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  • Knox-Brown, BenImperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England. (författare)

Small airways obstruction and its risk factors in the Burden of Obstructive Lung Disease (BOLD) study : a multinational cross-sectional study

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • Elsevier,2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-510352
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-510352URI
  • https://doi.org/10.1016/S2214-109X(22)00456-9DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background: Small airways obstruction is a common feature of obstructive lung diseases. Research is scarce on small airways obstruction, its global prevalence, and risk factors. We aimed to estimate the prevalence of small airways obstruction, examine the associated risk factors, and compare the findings for two different spirometry parameters.Methods: The Burden of Obstructive Lung Disease study is a multinational cross-sectional study of 41 municipalities in 34 countries across all WHO regions. Adults aged 40 years or older who were not living in an institution were eligible to participate. To ensure a representative sample, participants were selected from a random sample of the population according to a predefined site-specific sampling strategy. We included participants' data in this study if they completed the core study questionnaire and had acceptable spirometry according to predefined quality criteria. We excluded participants with a contraindication for lung function testing. We defined small airways obstruction as either mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FEF25-75) less than the lower limit of normal or forced expiratory volume in 3 s to forced vital capacity ratio (FEV3/FVC ratio) less than the lower limit of normal. We estimated the prevalence of pre-bronchodilator (ie, before administration of 200 mu g salbutamol) and post-bronchodilator (ie, after administration of 200 mu g salbutamol) small airways obstruction for each site. To identify risk factors for small airways obstruction, we performed multivariable regression analyses within each site and pooled estimates using random-effects meta-analysis.Findings: 36 618 participants were recruited between Jan 2, 2003, and Dec 26, 2016. Data were collected from participants at recruitment. Of the recruited participants, 28 604 participants had acceptable spirometry and completed the core study questionnaire. Data were available for 26 443 participants for FEV3/FVC ratio and 25 961 participants for FEF25-75. Of the 26 443 participants included, 12 490 were men and 13 953 were women. Prevalence of pre-bronchodilator small airways obstruction ranged from 5% (34 of 624 participants) in Tartu, Estonia, to 34% (189 of 555 participants) in Mysore, India, for FEF25-75, and for FEV 3/FVC ratio it ranged from 5% (31 of 684) in Riyadh, Saudi Arabia, to 31% (287 of 924) in Salzburg, Austria. Prevalence of post-bronchodilator small airways obstruction was universally lower. Risk factors significantly associated with FEV 3/FVC ratio less than the lower limit of normal included increasing age, low BMI, active and passive smoking, low level of education, working in a dusty job for more than 10 years, previous tuberculosis, and family history of chronic obstructive pulmonary disease. Results were similar for FEF25-75, except for increasing age, which was associated with reduced odds of small airways obstruction.Interpretation: Despite the wide geographical variation, small airways obstruction is common and more prevalent than chronic airflow obstruction worldwide. Small airways obstruction shows the same risk factors as chronic airflow obstruction. However, further research is required to investigate whether small airways obstruction is also associated with respiratory symptoms and lung function decline.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Patel, JayminiImperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England. (författare)
