Altitude and COPD prevalence : analysis of the PREPOCOL-PLATINO-BOLD-EPI-SCAN study
Horner, Andreas (Paracelsus Medical University)
Soriano, Joan B.. (Instituto de Investigación Hospital Universitario de la Princesa)
Puhan, Milo A. (University of Zurich Epidemiology, Biostatistics and Prevention Institute)
Studnicka, Michael (Paracelsus Medical University)
Kaiser, Bernhard (Johannes-Kepler-University)
Vanfleteren, Lowie E. G. W. (Program Development Centre)
Gnatiuc, Louisa (Imperial College)
Burney, Peter (Imperial College)
Miravitlles, Marc (Hospital Universitari Vall d'Hebron. Institut de Recerca)
García-Rio, Francisco (Instituto de Investigación Sanitaria del Hospital Universitario La Paz)
Ancochea, Julio (Universidad Autónoma de Madrid)
Menezes, Ana M. (Universidade Federal de Pelotas)
Perez-Padilla, Rogelio (Instituto Nacional de Enfermedades Respiratorias)
Montes de Oca, Maria (Universidad Central de Venezuela)
Torres-Duque, Carlos A. (Asociación Colombiana de Neumología y Cirugía de Tórax)
Caballero, Andres (Clínica Reina Sofía, Bogotá, Colombia)
González-García, Mauricio (Fundación Neumológica Colombiana)
Buist, Sonia (Oregon Health and Science University)
Flamm, Maria (Institute of General Practice)
Lamprecht, Bernd (Johannes-Kepler-University)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	COPD prevalence is highly variable and geographical altitude has been linked to it, yet with conflicting results. We aimed to investigate this association, considering well known risk factors. A pooled analysis of individual data from the PREPOCOL-PLATINO-BOLD-EPI-SCAN studies was used to disentangle the population effect of geographical altitude on COPD prevalence. Post-bronchodilator FEV1/FVC below the lower limit of normal defined airflow limitation consistent with COPD. High altitude was defined as >1500 m above sea level. Undiagnosed COPD was considered when participants had airflow limitation but did not report a prior diagnosis of COPD. Among 30,874 participants aged 56. 1 ± 11. 3 years from 44 sites worldwide, 55. 8% were women, 49. 6% never-smokers, and 12. 9% (3978 subjects) were residing above 1500 m. COPD prevalence was significantly lower in participants living at high altitude with a prevalence of 8. 5% compared to 9. 9%, respectively (p < 0. 005). However, known risk factors were significantly less frequent at high altitude. Hence, in the adjusted multivariate analysis, altitude itself had no significant influence on COPD prevalence. Living at high altitude, however, was associated with a significantly increased risk of undiagnosed COPD. Furthermore, subjects with airflow limitation living at high altitude reported significantly less respiratory symptoms compared to subjects residing at lower altitude. Living at high altitude is not associated with a difference in COPD prevalence after accounting for individual risk factors. However, high altitude itself was associated with an increased risk of undiagnosed COPD.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COPD ; Geographical altitude ; Risk factors ; Underdiagnosis ; Epidemiology
Publicat a:	Respiratory Research, Vol. 18 (august 2017) , ISSN 1465-993X

DOI: 10.1186/s12931-017-0643-5
PMID: 28835234

10 p, 652.2 KB

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