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|本期目录/Table of Contents|

中国人群主动吸烟与慢性阻塞性肺病关系的Meta分析(PDF)

《现代预防医学》[ISSN:1003-8507/CN:51-1365/R]

期数:
2022年22期
页码:
4064-4070
栏目:
流行病与统计方法
出版日期:
2022-11-30

文章信息/Info

Title:
A meta-analysis of the relationship between active smoking and chronic obstructive pulmonary disease in Chinese population
作者:
杨文怡; 王敬鑫; 艾丽梅; 赵健; 石钰霖; 王宇彤; 艾飞玲; 王雪威; 胡葵如; 万霞
中国医学科学院基础医学研究所 北京协和医学院基础学院，北京 100005
Author(s):
YANG Wen-yi;  WANG Jing-xin;  AI Li-mei;  ZHAO Jian;  SHI Yu-lin;  WANG Yu-tong;  AI Fei-lin;  WANG Xue-wei;  HU Kui-ru;  WAN Xia
Institute of Basic Medical Sciences, Chinese Academy of Medical Science & School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
关键词:
中国人群; 吸烟; COPD; 危险因素; Meta分析
Keywords:
Chinese population;  Smoking;  COPD;  Risk factors;  Meta analysis
分类号:
R563.9
DOI:
10.20043/j.cnki.MPM.202204482
文献标识码:
A
摘要:
目的 通过meta分析探究中国人群慢性阻塞性肺病（COPD）的危险因素，为制定中国控烟政策及评估中国烟草带来的疾病负担提供必要的参数。方法 在PubMed、Web of science、Embase、中国知网、维普、万方数据库中检索从建库至2021年6月31日发表的所有吸烟相关疾病的中、英文队列或病例对照研究文献，筛选并提取相关信息。 使用Stata 16.0进行meta分析，探究吸烟与慢性阻塞性肺病发病/死亡的关联。结果 最终纳入16篇文献，其中队列研究10篇，病例对照6篇。Meta分析结果显示，吸烟是COPD的重要危险因素，曾吸烟者较不吸烟者COPD患病/死亡风险更大，RR值为2.64（95%CI:1.74～4.00），其中男性RR为1.74（95%CI:1.44～2.09），女性RR为4.06（95%CI:2.53～6.52），女性显著高于男性。亚组分析结果显示，除男性曾吸烟者病例对照研究（RR: 2.22，95%CI:1.68～2.95)和队列研究（RR:1.33，95%CI:1.19～1.49）RR可信区间无交叠，差异有统计学意义外，其他不同类别的各亚组间RR值差异没有统计学意义。结论 虽然与西方国家相比，中国人群RR值偏低，但吸烟仍是COPD的重要危险因素，其中女性较男性危险度更高。为减轻COPD造成的疾病负担，应进一步加强控烟相关措施。同时，作为一篇只针对于中国人群的研究，本篇文献将为制定中国控烟政策及评估中国烟草带来的疾病负担提供相关依据。
Abstract:
Objective To explore the risk factors of chronic obstructive pulmonary disease (COPD) in Chinese population through meta-analysis, and to provide necessary parameters for the formulation of tobacco control policies and the assessment of disease burden caused by smoking in China. Methods The literature of all Chinese and English cohort or case-control studies on smoking-related diseases published from the establishment of the database to June 31, 2021 were retrieved from PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang databases, and the relevant information was screened and extracted. A meta-analysis was performed using Stata16.0 to investigate the association between smoking and morbidity/mortality from chronic obstructive pulmonary disease. Results Sixteen articles including 10 cohort studies and 6 case control studies were identified. Meta-analysis results showed that former smokers had a higher risk of COPD disease/death than non-smokers, with a relative risk (RR) of 2.64 (95%CI: 1.74-4.00) for both population and 1.74 (95%CI: 1.44-2.09) for males. RR value for females was 4.06 (95%CI: 2.53-6.52), which was significantly higher than males. The results of subgroup analysis showed except the statistically significant differences found for male former smokers in case-control study (RR=2.22, 95%CI: 1.68-2.95) and cohort study (RR=1.33, 95%CI: 1.19-1.49), no significant differences were observed for subgroups of other categories. Conclusion Although the RR values are lower in the Chinese population than in western countries, smoking remains an important risk factor for COPD, with women at higher risk than men. To reduce the disease burden caused by COPD, measures related to tobacco control should be further strengthened. At the same time, as a study only focused on the Chinese population, this paper will provide relevant basis for the formulation of tobacco control policies in China and the assessment of the disease burden caused by tobacco in China.

