Association between socioeconomic status and chronic obstructive pulmonary disease in Jiangsu province, China: a population-based study  

作　　者：Dan-Dan Zhang Jian-Nan Liu Qing Ye Zi Chen Ling Wu Xue-Qing Peng Gan Lu Jin-Yi Zhou Ran Tao Zhen Ding Fei Xu Linfu Zhou 

机构地区：[1]Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital,Nanjing Medical University,Nanjing,Jiangsu 210029,China [2]Chronic Airway Disease Research Office,Department of Respiratory Medicine,Geriatric Hospital of Nanjing Medical University,Nanjing,Jiangsu 210024,China [3]Department of Respiratory Medicine,Jiangsu Province Geriatric Hospital,Nanjing,Jiangsu 210024,China [4]Nanjing Municipal Center for Disease Control and Prevention,Nanjing,Jiangsu 210037,China [5]Department of Pharmacy,Geriatric Hospital of Nanjing Medical University,Nanjing,Jiangsu 210024,China [6]School of Public Health,Nanjing Medical University,Nanjing,Jiangsu 211166,China [7]Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China

出　　处：《Chinese Medical Journal》2021年第13期1552-1560,共9页中华医学杂志（英文版）

基　　金：supported by grants from the National Key Research and Development Program of China(No.2018YFC1313602 and 2016YFC1302603);National Natural Science Foundation of China(No.81820108001,81670029,and 81470273);Jiangsu Jian-kang Vocational College Project(No.JKC202012);Science and Technology Development Fund of Nanjing Medical University(No.NMUB2020190);Nanjing Medical Science and Technique Development Foundation(No.QRX17199);Nanjing Medical Science and Technique Development Foundation(No.QRX11038);National China Medicine Science and Technology Special Project of Jiangsu Province(No.BL2014083);Six Talent Peak Project of Jiangsu Province(No.2012-WS-l 14);Nanjing Science and Technology Plan Project(No.201803064);Jiangsu Pharmaceutical Association Project(No.Q2018049);Nanjing Key Project of Science and Technology(No.2019060002).

摘　　要：Background:Chronic obstructive pulmonary disease(COPD)is a common public health problem worldwide.Recent studies have reported that socioeconomic status(SES)is related to the incidence of COPD.This study aimed to investigate the association between SES and COPD among adults in Jiangsu province,China,and to determine the possible direct and indirect effects of SES on the morbidity of COPD.Methods:A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province,China.Participants were selected using a multistage sampling approach.COPD,the outcome variable,was diagnosed by physicians based on spirometry,respiratory symptoms,and risk factors.Education,occupation,and monthly family average income(FAI)were used to separately indicate SES as the explanatory variable.Mixed-effects logistic regression models were introduced to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for examining the SES-COPD relationship.A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.Results:The mean age of the 2421 participants was 56.63±9.62 years.The prevalence of COPD was 11.8%(95%CI:10.5%–13.1%)among the overall sample population.After adjustment for age,gender,residence,outdoor and indoor air pollution,body weight status,cigarette smoking,and potential study area-level clustering effects,educational attainment was negatively associated with COPD prevalence in men;white collars were at lower risk(OR:0.60,95%CI:0.43–0.83)of experiencing COPD than blue collars;compared with those within the lower FAI subgroup,participants in the upper(OR:0.68,95%CI:0.49–0.97)tertiles were less likely to experience COPD.Such negative associations between all these three SES indicators and COPD were significant among men only.Education,FAI,and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity(FEV1/FVC),FEV1,FVC,and FEV

关 键 词：Socioeconomic status Family average income SMOKING Air pollution Body mass index Chronic obstructive pulmonary disease 

分 类 号：R563[医药卫生—呼吸系统]