Incidence Of COPD Research Articles

COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems

Introduction and objectivesChronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. Materials and methodsWe designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. ResultsMedian municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34–0.41) for men and 0.39 (95% CI 0.34–0.45) for women. ConclusionsThere is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes.

Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study

BackgroundIt has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk.ObjectiveWe studied prospectively whether airway responsiveness...

Influence of deprivation on health care use, health care costs, and mortality in COPD.

Background and aimDeprivation is associated with the incidence of COPD, but its independent impact on clinical outcomes is still relatively unknown. This study aimed to explore the influence of deprivation on health care use, costs, and survival.MethodsA total of 424 outpatients with COPD were assessed for deprivation across two hospitals. The English Index of Multiple Deprivation (IMD) was used to establish a deprivation score for each patient. The relationship between deprivation and 1-year health care use, costs, and mortality was examined, controlling for potential confounding variables (age, malnutrition risk, COPD severity, and smoking status).ResultsIMD was significantly and independently associated with emergency hospitalization (β-coefficient 0.022, SE 0.007; p=0.001), length of hospital stay, secondary health care costs (β-coefficient £101, SE £30; p=0.001), and mortality (HR 1.042, 95% CI 1.015–1.070; p=0.002). IMD was inversely related to participation in exercise rehabilitation (OR 0.961, 95% CI 0.930–0.994; p=0.002) and secondary care appointments. Deprivation was also significantly related to modifiable risk factors (smoking status and malnutrition risk).ConclusionDeprivation in patients with COPD is associated with increased emergency health care use, health care costs, and mortality. Tackling deprivation is complex; however, strategies targeting high-risk groups and modifiable risk factors, such as malnutrition and smoking, could reduce the clinical and economic burden.

Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey

BackgroundOccupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function...

Prevalence and trend of COPD from 1995-1997 to 2006-2008: The HUNT study, Norway.

COPD is a major cause of morbidity and mortality across the world and new estimates of prevalence and trend are of great importance. We aimed to estimate the prevalence and trend of COPD from 1995-1997 to 2006-2008 in Norwegian adults ≥40 years from the Nord-Trøndelag Health Study. COPD was assessed using a fixed-ratio and lower limit of normal (LLN) criteria. Pre-bronchodilator spirometry was performed during 1995-1997 (n = 7158) and 2006-2008 (n = 8788). The prevalence of COPD was weighted using the inverse probability of selection and predicted probability of response. The prevalence of pre-bronchodilator COPD was 16.7% in 1995-1997 and 14.8% in 2006-2008 using fixed-ratio criteria, and 10.4% in 1995-1997 and 7.3% in 2006-2008 using LLN criteria. The prevalence of LLN COPD was higher among men (13.0% in 1995-1997, 7.7% in 2006-2008) than women (8.0% in 1995-1997, 6.9% in 2006-2008). From 1995-1997 to 2006-2008, the prevalence decreased among men but remained relatively stable among women. Over the 11-year period, the cumulative incidence of pre-bronchodilator COPD using LLN criteria was 3.3% and 2.7% among men and women respectively. The prevalence of self-reported asthma and respiratory symptoms increased. The prevalence declined in men but not in women from 1995-1997 to 2006-2008, and was consistently higher among men than women.

Incidence and risk of chronic obstructive pulmonary disease in a Korean community-based cohort.