参考文献/References

[ 1 ] GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990 - 2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. The Lancet. Respiratory Medicine, 2020, 8(6): 585 - 596.
[ 2 ] Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health[CPH]study):a National cross - sectional study[J]. Lancet, 2018, 391(10131): 1706 - 1717.
[ 3 ] Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces,1990 - 2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145 - 1158.
[ 4 ] Li W, Jiang GH, Wang DZ, et al. Smoking and mortality in Tianjin, China: a death Registry - Based Case - Control study,2010 - 2014[J]. Preventing Chronic Disease, 2018, 15: E104.
[ 5 ] 胡葵茹，王宇彤，石钰霖，等．中国人群吸烟所致疾病风险的Meta分析[J]．中国预防医学杂志，2021，22（4）：250 - 256．Hu KR, Wang YT, Shi YL, et al. Meta - analysis of the risk of smoking - related diseases in Chinese population[J]. Chinese Preventive Medicine, 2021, 22(4): 250 - 256.
[ 6 ] 李新华．2018中国成人烟草调查报告[M]．北京：北京人民卫生出版社，2010．Li XH. Chinese Adult Tobacco Survey Report 2018[M]. Beijing: Beijing People’s Medical Publishing House, 2010.
[ 7 ] Chen Y, Breithaup K, Muhajarine N. Occurrence of chronic obstructive pulmonary disease among Canadians and sex - related risk factors[J]. Journal of Clinical Epidemiology, 2000, 53(7): 755 - 761.
[ 8 ] Smith BM, Kirby M, Hoffman EA, et al. Association of dysanapsis with chronic obstructive pulmonary disease among older adults[J]. JAMA, 2020, 323(22): 2268 - 2280.
[ 9 ] Forey BA, Thornton AJ, Lee PN. Systematic review with meta - analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema[J]. BMC Pulmonary Medicine, 2011, 11(1): 36.
[ 10 ] Moll M, Sakornsakolpat P, Shrinr N, et al. Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population - based and case - control cohorts[J]. The Lancet. Respiratory Medicine, 2020, 8(7): 696 - 708.
[ 11 ] 顾建华，马晓天，李吉庆，等．健康管理队列慢性阻塞性肺疾病风险预测模型[J]．山东大学学报:医学版，2017，55（12）：62 - 65, 70．Gu JH, Ma XT, Li JQ, et al. Risk prediction model of chronic obstructive pulmonary disease in the health management cohort[J]. Journal of Shandong University: Medical Science, 2017, 55(12): 62 - 65, 70.
[ 12 ] 运玲，徐应军，喻昌利，等．唐山市农村地区慢性阻塞性肺疾病危险因素病例对照研究[J]．中国慢性病预防与控制，2009，17（5）：498 - 500．Yun L, Xu YJ, Yu CL, et al. Risk factors of chronic obstructive pulmonary disease: a case - control study in rural areas of Tang Shan[J]. Chronic Disease Prevention and Control in China, 2009, 17(5): 498 - 500.
[ 13 ] Junk KJ, Jeon C, Jee SH. The effect of smoking on lung cancer: ethnic differences and the smoking paradox[J]. Epidemiology and Health, 2016, 38: e2016060.
[ 14 ] Chen W, Thomas J, Sadatsafavi M, et al. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta - analysis[J]. The Lancet. Respiratory Medicine, 2015, 3(8): 631 - 639.
[ 15 ] Chen YS, Li XQ, Li HR, et al. Risk factors for small airway obstruction among Chinese island residents: a case - control study [J]. PLoS One, 2013, 8(7): e68556.
[ 16 ] Lam TH, Ho SY, Hedley AJ, et al. Mortality and smoking in Hong Kong: case - control study of all adult deaths in 1998 [J]. BMJ, 2001, 323(7309): 361.
[ 17 ] Liu BQ, Peto R, Chen ZM, et al. Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths [J]. BMJ, 1998, 317(7170): 1411 - 22.
[ 18 ] 祁军平,任红.兰州市居民COPD危险因素病例对照研究[J].甘肃医药,2015,34(03):176 - 178. Qi JP,Ren H. A case - control study on the risk factors of chronic obstructive pulmonary disease (COPD) in Lanzhou [J]. Gansu Medicine. 2015,34(03):176 - 178.
[ 19 ] 王文莉，文衍斌，陈楷诚等.汕头市男性居民吸烟与慢性病关系的前瞻性研究[J].广东医学,2004(07):842 - 843. Wang WL, Wen YB, Chen KC, et al. A prospective study on the relationship between smoking and chronic diseases in male residents in Shantou city [J]. Guangdong Medicine. 2015,34(03):176 - 178.