  • Potts, JamesImperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England. (författare)
  • Ahmed, RanaEpidemiol Lab Publ Hlth Res & Dev, Khartoum, Sudan. (författare)
  • Aquart-Stewart, AltheaUniv West Indies, Dept Med, Mona, Jamaica. (författare)
  • Cherkaski, Hamid HaceneUniv Badji Mokhtar Annaba, Fac Med Annaba, Dept Pneumol, Annaba, Algeria. (författare)
  • Denguezli, MeriamUniv Monastir, Fac Med Dent Monastir, Monastir, Tunisia. (författare)
  • Elbiaze, MohammedMohammed Ben Abdellah Univ, Univ Hosp, Fac Med, Dept Resp Med, Fes, Morocco. (författare)
  • Elsony, AsmaEpidemiol Lab Publ Hlth Res & Dev, Khartoum, Sudan. (författare)
  • Franssen, Frits M. E.Maastricht Univ, Dept Resp Med, Med Ctr, Maastricht, Netherlands.;CIRO, Dept Res & Educ, Horn, Netherlands. (författare)
  • Al Ghobain, MohammedKing Saud Bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Minist Natl Guard Hlth Affairs, Riyadh, Saudi Arabia. (författare)
  • Harrabi, ImedUniv Sousse, Ibn El Jazzar Fac Med Sousse, Sousse, Tunisia. (författare)
  • Janson, ChristerUppsala universitet,Lung- allergi- och sömnforskning(Swepub:uu)chrisjn (författare)
  • Jogi, RainUppsala universitet,Lung- allergi- och sömnforskning,Tartu Univ Hosp, Lung Clin, Tartu, Estonia. (författare)
  • Juvekar, SanjayKEM Hosp Res Ctr, Vadu Rural Hlth Program, Pune, India. (författare)
  • Lawin, HerveUniv Abomey Calavi, Unit Teaching & Res Occupat & Environm Hlth, Cotonou, Benin. (författare)
  • Mannino, DavidUniv Kentucky, Lexington, KY USA.;COPD Fdn, Miami, FL USA. (författare)
  • Mortimer, KevinUniv Cambridge, Cambridge, England.;Liverpool Univ Hosp NHS Fdn Trust, Liverpool, England. (författare)
  • Nafees, Asaad AhmedAga Khan Univ, Dept Community Hlth Sci, Karachi, Pakistan. (författare)
  • Nielsen, RuneHaukeland Hosp, Dept Thorac Med, Bergen, Norway.;Univ Bergen, Dept Clin Sci, Bergen, Norway. (författare)
  • Obaseki, DanielObafemi Awolowo Univ, Ife, Nigeria. (författare)
  • Paraguas, Stefanni Nonna M.Philippine Coll Chest Phys, Quezon City, Philippines.;Philippine Heart Ctr, Quezon City, Philippines. (författare)
  • Rashid, AbdulRCSI & UCD Malaysia Campus, George Town, Malaysia. (författare)
  • Loh, Li-CherRCSI & UCD Malaysia Campus, George Town, Malaysia. (författare)
  • Salvi, SundeepPulmocare Res & Educ Fdn, Pune, India.;Symbiosis Int Deemed Univ, Pune, India. (författare)
  • Seemungal, TerenceUniv West Indies, Fac Med Sci, St Augustine, Trinidad Tobago. (författare)
  • Studnicka, MichaelParacelsus Med Univ Salzburg, Univ Clin Pneumol, Salzburg, Austria. (författare)
  • Tan, Wan C.Univ British Columbia, Ctr Heart Lung Innovat, Vancouver, BC, Canada. (författare)
  • Wouters, Emiel E. F. M.Maastricht Univ, Dept Resp Med, Med Ctr, Maastricht, Netherlands.;Ludwig Boltzmann Inst Lung Hlth, Vienna, Austria. (författare)
  • Barbara, CristinaUniv Lisbon, Fac Med, Inst Saude Ambiental, Lisbon, Portugal.;Ctr Hosp Univ Lisboa Norte, Serv Pneumol, Lisbon, Portugal. (författare)
  • Gislason, ThorarinnLandspitali Univ Hosp, Dept Sleep, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland. (författare)
  • Gunasekera, KirthiCent Chest Clin, Med Res Inst, Colombo, Sri Lanka. (författare)
  • Burney, PeterImperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England. (författare)
  • Amaral, Andre F. S.Imperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England. (författare)
  • Imperial Coll London, Natl Heart & Lung Inst, London SW3 6LR, England.Epidemiol Lab Publ Hlth Res & Dev, Khartoum, Sudan. (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:The Lancet Global Health: Elsevier11:1, s. E69-E822214-109X

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