Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis.
Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis.
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DOI：
10.2147/copd.s146390
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发表时间：
2018
影响因子：
2.8
通讯作者：
Evangelou E
中科院分区：
文献类型：
--
作者：
Ntritsos G;Franek J;Belbasis L;Christou MA;Markozannes G;Altman P;Fogel R;Sayre T;Ntzani EE;Evangelou E
COPD被认为是老年男性的疾病。然而，仅在美国，估计就有超过700万女性患有COPD。尽管越来越多的文献表明女性COPD的负担越来越大，但证据有限。评估和综合基于人群的流行病学研究中的可用证据，并计算COPD在男性和女性中的全球患病率。进行了一项系统性综述和荟萃分析，报告了COPD的性别特异性患病率。按性别分列的流行率估计数摘自相关研究。还收集了相关的患者特征以及与诊断方法有关的自定义变量和其他重要的流行病学协变量。进行贝叶斯随机效应荟萃分析，调查按年龄、地理位置、日历时间、研究环境、诊断方法和疾病严重程度分层的COPD性别特异性患病率。在194项合格研究中，男性和女性的汇总患病率分别为9.23%（95%可信区间[CrI]：8.16%-10.36%）和6.16%（95%可信区间[CrI]：5.41%-6.95%）。世界卫生组织全球疾病负担次区域的性别患病率差异很大，北美女性患病率最高（8.07%对7.30%），城市环境中的参与者最高（13.03%对8.34%）。荟萃回归分析表明，年龄≥40岁和支气管扩张剂试验对研究间患病率估计值的异质性贡献最大。我们对COPD的全球患病率进行了有史以来规模最大的系统性综述和荟萃分析，并进行了首次大型性别特异性综述。这些结果将提高人们对COPD作为一个重要的女性健康问题的认识。
COPD has been perceived as being a disease of older men. However, >7 million women are estimated to live with COPD in the USA alone. Despite a growing body of literature suggesting an increasing burden of COPD in women, the evidence is limited. To assess and synthesize the available evidence among population-based epidemiologic studies and calculate the global prevalence of COPD in men and women. A systematic review and meta-analysis reporting gender-specific prevalence of COPD was undertaken. Gender-specific prevalence estimates were abstracted from relevant studies. Associated patient characteristics as well as custom variables pertaining to the diagnostic method and other important epidemiologic covariates were also collected. A Bayesian random-effects meta-analysis was performed investigating gender-specific prevalence of COPD stratified by age, geography, calendar time, study setting, diagnostic method, and disease severity. Among 194 eligible studies, summary prevalence was 9.23% (95% credible interval [CrI]: 8.16%–10.36%) in men and 6.16% (95% CrI: 5.41%–6.95%) in women. Gender prevalences varied widely by the World Health Organization Global Burden of Disease subregions, with the highest female prevalence found in North America (8.07% vs 7.30%) and in participants in urban settings (13.03% vs 8.34%). Meta-regression indicated that age ≥40 and bronchodilator testing contributed most significantly to heterogeneity of prevalence estimates across studies. We conducted the largest ever systematic review and meta-analysis of global prevalence of COPD and the first large gender-specific review. These results will increase awareness of COPD as a critical woman’s health issue.