PurposeCOPD is a leading cause of morbidity and mortality. However, few studies have used spirometry to investigate its incidence, especially in Asia. In the present study, we analyzed the incidence and risk factors of COPD using a community cohort database in Korea.Patients and methodsThe study included 6,517 subjects aged 40–69 years from the Ansung–Ansan cohort database I–III (2001–2006). We calculated the crude incidence rate and the standardized incidence rate corrected for the Korean general population and the world population with COPD. We also determined the relative risks (RRs) for incident COPD and the attributable risks.ResultsIn total, 329 new COPD cases were diagnosed during follow-up. The overall crude incidence rate per 100,000 person-years was 1,447. The standardized incidence rate corrected for the Korean general population was 1,550; this value was higher in men and increased with increasing age. Risk factors for incident COPD were age ≥60 years (adjusted RR [aRR] =2.52 vs age <60 years), male sex (aRR =2.02 vs female), heavy smoking (≥20 pack-years; aRR =2.54 vs never smoker), and lowest income group (first quartile; aRR =2.03 vs fourth quartile). The adjusted attributable risk was highest for education level of high school or lower (44.9%), followed by smoking history (25.8%), income (22.9%), and sex (12.0%).ConclusionIn Korea, 15.5/1,000 people are diagnosed with COPD annually. The incidence rate increases with increasing age, heavier smoking, and decreasing income, with a higher rate in men than in women.

Burden of COPD in Nepal.

BackgroundCOPD is a globally significant public health problem and is the second leading cause of mortality. This study presents the health burden of COPD in Nepal using the Global Burden of Disease (GBD) study 2016 dataset.MethodsThis study used the data from the GBD repository presenting morbidity and mortality attributed to COPD, by sex and age. In GBD 2016, due to a lack of the primary source of data in Nepal, estimations on morbidity and mortality of COPD were based on its predictive covariates. Years of life lost (YLLs) were calculated based on the cause of death estimations, applying GBD’s Cause of Death Ensemble modeling. Likewise, years lived with disability (YLDs) were calculated by multiplying the prevalence of each sequela by the disability weight. Disability-adjusted life years (DALYs) were derived as the sum of YLLs and YLDs.ResultsBetween 1990 and 2016, the estimated age-standardized mortality rate due to COPD was decreasing for both genders, but the decline was much higher among males. Unlike the high rate of incidence among males, the age-standardized DALYs were found to be high among females (2,274.9 [95% UI: 1,702.0–2,881.5] per 100,000). YLLs contributed around 80% of DALYs due to COPD in 2016. Age-standardized YLLs rate was higher among females, with a value of 1,860 (95% uncertainty interval (UI): 1,282.8–2,472.8) vs 1,547.6 (95% UI: 992.1–2,018.5) among the males per 100,000 population.ConclusionThe prevalence and incidence of COPD remained almost stationary over the years, but still very high. Though the incidence and prevalence of disease were high among males, the death rate and DALYs were more significant among females throughout the years. If the current situation prevails, the burden of COPD will continue to increase in the country. Hence, comprehensive social, environmental, and behavioral approaches to curtail the risk factors along with early identification, treatment, and management of COPD is of utmost importance.

Incisional Hernia Post Laparotomy-Incidence and Risk Factors

Laparotomy incisions are one of the most common procedures performed in any surgical service. However, they carry certain risks like surgical site infections, wound dehiscence and incisional hernia. There have been various risk factors associated with the incidence of incisional hernia post laparotomy. Some of these factors are patients- related like history of diabetes, obesity, smoking, sex and age. The other factors are related to the disease process itself like emergency surgeries, presence of peritonitis, history of radiation to the abdominal cavity or presence of surgical site infection. Another set of factors relates purely with the technique used to close the wound, choice of suture material and expertise of the surgeon. Methods. This is a retrospective chart review. Data was collected from all patients who were previously admitted at Hamad General Hospital for laparotomy and subsequently developed incisional hernia. Methods. All patients of age 18 years or above who were found to have incisional hernia after laparotomy were included in the study. Hospital medical records database were used for file reviews. Patients characteristics like age, sex, obesity, history of smoking, DM etc were recorded. Nature of surgeries like emergency or elective were documented along with other factors like suturing techniques etc. Results. The total number of study subjects was 672, out of which 47 (6.9%) developed incisional hernia. Out of these 23 were male and 24 were female. Diabetes was identified in 18 patients (38.3%) whereas the incidence of smoking, steroid use, COPD and obesity was 2 (4.3%), 0 (%), 3 (6.4%) and 7 (14.9%) respectively. Other risk factors like the nature of surgery (emergency vs electives) were addressed also. The incidence of immediate postop complications was also addressed. Three patients out of 47 (6.4%) developed surgical site infection whereas one patient (2.1%) had post -op wound dehiscence. The number of contaminated and dirty wounds during the initial surgery was 10 (21.3%) and 6 (12.8%) respectively.

