Objective: To understand the distribution and characteristics of people aged ≥40 years who are at high risk of COPD in China and provide evidence for COPD prevention and control. Methods: The survey was conducted among the subjects selected through multi-stage stratified cluster sampling from 31 provinces (autonomous regions and municipalities) in China for 2014-2015 national chronic obstructive pulmonary disease surveillance. A total of 75 107 people aged ≥40 years in 125 surveillance points were surveyed in face to face interviews. Subjects who met at least one of the following conditions, including chronic respiratory symptoms, exposure to risk factors, medical history of respiratory diseases, and family history, were defined as population at high risk. The weighted proportion of the population at high risk of COPD and 95%CI were estimated by using complex sampling design. Results: Among eligible 74 296 subjects, the proportion of population at high risk of COPD was 89.5% (95%CI: 87.8%-91.2%). The proportion significantly increased with age (P<0.001). The proportion of the population at high risk was significantly higher in men than in women (P<0.001), and in rural area than in urban area (P<0.001). The highest proportion of population at high risk was observed in men in rural area in western China. The proportion of population at high risk of COPD who met at least two conditions was 32.0% (95%CI:29.7%-34.2%), the proportion of those who met at least three conditions was 7.4% (95%CI: 6.6%- 8.3%), and the proportion of those who met all the conditions was 1.5% (95%CI: 1.2%-1.8%). Among population at high risk of COPD, those who only had exposure to one risk factor accounted for 61.7% (95%CI: 59.8%-63.7%). Conclusion: About 90% of people aged ≥40 years in China are at high risk for COPD. It is necessary to conduct population-based screening for COPD and take comprehensive measures to reduce prevalence of risk factors.
Adult ; Asian People/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Pulmonary Disease, Chronic Obstructive/ethnology* ; Risk Factors ; Rural Population ; Surveys and Questionnaires ; Urban Population

PURPOSE: Roflumilast is the only oral phosphodiesterase 4 inhibitor approved to treat chronic obstructive pulmonary disease (COPD) patients [post-bronchodilator forced expiratory volume in 1 second (FEV1) <50% predicted] with chronic bronchitis and a history of frequent exacerbations. This study evaluated the efficacy and safety of roflumilast in Korean patients with COPD and compared the efficacy based on the severity of airflow limitation. MATERIALS AND METHODS: A post-hoc subgroup analysis was performed in Korean COPD patients participating in JADE, a 12-week, double-blinded, placebo-controlled, parallel-group, phase III trial in Asia. The primary efficacy endpoint was the mean [least-squares mean adjusted for covariates (LSMean)] change in post-bronchodilator FEV1 from baseline to each post-randomization visit. Safety endpoints included adverse events (AEs) and changes in laboratory values, vital signs, and electrocardiograms. RESULTS: A total of 260 Korean COPD patients were recruited, of which 207 were randomized to roflumilast (n=102) or placebo (n=105) treatment. After 12 weeks, LSMean post-bronchodilator FEV1 increased by 43 mL for patients receiving roflumilast and decreased by 60 mL for those taking placebo. Adverse events were more common in the roflumilast group than in the placebo group; however, the types and frequency of AEs were comparable to those reported in previous studies. CONCLUSION: Roflumilast significantly improved lung function with a tolerable safety profile in Korean COPD patients irrespective of the severity of airflow limitation.
Aged ; Aminopyridines/*therapeutic use ; *Asian Continental Ancestry Group ; Benzamides/*therapeutic use ; Cyclopropanes/therapeutic use ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Phosphodiesterase 4 Inhibitors/*therapeutic use ; Pulmonary Disease, Chronic Obstructive/*drug therapy/*ethnology/physiopathology ; Republic of Korea ; Respiratory Function Tests ; Treatment Outcome

