/LAMA combination. FEV1 showed a mean increase of 140 mL, mMRC ≥ 2 decreased from 54.9% to 23.5%, CAT exhibited a 3.6 point mean decrease, and only 13 patients (3.9%) experienced mild/moderate exacerbations in the last 6 months.</p><p><strong>Conclusion: </strong>ASTER study highlights the effectiveness of COPD treatment by GPs in Italy. Early detection and proactive management, along with a regular treatment prescription was associated with improved lung function, dyspnea, quality of life, and a reduction in the incidence of exacerbations. Empowering GPs with diagnostic and therapeutic responsibilities, improves care and outcomes of COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3135-3145"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Major Adverse Cardiovascular Events in Chronic Obstructive Pulmonary Disease.","authors":"Kazuki Hamada, Keiji Oishi, Tasuku Yamamoto, Yoriyuki Murata, Maki Asami-Noyama, Nobutaka Edakuni, Tsunahiko Hirano, Takeshi Abe, Masahiko Nakatsui, Yoshiyuki Asai, Kazuto Matsunaga","doi":"10.2147/COPD.S538054","DOIUrl":"10.2147/COPD.S538054","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is associated with frailty and leads to poor outcomes. The relationship between COPD and cardiovascular events is well established. However, the impact of frailty on cardiovascular events in COPD patients remains unknown. We aimed to evaluate the long-term association between frailty, assessed using the hospital frailty risk score (HFRS), and major adverse cardiovascular events (MACE) in COPD patients.</p><p><strong>Patients and methods: </strong>We recruited Japanese patients with COPD between 2013 and 2023 from Sado-Himawari Net, a regional electronic health record system in Sado City, Niigata Prefecture, Japan. MACE were defined as a composite of acute coronary syndrome, heart failure, and stroke. We classified the participants into four frailty categories according to HFRS: no-frailty with HFRS=0, low with HFRS >0 and <5, intermediate with HFRS ≥5 and <15, and high with HFRS ≥15. We used a Cox regression model adjusted for age, sex, inhaled treatments, and comorbidities to evaluate the hazard ratio (HR) for MACE.</p><p><strong>Results: </strong>We recruited 1527 patients with COPD. In multivariable analysis, COPD was associated with MACE as follows: no-frailty versus low HFRS (HR, 1.47 [95% confidence interval, 1.01-2.14], p<0.05), intermediate HFRS (HR 2.00 [1.34-2.97], p<0.001), and high HFRS (HR 2.62 [1.50-4.59], p<0.001). Similar relationships were observed even after adjusting for the severity of airflow limitation and COPD exacerbation.</p><p><strong>Conclusion: </strong>Frailty was independently associated with MACE in COPD patients during the 10-year follow-up period. Frailty assessment supports the identification of patients with COPD at risk of MACE.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3111-3122"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Arrhythmias in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.","authors":"Nan Ding, Weida Qiu, Jinmin Chen, Kaihao Wang, Zeyue Chen, Ruli Cai, Ailan Chen","doi":"10.2147/COPD.S545658","DOIUrl":"10.2147/COPD.S545658","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrhythmias are commonly seen in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but their prevalence, risk factors, and prognostic significance are still not fully understood.</p><p><strong>Objective: </strong>To estimate the prevalence of arrhythmias in patients with AECOPD, identify related clinical factors, and assess their influence on in-hospital mortality.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Web of Science, CENTRAL, and Cochrane Reviews was conducted to identify observational studies and randomized controlled trials. A random-effects meta-analysis using the DerSimonian-Laird method was performed. Subgroup and sensitivity analyses were conducted to explore heterogeneity, and publication bias was assessed using Egger's and Begg's tests.</p><p><strong>Results: </strong>Twenty-eight studies were included. The pooled prevalence of arrhythmias in AECOPD patients was 15% (95% CI: 12-18%), with considerable heterogeneity (I² = 99.93%). Prevalence was higher in studies from developed countries, particularly those with larger sample sizes and older populations. Advanced age (WMD = 2.79 years) and elevated C-reactive protein levels (WMD = 5.32) were associated with increased arrhythmia risk. Use of long-acting beta-agonists (LABAs) was associated with a reduced risk (OR = 0.42), although the causal mechanism remains uncertain. Arrhythmias were significantly associated with increased in-hospital mortality (RR = 3.33, 95% CI: 3.27-3.38). In a predefined subgroup analysis, atrial fibrillation (AF) was also linked to a higher risk of death (RR = 3.70, 95% CI: 2.40-5.70). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.