Consuming Green Tea at Least Twice Each Day Is Associated with Reduced Odds of Chronic Obstructive Lung Disease in Middle-Aged and Older Korean Adults

The frequent consumption of green tea has been shown to have antioxidant and anti-inflammatory effects and to reduce the risk of lung cancer and type 2 diabetes. However, few studies have investigated the relation between green tea consumption and the risk of chronic obstructive lung disease (COPD). This study aimed to examine the association between green tea intake and COPD with the use of a nationwide representative database. This study was designed as a cross-sectional survey with the use of data from the Korean National Health and Nutritional Examination Survey collected between 2008 and 2015. Of these participants, 13,570 participants aged ≥40 y were included in the study population. COPD was defined as forced expiratory volume in 1 s (FEV1) divided by forced vital capacity (FVC) <0.70. Multiple linear and logistic regression models were used to examine the association between the frequency of green tea intake and risk of COPD after adjusting for age, sex, body mass index, smoking status, alcohol consumption, physical activity, and socioeconomic status. The incidence of COPD decreased from 14.1% to 5.9% with increased frequency of green tea intake from never to ≥2 times/d (P < 0.001). In the fully adjusted multiple linear regression model, the frequency of green tea intake showed a linear dose-response relation with FEV1/FVC (P-trend = 0.031). In the multiple logistic regression model, the OR for COPD among people who consumed green tea ≥2 times/d was 0.62 (95% CI: 0.40, 0.97), compared with those who never drank green tea, after adjusting for all covariates. This study suggests that the consumption of green tea ≥2 times/d is associated with a reduced risk of COPD in Korean populations.

Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation

BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors.The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. MethodsThis observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (>2 vs <2) and presence/absence of COPD. To detect AF appearance, patients underwent, every 6months, physical examination, standard 12‑lead electrocardiogram and routine laboratory tests. ResultsCOPD prevalence was significantly higher in patients with CHA2DS2-VASc≥2 vs CHA2DS2-VASc<2 category (13.3% vs 10.5%, P=0.009). During the follow-up, 589 cases of AF were documented (3.8 events/100 patients-year). COPD+ showed a significantly higher incidence of AF vs COPD− patients (17.4 vs 8.4 events/100 patients-year, P<0.0001). In Cox regression models both CHA2DS2-VASc score (HR=4.70, 95% CI=3.63–6.08) and COPD (HR=2.04, 95% CI=1.69–2.48) significantly predicted the incidence rate of AF; this was also confirmed introducing the two variables into the same Cox model. A significant competitive interaction between CHA2DS2-VASc and COPD was found in a Cox model in patients with CHA2DS2-VASc<2 (HR=8.45, 95% CI=5.20–13.74) than in those with CHA2DS2-VASc≥2. ConclusionsCOPD is an independent and strong predictor of incident AF. The presence of COPD increases the HR for incident AF about five times in patients with CHA2DS2VASc score<2, while the coexistence of a CHA2DS2Vasc score≥2 minimizes the prognostic significance of COPD.

Paparan pestisida terhadap kejadian penyakit paru obstruktif kronis pada petani

PurposeThis study aims to analyze and describe the risk of exposure to pesticides (age, sex, education, smoking habits, length of service, time of spraying, number of pesticides and personal protective equipment) related to the incidence of COPD to farmers in Barus Jahe, Karo District.Methods This case control study with a total sample of 90 people, consisting of 45 cases and 45 controls. Samples were taken by simple random sampling. Data analysis was performed using univariable tests, bivariable with Chi-square tests and multivariable with logistic regression.Results There was a significant correlation between age, gender, education, employment, personal protective equipment to the incidence of COPD, while there was no significant association between the time of spraying, the amount of pesticides and smoking status with the incidence of COPD. The most influential factors on the incidence of COPD is the working period and personal protective equipment.Conclusion Farmers should always use personal protective equipment and appropriate dosage of pesticide as stated on the packaging label. Public health office also can reduce COPD infections with early detection to farmers who exposed to pesticides every day.

