Risk of Rapid Lung Function Decline in Young Adults With Chronic Obstructive Pulmonary Disease: A Community-Based Prospective Cohort Study

Global, regional, and national burden of young COPD, 1990-2021, with forecasts to 2050: a systematic analysis for the global burden of disease study 2021

BACKGROUND

Young chronic obstructive pulmonary disease (COPD) refers to people with COPD between the ages of 20 and 50 years. Current epidemiological studies focus on local geography, and there is a lack of global-level analysis. This study provides in-depth analyses of the disease burden of young COPD at global, regional, and national levels.

METHODS

This study used the Global Burden of Disease Study 2021 (GBD). The age-standardised prevalence rate (ASPR), age-standardised incidence rate (ASIR), age-standardised death rate (ASDR), and age-standardised disability-adjusted life years (DALYs) rate were used to describe the disease burden. The estimated annual percentage change (EAPC) during the study period was calculated. Joinpoint regression analysis examined the time trend from 1990 to 2021. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Risk factors were reported by region and sex.

RESULTS

In 2021, the global number of young COPD cases was 30,384,539, and the ASPR, ASIR, ASDR, and age-standardised DALYs rates fell slightly. Oceania reported the highest ASPR, ASDR, and age-standardised DALYs rate. High-income North America has the highest ASIR. In 2021, the prevalence, incidence, death, and DALYs rates exhibited similar trends, increasing with age. From 1990 to 2021, both the prevalence and death rates showed a consistent downward trend across all age groups. Joinpoint regression analysis indicated a slight increase in both the ASPR (APC: 0.13; 95% CI: 0.06 to 0.19) and the ASIR (APC: 0.17; 95% CI: 0.10 to 0.24) during the period from 1990 to 1994. The leading DALYs attributable to risk factors for young COPD are household air pollution from solid fuels (20.4%), ambient particulate matter pollution (17.9%), and smoking (13.5%).

CONCLUSIONS

The global burden of ASPR, ASIR, ASDR, and age-standardised DALYs rates in young COPD has decreased, however, the absolute number of patients has increased. The global burden shows noticeable regional differences, with particularly high burdens observed in Oceania. Improving air quality, promoting smoking cessation, and increasing access to lung function tests, raising awareness of young COPD are key strategies for alleviating the burden of young COPD.

Genome-Wide Association Analysis of Rapid Decline in Lung Function: Analysis From the Korean Genome and Epidemiology Study

BACKGROUND

A rapid decline in forced expiratory volume in 1 second (FEV1) is considered an important phenotype of the development of chronic obstructive pulmonary disease (COPD). However, the associations between specific genetic variants (single-nucleotide polymorphisms; SNPs) and this phenotype remain uncertain.

METHODS

We enrolled 6,516 individuals from the Korean Genome and Epidemiology Study (KoGES). A rapid decline in FEV1 was defined as an annual decrease of FEV1 ≥ 60 mL/year. A multivariable logistic regression model was used to assess the associations between SNP variants and the rapid decline in FEV1. Considering the significant impact of smoking on lung function, a subgroup analysis based on smoking history was also conducted.

RESULTS

A genome-wide association analysis of the rapid decline in FEV1 identified 15 association signals (P < 5.0 × 10-8). Among the 15 nucleotide variants, rs9833533 and rs1496255 have been previously reported to be associated with lung function development. In the subgroup analysis, rs16951883 (adjusted odds ratio [aOR], 3.24; P = 5.87 × 10-8) was the most significant SNP associated with rapid decline in FEV1 among never smokers, followed by rs41476549, rs16840064, and rs1350110. Conversely, among ever smokers, rs10959478 (aOR, 4.74; P = 8.27 × 10-7) showed the highest significance, followed by rs6805861, rs9833533, and rs16906215.

CONCLUSION

We identified 15 nucleotide variants linked to a rapid decline in FEV1, including two SNPs previously reported to be associated with lung function development. Additional SNPs, which were associated with COPD, may be found using novel phenotypes.

Prevalence of and factors associated with likely obstructive sleep apnea in individuals with airflow limitation

Introduction

Obstructive sleep apnea (OSA) is frequently associated with airflow limitation (AFL). However, information on the prevalence of and factors associated with likely OSA in individuals with AFL in Korea is limited.

Methods

Data from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used, and 3,280 individuals (2,826 individuals without AFL and 454 individuals with AFL) were included. AFL was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 0.7. A score ≥ 5 on the STOP-BANG questionnaire was used to identify individuals with likely OSA. The prevalence of likely OSA was compared between individuals with and without AFL. In addition, factors associated with likely OSA in individuals with AFL were evaluated using multivariable logistic regression analysis.

Results

Of 3,280 individuals, 13.8% had an AFL. The prevalence of likely OSA was significantly higher in individuals with AFL than in individuals without AFL (9.2% vs. 5.0%, p = 0.014). Among 454 individuals with AFL, obesity (adjusted odds ratio [aOR] = 14.78, 95% confidence interval [CI] = 4.20-52.02) was most strongly associated with likely OSA, followed by heavy alcohol consumption (aOR = 4.93, 95% CI = 1.91-12.70), hypertension (aOR = 4.92, 95% CI = 1.57-15.46), overweight (aOR = 4.71, 95% CI = 1.76-12.64), college graduate (aOR = 4.47, 95% CI = 1.10-18.22), and history of pulmonary tuberculosis (aOR = 3.40, 95% CI = 1.06-10.96).

Conclusion

In Korea, approximately 1 in 10 individuals with AFL had likely OSA. Overweight and obesity, heavy alcohol consumption, high educational level, hypertension, and history of pulmonary tuberculosis were associated with likely OSA in individuals with AFL.

Association Between Instant Coffee Consumption and the Development of Chronic Obstructive Pulmonary Disease: Results From a Community-Based Prospective Cohort

BACKGROUND

A poor diet is a risk factor for chronic obstructive pulmonary disease (COPD). The interaction between dietary factors and cigarette smoking in the development of COPD is unclear. We investigated the interactions between dietary patterns and smoking status on COPD-related outcomes.

METHODS

We used data from the Anseong-Ansan cohort that has been followed for 20 years. A total of 6,221 individuals without COPD in the baseline survey were analyzed. Five dietary patterns were identified using a semi-quantitative food frequency questionnaire. Associations of dietary patterns with COPD and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio in different strata of smoking status were evaluated using Cox regression and linear mixed models, respectively.

RESULTS

The highest quartile of the "coffee" pattern (high coffee consumption) was associated with COPD (hazard ratio, 1.46; 95% confidence interval [CI], 1.03-2.08) and lower FEV1/FVC ratio (β = -1.2%; 95% CI, -1.9% to -0.6%) using the lowest quartile as a reference for heavy smokers, but not light or never smokers (P value for interaction = 0.035 for COPD). Regarding the associations between various consumption levels of black coffee, combined coffee, and instant coffee and COPD, an association with COPD was only observed for instant coffee in heavy smokers.

CONCLUSION

High instant coffee consumption is associated with COPD development in heavy smokers, but not in light or never smokers. This may be attributed to sugar and cream in instant coffee mixes.