</p><p><strong>Conclusion: </strong>Arrhythmias are common during AECOPD and are associated with increased short-term mortality, especially in patients with AF. Aging and systemic inflammation appear to be key contributors. While LABA use may have a protective association, this finding requires cautious interpretation. Standardized ECG monitoring and individualized risk stratification are warranted to improve patient outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3059-3072"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Urban Green Space and Acute Exacerbations of COPD in Korea: A Nationwide Study Using the NHIS-NSC Cohort.","authors":"Hae In Jung, Ju Won Lee, Hyochan Kim, Hoyoung Cha, Jongjin Baik, Kyoung Min Moon, Changhyun Jun, Sun-Young Jung, Kang-Mo Gu","doi":"10.2147/COPD.S530556","DOIUrl":"10.2147/COPD.S530556","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a major health concern in Korea, with a higher burden of acute exacerbations (AE-COPD) compared to Western populations. Environmental exposures such as smoking and air pollution are known contributors, but the impact of urban green space remains underexplored.</p><p><strong>Methods: </strong>We conducted a cohort study using the Korean National Health Insurance Service-National Sample Cohort (2006-2019), including 5,171 patients aged ≥40 years with at least two COPD-related prescriptions within one year. Urban green space exposure was defined as the proportion of designated park area to total district area (2017 KOSIS data) and categorized into quartiles. Cox proportional hazards models estimated associations with AE-COPD and all-cause mortality, adjusting for demographic and clinical factors. Subgroup analyses were conducted by age, sex, income, comorbidities, BMI, smoking, and physical activity.</p><p><strong>Results: </strong>Among 5,171 COPD patients (mean age, 67.5 years; 60.7% male), 1,431 AE-COPD events occurred over 40,486 person-years. AE-COPD incidence declined from 35.4 to 31.3 per 1,000 person-years across green space quartiles. Compared to the lowest quartile, the highest quartile showed a lower AE-COPD risk (adjusted hazard ratio [aHR], 0.75; 95% CI, 0.58-0.96; p for trend = 0.016). Stronger trends were observed in younger adults, men, high-income individuals, and those with comorbidities, though interaction tests were not significant. In a health screening subgroup (n = 3,318), patterns were consistent. No significant association was found with all-cause mortality.</p><p><strong>Conclusion: </strong>Greater urban green space coverage may be associated with reduced AE-COPD risk. However, results should be interpreted with cautiously given model limitations and exploratory nature of subgroup findings.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3035-3044"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram Model for Identifying the Risk of Coronary Heart Disease in Patients with Chronic Obstructive Pulmonary Disease Based on Deep Learning Radiomics and Clinical Data: A Multicenter Study.","authors":"Hupo Bian, Huiying Qian, Shaoqi Zhu, Jingnan Xue, Luying Qi, Xiuhua Peng, Mei Li, Yifeng Zheng, Pengliang Xu, Hongxing Zhao, Jianping Jiang","doi":"10.2147/COPD.S539307","DOIUrl":"10.2147/COPD.S539307","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and validate a deep learning radiomics (DLR) nomogram for individualized CHD risk assessment in the COPD population.</p><p><strong>Methods: </strong>This retrospective study included 543 COPD patients from two different centers. Comprehensive clinical and imaging data were collected for all participants. In Center 1, 398 patients were randomly allocated into a training set and an internal validation set at a 7:3 ratio. An external test set was established using 145 patients from Center 2. Radiomics features were extracted from computed tomography (CT) images, and deep learning features were generated using ResNet50. By integrating traditional clinical data, radiomics features, and three-dimensional (3D) deep learning features, a combined predictive model was developed to estimate the risk of CHD in COPD patients.</p><p><strong>Results: </strong>Validation cohort AUCs revealed the nomogram's optimal predictive performance (Internal: 0.800; External: 0.761) compared to clinical (0.759, 0.661), radiomics (0.752, 0.666), and DLR (0.767, 0.732) models. This integrative approach demonstrated a 9.1% and 13.4% relative AUC improvement over clinical and radiomics models in external validation. DCA corroborated these findings, showing the nomogram provides the highest net benefit for clinical decision-making across probability thresholds in COPD patients at risk for CHD.