BACKGROUND/AIMS: Cigarette smoking is the most common risk factor for chronic obstructive pulmonary disease (COPD). However, few studies of the attitudes toward COPD of smokers, the group at risk of developing this condition, have been conducted. The purpose of this study was to explore the awareness of and attitudes toward COPD of current smokers. METHODS: The sample consisted of 502 individuals aged 45 and older from throughout Korea who smoked at least 10 packs of cigarettes per year. Telephone interviews using a structured questionnaire were conducted with respondents. RESULTS: First, we evaluated the health status of subjects, finding that 45.4% considered themselves to be in good health. We also asked about COPD-related symptoms, and 60.6% of subjects reported such symptoms. However, only 1.2% of subjects had been diagnosed with or treated for COPD, only 0.4% spontaneously mentioned COPD as a respiratory disease, and only 26.5% recognized COPD as a respiratory disease after seeing a list of such diseases. Television ranked as the top source of information about COPD. The willingness of 45.0% of subjects to stop smoking increased after being informed about COPD. CONCLUSIONS: Despite having COPD-related symptoms, most smokers did not know that COPD is a respiratory disease. The attitudes of smokers toward COPD and smoking cessation varied according to socioeconomic status. In summary, a continuous effort to increase the awareness of COPD among smokers is needed. Additionally, strategies tailored according to different socioeconomic groups will also be necessary.
Aged ; Asian Continental Ancestry Group/*psychology ; *Awareness ; Consumer Health Information ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice/*ethnology ; Health Promotion ; Health Status ; Health Surveys ; Humans ; Male ; Mass Media ; Middle Aged ; Patient Compliance/ethnology ; Pulmonary Disease, Chronic Obstructive/diagnosis/*ethnology/psychology/therapy ; Republic of Korea/epidemiology ; Risk Factors ; Risk Reduction Behavior ; Smoking/*adverse effects/*ethnology/prevention & control/psychology ; Smoking Cessation/ethnology ; Socioeconomic Factors ; Surveys and Questionnaires ; Time Factors

No abstract available.
Asian Continental Ancestry Group/*psychology ; *Awareness ; Female ; Health Knowledge, Attitudes, Practice/*ethnology ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive/*ethnology ; Smoking/*adverse effects/*ethnology

OBJECTIVE: To test the association of K469E, the common intercellular adhesion molecule-1 (ICAM-1) polymorphism with chronic obstructive pulmonary disease (COPD) and expression of ICAM-1 in Han people of Central and South Region in China. METHODS: A case-control study was done on 91 patients with COPD and 80 matched controls of Han people from central and south region in China, mainly from Hunan Province. Genomic DNA was extracted from white blood cells. ICAM-1 sequences were amplified by PCRand analyzed by agarose gel electrophoresis. Genotypes were defined by base sequencing. In addition, soluable intercellular adhesion molecule-1 (sICAM-1) serum levels were measured in 86 people picked out randomly from the COPD group and the control group. RESULTS: There was no difference in the frequency of the genotype and allele between the COPD group and the controls, but compared with those who were not very severe, the frequency of KE/ EE genotypes and E allele in COPD patients at very severe stage was significantly higher (10/16 vs 26/75, 12/30 vs 20/150, P<0.05). The level of sICAM-1 increased in the COPD patients, with negative correlation to forced expiratory volume in one second for the percentage of predicted value (FEV1%). But in both COPD patients and controls, the level of sICAM-1 did not differ significantly in different genotypes(P>0.05). CONCLUSION K469E polymorphism of ICAM-1 may not affect the susceptibility of COPD and the expression of ICAM-1 in Han people from central and south of China in this study, but carriers of E allele are at high risk of developing severe stage of COPD.
Aged ; Alleles ; Base Sequence ; Case-Control Studies ; China ; ethnology ; Female ; Genotype ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Genetic ; Prognosis ; Pulmonary Disease, Chronic Obstructive ; genetics ; Risk Factors

BACKGROUNDGenetic factors are believed to play a role in the individual susceptibility to chronic obstructive pulmonary disease (COPD). A single nucleotide polymorphism (SNP) of tumour necrosis factor-alpha (TNF-alpha) has been reported but inconsistent results may arise from different populations and phenotypes of COPD. There are only a few published studies of interleukin-13 (IL-13) SNPs on COPD. The SNPs of TNF-alpha and IL-13 have not been studied in the Chinese population. This research was conducted to study the frequencies of IL-13 gene promoter 1055 (IL-13-1055) and TNF-alpha gene-308 polymorphisms in the patients with COPD and to investigate the effect of those genetic polymorphisms on COPD in the Chinese population.

