RISK FACTORS FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE

慢性阻塞性肺疾病(COPD)是导致 发达国家的发病率和死亡率。在发达地区 国家慢性阻塞性肺病主要与吸烟有关。寻找 定义吸烟易感性的因素是一个重要的因素 只有15%的吸烟者会患上慢性阻塞性肺疾病。慢性阻塞性肺病也是一个主要原因。 1973年-2005年中国农村和农村居民发病率和过早死亡情况 在受影响最严重的地区，65岁的累积死亡率为16%。 上世纪70年代中期，中国的男女死亡率大致相当 尽管吸烟频率有很大差异(77%的男性 而女性的比例为12%)。这可能反映了较低的累积暴露于 制造的香烟，并可能表明其他风险的重要性 各种因素。20世纪80年代，中国的卷烟生产增加了 戏剧性地，今天的年轻人将达到中老年 在下个世纪，累积暴露水平很高。建议数 该项目旨在确定该人群中与慢性阻塞性肺疾病风险相关的因素 在那里，吸烟的全部影响还不明显。这个 研究可以获得详细信息，包括肺功能 使用标准化方法进行测试和测量血压，在 居住在北京的大约10,000名35岁的男女 中国农村69个县，台湾16个县。本研究 人口具有许多优势，包括累积包装年数较低 暴露和关于许多潜在风险因素的完整数据，包括年龄， 性，吸烟，饮酒，童年接触，室内空气污染， 成人病史和营养状况的问卷调查 和生化标记物。 设想了三个相辅相成的子项目以满足 这个项目的具体目标。第一阶段，县级慢阻肺 1986-88年死亡率数据和发病率的汇总测量(汇总 个体肺活量读数)将用于生态分析和 与风险暴露的简要措施相关的审查。接下来，数据位于 个别研究对象将被用来检验一个 通过肺功能评估COPD发病率的各种因素 测试和呼吸道症状问卷。最后，更小的 对个体的研究计划采用嵌套病例对照或 队列设计，进一步探讨生化标记物之间的关系 营养状况与慢性阻塞性肺疾病发病的关系。

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality throughout the developed world. In developed countries COPD is primarily related to cigarette smoking. The search for factors that define susceptibility to cigarette smoke is an important task as only 15% of smokers develop COPD. COPD also is a leading cause of morbidity and premature mortality in rural China and in 1973-5 cumulative mortality to age 65 was 16% in the worst affected areas. Female and male mortality rates in China were about equal in the mid-70s despite dramatic differences in the frequency of smoking (77% of men versus 12% of women). This may reflect the low cumulative exposure to manufactured cigarettes and may indicate the importance of other risk factors. In the 1980s the manufacture of cigarettes in China increased dramatically, and the young people of today will reach middle and old age in the next century with high cumulative exposure levels. The proposed project seeks to identify factors related to COPD risk in this population where the full effects of cigarette smoking are not yet evident. The study has access to detailed information, including pulmonary function tests and blood pressure measurements using standardized methodology, on a cohort of approximately 10,000 35-64 year old men and women residing in 69 counties in rural China and 16 counties in Taiwan. This study population offers many advantages including low cumulative pack-years exposure and complete data on many potential risk factors including age, sex, smoking, alcohol intake, childhood exposures, indoor air pollution, adult medical history, and nutritional status measured by questionnaire and biochemical markers. Three complementary subprojects are envisioned to meet the specific aims of this project. At the first stage, county-level COPD mortality data from 1986-88 and summary measures of morbidity (aggregated individual spirometry readings) will be used in ecologic analyses and examined in relation to summary measures of exposure. Next, data on individual study subjects will be used to examine the relation of a variety of factors to COPD morbidity, assessed through pulmonary function testing and a respiratory symptom questionnaire. Finally, smaller studies of individuals are planned using either nested case-control or cohort designs, to further explore the relation of biochemical markers of nutritional status to COPD morbidity.