</p><p><strong>Conclusion: </strong>The nomogram model, which integrates clinical, radiomics, and deep learning features, exhibits promising performance in predicting CHD risk among COPD patients. It may offer valuable insights for early intervention and management strategies for CHD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3045-3057"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Trait Genome-Wide Association Study Identifies Shared Genetic Risk Loci Between COPD and Five Autoimmune Diseases.","authors":"Huilan Wen, Runan Zhang, Bin Zhong, Huan Liu, Chunhua Liu","doi":"10.2147/COPD.S533401","DOIUrl":"10.2147/COPD.S533401","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) frequently co-occurs with autoimmune diseases (ADs), yet their shared genetic basis remains incompletely understood. This study aimed to evaluate genetic correlations between COPD and seven ADs and identify shared genetic risk loci underlying this comorbidity.</p><p><strong>Methods: </strong>We integrated summary statistics from large-scale genome-wide association studies (GWAS) of COPD and seven ADs in European populations. Genetic correlations were assessed using linkage disequilibrium score regression (LDSC) and high-definition likelihood (HDL). Pleiotropic loci were identified via the Pleiotropic Analysis under Composite Null Hypothesis (PLACO) and annotated through the FUMA platform. Multidimensional enrichment analyses were conducted using MAGMA and Metascape, and complementary evidence for the identification of pleiotropic genes was provided by summary-based Mendelian randomization (SMR) and transcriptome-wide association studies (TWAS).</p><p><strong>Results: </strong>Significant genetic correlations were observed between COPD and five of the seven ADs analyzed. Joint analyses identified 57 shared risk loci, including 17q12 and 16p11.2, with 22 loci supported by colocalization evidence. MAGMA identified 162 pleiotropic genes, such as ORMDL3, GSDMB, and MAPK3. Pathway analyses demonstrated enrichment in immune-related processes, particularly T cell activation and regulation of immune responses. SMR and TWAS further implicated ORMDL3, PGAP3, MAPK3, and GMPPB as putative contributors to shared disease susceptibility. However, additional experimental validation is warranted to substantiate these associations.</p><p><strong>Conclusion: </strong>This study highlights shared genetic loci and immune pathways linking COPD and ADs in European ancestry populations. Findings lay the groundwork for future research but require functional validation and replication in diverse cohorts to establish causality.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3019-3034"},"PeriodicalIF":3.1,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Spirometry-Defined Small Airway Dysfunction in the High-Risk Population for COPD in Yunnan Province, China: A Population Based Cross-Sectional Study.","authors":"Geyi Wen, Jinliang Meng, Yanyan Xu, Ruiqi Wang, Huadan Wang, Puxian Peng, Zhengmao Yan, Songyuan Tang, Yunhui Zhang","doi":"10.2147/COPD.S543042","DOIUrl":"10.2147/COPD.S543042","url":null,"abstract":"<p><strong>Purpose: </strong>Small airway dysfunction (SAD) is a key early marker of chronic obstructive pulmonary disease (COPD) development. While many studies have examined the link between SAD and early COPD, the epidemiology of SAD in high-risk COPD populations remains understudied.</p><p><strong>Patients and methods: </strong>This cross-sectional study utilized a multi-stage randomized cluster sampling method and recruited 11,095 adult residents aged ≥20 years from different elevations in Yunnan Province, China. High-risk individuals were identified using screening questionnaires and subsequently underwent pulmonary function tests. COPD was diagnosed based on post-bronchodilator test results. Spirometry-defined SAD was defined as the presence of at least two out of three indicators (MMEF, FEF50%, FEF75%) being below 65% of the predicted values. Multivariate logistic regression models were employed to examine the influencing factors of spirometry-defined SAD.</p><p><strong>Results: </strong>Of 2191 high-risk COPD subjects aged ≥40 years, 1186 (54.1%) had spirometry-defined SAD. Notably, 49.9% of spirometry-defined SAD cases had coexisting COPD, and 97.4% of COPD patients exhibited spirometry-defined SAD. Multivariable analysis identified the following risk factors for spirometry-defined SAD: advanced age, low BMI, limited education, childhood respiratory disease history, tobacco exposure, and residence at lower altitudes.</p><p><strong>Conclusion: </strong>The study found a high prevalence of spirometry-defined SAD in individuals at high risk for COPD, with nearly all COPD patients exhibiting spirometry-defined SAD in this cohort. Risk factors for spirometry-defined SAD included older age, low BMI, low education level, childhood respiratory disease history, tobacco exposure, and lower altitude residence.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"3005-3017"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Humanistic and Economic Burden of COPD Patients in Urban China: A Propensity Score Matching Study.","authors":"Lei Dou, Yu Zheng, Junchao Feng, Zhezhou Huang, Fei Qin, Mingyue Gao, Shunping Li","doi":"10.2147/COPD.S524028","DOIUrl":"10.2147/COPD.S524028","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of death in China. However, few national surveys have comprehensively evaluated the health and economic outcomes among COPD patients in China. The objective of this study was to examine and compare the humanistic and economic burden of COPD patients with a control group.