METHODSA cohort of COPD patients and age matched controls were recruited from an inpatient hospital service in Beijing. Venous blood was obtained and genomic DNA was extracted from peripheral blood monocytes using standard method. Genomic DNA was used as a template for amplification by polymerase chain reaction (PCR) to determine the polymorphism at -1055 in the IL-13 gene promoter region. PCR restriction fragment length polymorphism (RFLP) was used to determine polymorphisms in the TNF-alpha gene-308 position. The products were investigated by sequence analysis also.

RESULTSOne hundred and eleven COPD patients and 97 controls were studied. Seventy-five cases were current smokers in COPD patients and 36 were current smokers in controls. The frequencies of TT genotype in the IL-13 gene promoter region were 11.7% (13/111) in the COPD group and 13.4% (13/97) in the controls (P = 0.713). However, the OR value of TT genotype was significantly increased to 6.4 (95% CI 1.62 - 25.39) in the smokers with COPD. TT genotype was also positively related to family history of COPD, OR = 7.7 (95% CI 1.37 - 43.80). The frequencies of A allele in the TNF-alpha gene were 5.9% in COPD and 3.1% in controls (P = 0.131). The OR value of A allele was 5.0 (95% CI 1.011 to 25.059) in smokers with COPD.

CONCLUSIONSThere is no significant difference in the frequencies of the TT genotype of IL-13-1055 or the A allele of the TNF-alpha between Han Chinese patients with COPD versus control. Thus, it does not appear that these SNPs are independent factors in COPD for Han nationality in Beijing. However, these SNPs may increase the risk of COPD among smokers.

Adult ; Aged ; China ; ethnology ; Female ; Genotype ; Humans ; Interleukin-13 ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Pulmonary Disease, Chronic Obstructive ; genetics ; immunology ; Tumor Necrosis Factor-alpha ; genetics

OBJECTIVETo study the association between the functional polymorphism of matrix metalloproteinases (MMPs) and the development of chronic obstructive pulmonary disease (COPD).

METHODS147 COPD patients and 120 healthy smoking controls were selected. Spirometry and chest X-rays had been taken. Questionnaires including sex, age, smoking history, occupational exposure were completed. MMP-9 (-1562 C/T), MMP-1(-1607 1G/2G), MMP-12 (-82 A/G), MMP-12(-357 Asn/ Ser) alleles were determined using PCR-RFLP method. Independent samples T test analysis was carried out to compare patients' age, smoking index, FEV1 /FVC, FEV1 % pred with that of healthy controlled group. The frequencies of genotypes and alleles between groups were analyzed by chi-square tests and multilogistic regression.

RESULTSMMP12 Asn/Asn, CT/AsnAsn were risk factors for smoking-induced COPD. The ORs were 2.361 (95% CI: 1.369-4.017) and 2.433(95% CI: 1.159-5.342) respectively while CC/1G1G/ SerSer seemed to be a protective factor for smoking-induced COPD, with OR as 0.457 and 95% CI as 0.231-0.911.

CONCLUSIONAsn/Asn, CT/AsnAsn might be susceptible genotypes while CC/GG/SerSer might serve as protective genotype.