The Effect of Concurrent Bronchodilator Therapy on the Efficacy and Safety of a Novel, Nebulized Glycopyrrolate in Phase 3 Studies in Subjects With Moderate to Very Severe COPD

SESSION TITLE: COPD: Advances in Pharmacotherapy SESSION TYPE: Original Investigation Slide PRESENTED ON: Tuesday, October 31, 2017 at 11:00 AM - 12:15 PM PURPOSE: The GOLDEN Phase 3 studies assessed the efficacy and safety of a novel, nebulized glycopyrrolate (GLY) for up to 48 weeks, and included subjects on stable doses of long-acting β2-agonists (LABA) ± inhaled corticosteroids (ICS) who continued background therapy over the treatment period. METHODS: In two 12-week placebo-controlled studies and one 48-week active-controlled study, 2379 subjects were stratified by background LABA±ICS (LABA-yes [n=861] vs LABA-no [n=1518]) and randomized to placebo, GLY 25 or 50 mcg twice daily (BID) via an investigational eFlow Closed System nebulizer (PARI Pharma, Germany), or tiotropium (TIO; 18 mcg once daily). Lung function, patient-reported outcomes, exacerbations and safety were assessed in the LABA subgroups. Statistical methodology included mixed-model repeated measures, analysis of covariance and descriptive safety data. RESULTS: GLY 25 and 50 mcg BID produced statistically significant and clinically important improvements vs placebo in trough forced expiratory volume in 1 second (FEV1; 92-110 mL, p<0.001) in LABA subgroups at week 12. The overall change from baseline in trough FEV1 was similar for GLY 50 mcg BID and TIO (92-106 mL) in both LABA subgroups at week 48. At 12 weeks, GLY produced statistically significant improvements in SGRQ in LABA subgroups (-2.073 to -3.888 vs placebo, p<0.05), and the proportion of SGRQ responders was consistently higher with GLY 25 and 50 mcg BID (LABA-yes: 48.3%, 43.4%; LABA-no: 46.1%, 40.9%) than placebo (yes: 24.8%; no: 38.7%). Over 48 weeks, change from baseline SGRQ in the LABA-yes subgroup was -5.190 for GLY and -3.094 for TIO, and -4.368 and -4.821, respectively, in the LABA-no subgroup. The proportion of GLY SGRQ responders was higher in the LABA-yes (53.7% vs 41.1% TIO) and similar to TIO in the LABA-no (42.6% vs 48.8% TIO) subgroups after 48 weeks. Exacerbation rates were generally similar across treatments and most were moderate in severity in both LABA subgroups after 12 and 48 weeks. The incidence of adverse events leading to discontinuation was similar in the LABA subgroups and less frequent in the GLY groups compared to placebo at 12 weeks. There was a higher discontinuation rate in the GLY LABA subgroups, with higher overall cough and COPD incidence rates (IRs) vs TIO. Cardiovascular events of special interest were more frequent in the LABA-no subgroup with generally similar IRs between treatments in LABA subgroups at 12 and 48 weeks. At 12 weeks, there were two major adverse cardiac events (MACE; IR per thousand patient-years=23.6) in the placebo LABA-no group and three MACE (IR=33.9) in the GLY 50 mcg BID LABA-no group. The MACE IRs in the TIO group were numerically higher than GLY in both LABA subgroups at 48 weeks. CONCLUSIONS: Nebulized GLY improved lung function and patient-reported outcomes with an acceptable safety/tolerability profile in subjects with COPD, with and without background LABA±ICS, for up to 48 weeks. CLINICAL IMPLICATIONS: Nebulized GLY is well tolerated and effective when administered with or without concurrent bronchodilator therapy and provides a novel treatment option for patients who may require or benefit from nebulized LAMA therapy. DISCLOSURE: Edward Kerwin: Consultant fee, speaker bureau, advisory committee, etc.: Sunovion Robert Tosiello: Employee: Sunovion Pharmaceuticals Inc. Barry Price: Employee: Sunovion Pharmaceuticals Inc. Thomas Goodin: Employee: Sunovion Pharmaceuticals Inc. Abstract describes analysis from Phase 3 trials of nebulized glycopyrrolate in COPD (not currently approved)