</p><p><strong>Patients and methods: </strong>Data from the 2020 National Health and Wellness Survey (NHWS) in China (N=20051), a nationally representative survey targeting urban adults, was used in this study. The propensity score matching (PSM) method was employed to match respondents who reported being diagnosed with COPD by a physician with those who did not have COPD. Differences between COPD patients and matched controls were assessed in terms of quality of life (using EQ-5D-5L and SF-12v2), work productivity loss, healthcare resource utilization over the past 6 months, and estimated annual indirect costs.</p><p><strong>Results: </strong>COPD patients exhibited significantly worse outcomes compared to non-COPD respondents. The mean scores for MCS, PCS, and health state utility (HSU) were substantially lower in COPD patients than in the control group (47.69 vs 49.49, 47.27 vs 51.71, and 0.90 vs 0.94, respectively; all P <0.01). Moreover, the score difference between COPD patients and the control group reached minimal clinically important difference (MCID) for both PCS and HSU. Compared to the non-COPD population, COPD patients reported higher rates of absenteeism (6.88% vs 3.74%, P<0.01), presenteeism (28.02% vs 21.43%, P<0.01), work productivity loss (31.31% vs 23.57%, P<0.01) and activity impairment (27.15% vs 19.53%, P<0.01), resulting in greater indirect cost. The number of hospitalizations was significantly higher among COPD patients than the non-COPD population (2.11 vs 1.96, P<0.01), while the number of outpatient visits was similar to that of the control group.</p><p><strong>Conclusion: </strong>These findings highlight the pervasive impact of COPD on health outcomes. The results highlight the substantial burden of COPD compared with the non-COPD population, suggesting that increased attention and targeted interventions are warranted to address the significant health and economic challenges posed by this disease.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2993-3004"},"PeriodicalIF":3.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Ancestry Mendelian Randomization Reveals Lipid-Associated Genetic Risk Factors for COPD.","authors":"Hailan Wu, Huan Li, Weiwei Tang, Yicheng Di, Yingran Zhu, Wei Dai, Ming Zhao","doi":"10.2147/COPD.S532361","DOIUrl":"10.2147/COPD.S532361","url":null,"abstract":"<p><strong>Background: </strong>Previous Mendelian randomization (MR) studies investigating the causal relationship between lipid traits and chronic obstructive pulmonary disease (COPD) have primarily focused on individuals of European (EUR) ancestry, limiting the generalizability of findings. This study aimed to address this limitation.</p><p><strong>Methods: </strong>Summary-level data for individuals of East Asian (EAS), African (AFR), and Hispanic (HIS) ancestry were obtained from large-scale genetic databases. Lipid traits, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were derived from the Global Lipids Genetics Consortium (GLGC). The discovery COPD dataset was sourced from the Global Biobank Meta-analysis Initiative (GBMI), while replication datasets came from the Million Veteran Program (MVP) and Biobank Japan (BBJ). Causal effects were assessed through meta-analysis across discovery and replication cohorts, supplemented by a series of sensitivity analyses, including the Steiger test, Causal Analysis Using Summary Effect Estimates (CAUSE), MRLap, RadialMR, Bonferroni correction, among others.</p><p><strong>Results: </strong>In the EAS population, strong evidence supported a causal relationship between genetically predicted TC levels and reduced COPD risk (OR = 0.891, 95% CI: 0.841-0.944, <i>P</i> = 9.91×10^-5). Additionally, the association between TG and COPD (OR = 0.827, 95% CI: 0.739-0.925, <i>P</i> = 9.04×10^-4) in EAS was primarily driven by the rs7350481 variant in the <i>MAML2</i> gene. Suggestive evidence also indicated a positive causal association between TG levels and increased COPD risk (OR = 1.438, 95% CI: 1.091-1.896, <i>P</i> = 0.009) in the AFR population. No other significant causal relationships were detected.</p><p><strong>Conclusion: </strong>This study reveals ancestry-specific causal links between lipid traits and COPD risk. The protective effect observed for TG in EAS may reflect variant-level pleiotropy rather than a true metabolic influence, warranting cautious interpretation. These findings highlight the importance of multi-ancestry analyses in contextualizing genetic associations across diverse populations.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2979-2992"},"PeriodicalIF":3.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}