Aged ; Case-Control Studies ; China ; ethnology ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Logistic Models ; Male ; Matrix Metalloproteinase 1 ; genetics ; Matrix Metalloproteinase 12 ; genetics ; Matrix Metalloproteinase 9 ; genetics ; Polymorphism, Genetic ; Pulmonary Disease, Chronic Obstructive ; genetics

Whether surfactant protein B (SP-B)-18A/C and 1580C/T polymorphism were associated with susceptibility to chronic obstructive pulmonary disease (COPD) in Chinese Han population was investigated. After genomic DNA was isolated from blood of COPD smokers and control smokers, the genotypes of SP-B-18A/C and SP-B1580C/T polymorphism loci were determined by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) respectively. The results showed that there was significant difference in genotypes distribution frequency of SP-B1580C/T polymorphism locus between COPD smokers and control smokers. C-->T mutation rate (including TT homozygote and CT heterozygote) in COPD smokers was higher than in control smokers (57.9% vs 41.7%, chi2 = 4.93, P<0.05), whereas there was no significant difference in genotypes distribution frequency of SP-B1580-18A/C locus between COPD smokers and control smokers. The allele frequency (29.1%) of SP-B1580-18A/C locus is lower than T allele (70.9%) in Chinese Han Population, and the distribution was different from that in Mexican, in which, the A and T allele frequencies were 85% and 15% respectively. It was concluded that SP-B1580 T allele was probably associated with increased susceptibility to COPD in Chinese Han population; The polymorphism of SP-B-18A/C locus maybe varied with race.
Alleles ; China ; ethnology ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Male ; Polymorphism, Genetic ; genetics ; Pulmonary Disease, Chronic Obstructive ; genetics ; Pulmonary Surfactant-Associated Protein B ; genetics ; physiology ; Smoking ; genetics

BACKGROUNDThere are many candidate genes for chronic obstructive pulmonary disease (COPD). Matrix metalloproteinase-9 (MMP-9) plays an essential role in tissue remodeling and repair associated with development of COPD. In this study we investigated the correlation between MMP-9 gene polymorphism and COPD susceptibility in the Han population of South China.

METHODSWe examined the frequency of polymorphic genotypes of the MMP-9 promoter (-1562C/T) in 100 COPD patients and 98 healthy smokers by restriction fragment length polymorphism.

RESULTSThe frequencies of polymorphic genotypes in promoters of MMP-9 were C/C 86%, C/T 14% in COPD group; and C/C 98%, C/T 2% in the control group. There were significant differences between the two groups (P < 0.01). The allele frequencies were also significantly different between the COPD group and the control group (C allele frequency: 93% vs 99%, T allele frequency: 7% vs 1%, P < 0.05 respectively).

CONCLUSIONThe genetic polymorphism in promoters of MMP-9 gene is associated with the susceptibility to COPD in the Han population of South China.

Adult ; Aged ; China ; ethnology ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Matrix Metalloproteinase 9 ; genetics ; Middle Aged ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Pulmonary Disease, Chronic Obstructive ; genetics

In order to investigate whether polymorphism in gene for heat shock protein 70 (HSP70) has any bearing on individual susceptibility to the development of chronic obstructive pulmonary disease (COPD), the geotypes of 88 patients with COPD and 87 healthy smoking control subjects were tested by polymerase chain reaction followed by restriction fragment polymorphism analysis for HSP70 gene. In COPD group, HSP70-1 genotype A/A, A/B and B/B was 59.1%, 35.2% and 5.7%, HSP70-2 genotype A/A, A/B and B/B was 26.1%, 54.6% and 19.3%, and HSP70-hom genotype A/A, A/B and B/B was 70.4%, 27.3% and 2.3% respectively. In the control group, it was 60.9%, 27.5% and 3.5%, 20.7%, 56.3% and 23.0%, and 54.0%, 42.5% and 3.5%, respectively. The frequency of polymorphic genetypes showed no difference between the COPD group and the control group (P>0.05). It was suggested that geneic polymorphism in HSP70 is not associated with development of COPD in Han nationality of China.
China ; ethnology ; Ethnic Groups ; Genetic Predisposition to Disease ; genetics ; HSP70 Heat-Shock Proteins ; genetics ; Humans ; Polymorphism, Restriction Fragment Length ; Pulmonary Disease, Chronic Obstructive ; genetics ; Smoking