Abstract: Posterior Sheath Repair in Abdominal Wall Reconstruction: Achieving Retromuscular Mesh Placement

INTRODUCTION: Ventral hernia repair (VHR) remains a difficult surgical problem to manage. Retromuscular sublay mesh placement in VHR consistently provides favorable outcomes regardless of mesh type utilized, presumably highlighting the importance of the posterior rectus sheath. We hypothesized that posterior sheath repair to achieve retromuscular closure demonstrates improved outcomes compared to intraperitoneal repair as well as comparable recurrence and complication profiles to retromuscular sublay repair. METHODS: We performed a single-institution retrospective review over three-years of consecutive hernia repairs for two surgeons. Included patients were grouped according to repair-type: A) sublay placement with reconstructed posterior sheath, B) retromuscular repair with unaltered posterior sheath, and C) intraperitoneal or underlay repair. Primary outcome measures included hernia recurrence and surgical site occurrence (SSO). Analysis included multivariate logistic regression and descriptive statistics. RESULTS: One-hundred seventy-nine patients met inclusion criteria. There were 25 (14.0%) in Group-A, 89 (48.7%) in Group-B, and 65 (36.3%) in Group-C. Groups did not differ in average age 56.5 (p<0.298), BMI 32.4 (p<0.774), incidence of diabetes, hypertension, hyperlipidemia, COPD, tobacco use, OR time, or ostomy reversal. The majority of cases consisted of ASA class 3 (54.2%), Ventral Hernia Working Group (VHWG) class 2 (47.5%), and clean wound classification (63.7%). Prior hernia repairs were performed in 102 (57%) patients. Biologic mesh was used in 56 (31.3%) patients, synthetic in 103 (57.5%), and biosynthetic in 20 (11.2%). Patient post-operative follow-up averaged 15.5 months. Analysis of 11 recurrences yielded significant differences between Groups-B and C (p<0.009), a trend towards significance between Groups-A and C (p<0.058), and no difference between Groups-A and B (p<0.608). Retromuscular mesh placement and anterior components separation demonstrated protective effects on recurrence (OR: 0.148, p<0.081 and OR: 0.259, p<0.067). Postoperative mesh infection (OR: 72.03, p<0.012) and seroma (OR: 8.992, p<0.036) were significant predictors of hernia recurrence. BMI (OR: 1.052, p<0.015), VHWG (OR: 1.617, p<0.036), and hyperlipidemia (OR: 2.157, p<0.049) were significant predictors of SSO on multivariate regression. The posterior sheath was reconstructed primarily using absorbable suture for small defects, or biologic mesh for larger defects. CONCLUSION: Initial analysis of posterior sheath repair to allow for retromuscular VHR suggests noninferiority, when compared to traditional sublay reconstruction. We present the first known description of discrete posterior sheath reconstruction to aid in retromuscular closure of complex ventral hernia.

Risk factors of chronic obstructive pulmonary disease among adults in Chinese mainland: A systematic review and meta-analysis.