[ 20 ] Chang LC, Loh EW, Tsai YW, et al. Clinical benefits of smoking cessation in reducing all - cause and disease - specific mortality among older people in Taiwan: A 10 - year nationwide retrospective cohort study [J]. Eur Geriatr Med, 2014, 5(3): 149 - 54.
[ 21 ] Lam T H, Li ZB, Ho SY, et al. Smoking, quitting and mortality in an elderly cohort of 56,000 Hong Kong Chinese [J]. Tob Control, 2007, 16(3): 182 - 9.
[ 22 ] Yuan JM, Ross RK, Wang XL, et al. Morbidity and mortality in relation to cigarette smoking in Shanghai, China. A prospective male cohort study [J]. JAMA, 1996, 275(21): 1646 - 50.
[ 23 ] Lam TH, He Y, Li LS, et al. Mortality attributable to cigarette smoking in China [J]. JAMA, 1997, 278(18): 1505 - 8..
[ 24 ] He Y, Jiang B, Li LS, et al. Changes in smoking behavior and subsequent mortality risk during a 35 - year follow - up of a cohort in Xi’an, China [J]. Am J Epidemiol, 2014, 179(9): 1060 - 70.
[ 25 ] Chen Z, Peto R, Zhou M, et al. Contrasting male and female trends in tobacco - attributed mortality in China: evidence from successive nationwide prospective cohort studies [J]. Lancet, 2015, 386(10002): 1447 - 56.
[ 26 ] Chapman RS, He X, Blair AE, et al. Improvement in household stoves and risk of chronic obstructive pulmonary disease in Xuanwei, China: retrospective cohort study [J]. BMJ, 2005, 331(7524): 1050.
[ 27 ] Lam TH, Xu L, Schooling CM, et al. Smoking and mortality in a prospective cohort study of elderly Chinese in Hong Kong [J]. Addiction, 2015, 110(3): 502 - 10.
[ 28 ] Vogelmeier, CF. ,Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017. 195(5): p. 557 - 582.
[ 29 ] Rahman, I., Oxidative stress in pathogenesis of chronic obstructive pulmonary disease: cellular and molecular mechanisms. Cell Biochem Biophys, 2005. 43(1): p. 167 - 88.
[ 30 ] Yasuo, M. The relationship between acrolein and oxidative stress in COPD: in systemic plasma and in local lung tissue. Int J Chron Obstruct Pulmon Dis, 2019. 14: p. 1527 - 1537.
[ 31 ] Valavanidis, AT. Vlachogianni and K. Fiotakis, Tobacco smoke: involvement of reactive oxygen species and stable free radicals in mechanisms of oxidative damage, carcinogenesis and synergistic effects with other respirable particles. Int J Environ Res Public Health, 2009. 6(2): p. 445 - 62.
[ 32 ] Bartal M. Health effects of tobacco use and exposure [J]. Monaldi Arch Chest Dis, 2001, 56(6): 545 - 54.
[ 33 ] The Surgeon General’s 1990 Report on the Health Benefits of Smoking Cessation Executive Summary,[Z]1990. https://www.cdc.gov/ mmwr/preview/mmwrhtml/00001801.htm
[ 34 ] Shetty BSP, DsouzaG, Padukudru AM. Effect of Indoor Air Pollution on Chronic Obstructive Pulmonary Disease (COPD) Deaths in Southern Asia - A Systematic Review and Meta - Analysis [J]. Toxics, 2021, 9(4).
[ 35 ] Vikgren J, Bake B, Ekberg-Jansson A, et al. Value of air trapping in detection of small airways disease in smokers [J]. Acta Radiol, 2003, 44(5): 517-24.
[ 36 ] Liu T, Chen R, Zheng R, et al. Household Air Pollution From Solid Cooking Fuel Combustion and Female Breast Cancer [J]. Front Public Health, 2021, 9: 677851.
[ 37 ] 艾飞玲, 胡葵茹, 石钰霖等. 基于纽卡斯尔-渥太华量表对中国吸烟队列研究文献的质量评价 [J]. 中华疾病控制杂志, 2021, 25(06): 722-9. Ai FL, Hu KR, Shi YL, et al. Quality evaluation of smoking cohort studies in China based on Newcastle-Ottawa Scale [J].Chinese Journal of Disease Control,2021, 25(06): 722-9.

备注/Memo

备注/Memo:
基金项目：中国医学科学院协同创新团队项目“基于队列的环境因素和消化道微生态变化对我国消化系统相关疾病健康效应研究”（2016-12M-3 -001）；美国中华医学基金会(China Medical Board)项目“Strengthen Capacity of Study and Application on Burden of Disease in Health Care System of China–Establishment and Development of Chinese Burden of Disease Research and Dissemination Center”(15-208)
作者简介：杨文怡（1998—），硕士在读，研究方向：疾病负担和烟草控制相关研究
通信作者：万霞，E-mail：xiawan@ibms.pumc.edu.cn
更新日期/Last Update: 2022-11-30