Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB). Issue 1 (9th May 2014)

• Record Type: Journal Article
• Authors: Kurmi, Om P; Li, Liming; Smith, Margaret; Augustyn, Mareli; Chen, Junshi; Collins, Rory; Guo, Yu; Han, Yabin; Qin, Jingxin; Xu, Guanqun; Wang, Jian; Bian, Zheng; Zhou, Gang; Davis, Kourtney; Peto, Richard; Chen, Zhenming
• Other Names: Li Liming author non-byline.; Chen Zhengming author non-byline.; Chen Junshi author non-byline.; Collins Rory author non-byline.; Peto Richard author non-byline.; Chen Zhengming author non-byline.; Lancaster Garry author non-byline.; Yang Xiaoming author non-byline.; Williams Alex author non-byline.; Smith Margaret author non-byline.; Yang Ling author non-byline.; Chang Yumei author non-byline.; Millwood Iona author non-byline.; Chen Yiping author non-byline.; Lewington Sarah author non-byline.; Sansome Sam author non-byline.; Walters Robin author non-byline.; Kurmi Om author non-byline.; Guo Yu author non-byline.; Bian Zheng author non-byline.; Hou Can author non-byline.; Tan Yunlong author non-byline.; Wang Zheng author non-byline.; Cai Xin author non-byline.; Zhou Huiyan author non-byline.; Chen Xuguan author non-byline.; Pang Zengchang author non-byline.; Li Shanpeng author non-byline.; Wang Shaojie author non-byline.; lv Silu author non-byline.; Zhao Zhonghou author non-byline.; Liu Shumei author non-byline.; Pang Zhigang author non-byline.; Yang Liqiu author non-byline.; He Hui author non-byline.; Yu Bo author non-byline.; Wang Shanqing author non-byline.; Wang Hongmei author non-byline.; Chen Chunxing author non-byline.; Zheng Xiangyang author non-byline.; Hu Xiaoshu author non-byline.; Zhou Minghao author non-byline.; Wu Ming author non-byline.; Tao Ran author non-byline.; Wang Yeyuan author non-byline.; Hu Yihe author non-byline.; Ma Liangcai author non-byline.; Zhou Renxian author non-byline.; Tang Zhenzhu author non-byline.; Chen Naying author non-byline.; Huang Ying author non-byline.; Li Mingqiang author non-byline.; Gan Zhigao author non-byline.; Meng Jinhuai author non-byline.; Qin Jingxin author non-byline.; Wu Xianping author non-byline.; Zhang Ningmei author non-byline.; Luo Guojin author non-byline.; Que Xiangsan author non-byline.; Chen Xiaofang author non-byline.; Ge Pengfei author non-byline.; Ren Xiaolan author non-byline.; Dong Caixia author non-byline.; Zhang Hui author non-byline.; Mao Enke author non-byline.; Li Zhongxiao author non-byline.; Zhou Gang author non-byline.; Feng Shixian author non-byline.; Gao Yulian author non-byline.; He Tianyou author non-byline.; Jiang Li author non-byline.; Sun Huarong author non-byline.; Yu Min author non-byline.; Su Danting author non-byline.; Lu Feng author non-byline.; Qian Yijian author non-byline.; Shi Kunxiang author non-byline.; Han Yabin author non-byline.; Chen Lingli author non-byline.; Li Guangchun author non-byline.; Liu Huilin author non-byline.; Yin LI author non-byline.; Xiong Youping author non-byline.; Tan Zhongwen author non-byline.; Jia Weifang author non-byline.;
• Is Part Of: BMJ open respiratory research. Volume 1:Issue 1(2014)
• Publication Date: 2014-05-09
• Subjects: COPD Epidemiology -- Tobacco and the Lung; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; Respiratory therapy -- Periodicals; 616.2005
• DOI: 10.1136/bmjresp-2014-000025
• Languages: English
• ISSNs: 2052-4439

Abstract

Abstract : Background: Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors. Methods: We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004–2008. Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-measured lung function. The prevalence of AFO was analysed by region, age, socioeconomic status, body mass index (BMI) and smoking history and compared with the prevalence of self-reported physician-diagnosed chronic bronchitis or emphysema (CB/E) and its symptoms. Findings: The prevalence of AFO was 7.3% in men (range 2.5–18.2%) and 6.4% in women (1.5–18.5%). Higher prevalence of AFO was associated with older age (p<0.0001), lower income (p<0.0001), poor education (p<0.001), living in rural regions (p<0.001), those who started smoking before the age of 20 years (p<0.001) and low BMI (p<0.001). Compared with self-reported diagnosis of CB/E, 88.8% of AFO was underdiagnosed; underdiagnosis proportion was highest in 30–39-year olds (96.7%) compared with the 70+ age group (81.1%), in women (90.7%), in urban areas (89.4%), in people earning 5K–10 K ¥ monthly (90.3%) and in those with middle or high school education (92.6%). Interpretation: In China, the burden of AFO based on spirometry was high and significantly greater than that estimated based on self-reported physician-diagnosed CB/E, especially in rural areas, reflecting major issues with diagnosis of AFO that will impact disease treatment and management.