Identifying risk factors is a key point for preventive strategies to reduce the incidence of COPD. The aim of this systematic review and meta-analysis was to determine the most important risk factors for COPD among adults in Chinese Mainland, so as to provide some precautions and interventions on this disease and preventing further recurrences. A comprehensive literature review relating to risk factors for COPD through PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database and VIP database was conducted before March 31, 2017. Odds ratio (OR) with 95% confidence interval (CI) was calculated after data combination to assess the associations between risk factors and COPD. Heterogeneity between the studies was assessed by I2 and Cochran's Q test. Egger's test was used to assess publication bias. A total of 13893 participants (6383 cases and 7510 controls) from 19 case-controls studies were included. 12 risk factors with significant differences found between COPD and control groups were listed as follows: male sex (OR=1.467; 95%CI: 1.097-1.962), smoking (OR=2.092; 95%CI: 1.707-2.565), low educational level (OR=1.609; 95%CI: 1.206-2.147), low BMI (OR=3.831; 95%CI: 2.223-6.603), family history of respiratory disease (OR=2.068; 95%CI: 1.466-2.918), allergy history (OR=2.381; 95%CI: 1.385-4.093), respiratory infection during childhood (OR=2.695; 95%CI: 1.504-4.828), recurrent respiratory infection (OR=15.015; 95%CI: 4.538-49.684), occupational dust exposure (OR=1.791; 95%CI: 1.151-2.788), biomass burning (OR=2.218; 95%CI: 1.308-3.762), poor housing ventilation (OR=3.993; 95%CI: 1.244-12.820), and living around polluted area (OR=1.631; 95%CI: 1.202-2.214). Twelve risk factors are associated with the occurrence of COPD in Chinese Mainland, which can be used to distinguish high-risk population. Health education and promotion campaigns should be designed in order to minimize or prevent the occurrence of COPD in Chinese Mainland.

Wellbeing and chronic lung disease incidence: The Survey of Health, Ageing and Retirement in Europe.

BackgroundPrevious studies indicate that psychosocial factors can impact COPD prevalence. However, research into this association has predominantly focused on negative factors such as depression. The aim of this study was to examine whether high subjective wellbeing is associated with a lower risk of developing COPD.MethodsThe sample consisted of 12,246 participants aged ≥50 years from the Survey of Health, Ageing and Retirement in Europe. We used Cox proportional hazards regression to examine the relationship between wellbeing (measured using the CASP-12) and incidence of COPD over a follow-up period of 9 years.ResultsThere was a significant association between wellbeing and COPD risk. In age-adjusted analyses, a standard deviation increase in CASP-12 score was associated with a reduced risk of COPD; hazard ratios (95% confidence intervals) for men and women were 0.67 (0.60–0.75) and 0.80 (0.73–0.87) respectively. After additional adjustment for demographic and health behaviour variables, this association remained significant for men but not for women: the fully-adjusted hazard ratios were 0.80 (0.70–0.91) and 0.91 (0.82–1.03) respectively.ConclusionsGreater wellbeing is associated with a reduced risk of COPD, particularly in men. Future research is needed to establish whether gender reliably moderates this association.

Effects of the common polymorphism in the human aldehyde dehydrogenase 2 (ALDH2) gene on the lung

BackgroundAldehyde dehydrogenases (ALDHs) play a major role in detoxification of aldehydes. High expression of ALDHs is a marker for stem cells of many organs including the lungs. A common polymorphism in ALDH2 gene (ALDH2*2) results in inactivation of the enzyme and is associated with alcohol flushing syndrome and increased risk for cardiovascular and Alzheimer’s diseases and some cancers. The effect of this ALDH2 polymorphism on the lung and its stem cells has not been thoroughly examined.MethodsWe examined the association between the ALDH2*2 allele and lung function parameters in a population of healthy individuals. We also examined its association with the incidence of asthma and COPD in patient cohorts. We used the in vitro colony forming assay to detect the effect of the polymorphism on lung epithelial stem cells from both primary human surgical samples and Aldh2*2 transgenic (Tg) and Aldh2−/− mice. Response to acute and chronic lung injuries was compared between wild type (WT), Aldh2*2 Tg and Aldh2−/− mice.ResultsIn humans, the ALDH2*2 allele was associated with lower FEV1/FVC in the general population, but not with the development of asthma or COPD. Both the bronchial and lung epithelium carrying the ALDH2*2 allele showed a tendency for lower colony forming efficiency (CFE) compared to ALDH2 allele. In mice, the tracheal epithelial thickness, nuclear density, and number of basal stem cells were significantly lower in Aldh2−/− and Aldh2*2 Tg adult mice than in WT. Electron microscopy showed significantly increased number of morphologically abnormal mitochondria in the trachea of Aldh2−/− mice. Aldh2−/− tracheal and lung cells showed higher ROS levels and fewer functional mitochondria than those from WT mice. No significant differences were detected when tracheal and lung epithelial stem cells were examined for their in vitro CFE. When exposed to chronic cigarette smoke, Aldh2*2 Tg mice were resistant to emphysema development, whereas influenza infection caused more epithelial damage in Aldh2−/− mice than in WT mice.ConclusionsALDH2 polymorphism has several subtle effects on the lungs, some of which are similar to changes observed during normal aging, suggesting a “premature lung aging” effect.

Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men

BackgroundAntioxidants present in fruits and vegetables may protect the lung from oxidative damage and prevent COPD.AimsTo determine the association between fruit and vegetable consumption and risk of COPD by smoking...

Genomic mechanisms of transformation from chronic obstructive pulmonary disease to lung cancer.

Genetic variations in COPD and lung cancer may be one of the molecular mechanisms responsible for COPD-lung cancer transformation. The present review highlights main genetic variations co-existed in COPD and lung cancer and integrates the varied genes into four molecular mechanisms, e.g. activated cell proliferation pathway, tumor suppressor and DNA repair gene dysfunction, chronic inflammatory microenvironment, and impaired immune response, by which COPD epithelial cells may be transformed into tumorigenic status. We call special attention to further investigate the transformation from COPD to lung cancer and understand the exact molecular mechanisms, to prevent and reduce the increased incidence of COPD and lung cancer. We call direct evidence to show the existence of COPD-lung cancer transformation, since current evidence to support the transformation from COPD to lung cancer is the co-existence of selected genes and proteins in both. We should furthermore explore and understand the homogeneity and heterogeneity of gene mutation, epigenetics, sequencing, and function between COPD and lung cancer. The defining and understanding of COPD-lung cancer transformation will provide new diagnostic and therapeutic biomarkers as a new milestone to prevent and treat lung cancer.

Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study.

COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC < 0.70). In absence of an interpretable spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician. Incidence rates were calculated by dividing the number of incident cases by the total number of person years of subjects at risk. In this cohort of 14,619 participants, 1993 subjects with COPD were identified of whom 689 as prevalent ones and 1304 cases as incident ones. The overall incidence rate (IR) of COPD was 8.9/1000 person-years (PY); 95 % Confidence Interval (CI) 8.4–9.4. The IR was higher in males and in smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-016-0132-z) contains supplementary material, which is available to authorized users.

Over-indebtedness and chronic disease: a linked register-based study of Finnish men and women during 1995-2010.

More knowledge of the associations between over-indebtedness and health is needed. This study is the first longitudinal register-based study analysing long-term health consequences of severe over-indebtedness. Adult Finnish persons, identified in 2010 as having been over-indebted for at least 15years, were compared with matched controls (total N=48,778). The analyses utilized register data on socio-demographic and health-related factors. Incidence of chronic disease during 1995-2010 was measured with entitlements to special reimbursement for medicines for treatment of severe and chronic diseases. Incidence of all diseases was examined, as well as incidence of hypertension, diabetes, bronchial asthma and COPD, coronary heart disease, and psychoses. Multivariate analyses were conducted with the Cox proportional hazards method. Severe over-indebtedness was associated with increased incidence of any chronic disease, and most notably with increased risk of psychoses and diabetes. The associations were stronger among women than among men. Over-indebtedness is associated with harmful health conditions. Policy makers should consider taking steps to prevent over-indebtedness and to increase the awareness of social and health service professionals of the problems associated with over-indebtedness.