The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population: Results from the Canadian obstructive lung disease (COLD) study

Clarus Leung; Jean Bourbeau; Don D. Sin; Shawn D. Aaron; J. Mark Fitzgerald; François Maltais; Darcy D. Marciniuk; Denis O’donnell; Paul Hernandez; Kenneth R. Chapman; Brandie Walker; Jeremy D. Road; Liyun Zheng; Carl Zou; James C. Hogg; Wan C. Tan

doi:10.2147/COPD.S285338

The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population: Results from the Canadian obstructive lung disease (COLD) study

Clarus Leung, Jean Bourbeau, Don D. Sin, Shawn D. Aaron, J. Mark Fitzgerald, François Maltais, Darcy D. Marciniuk, Denis O’donnell, Paul Hernandez, Kenneth R. Chapman, Brandie Walker, Jeremy D. Road, Liyun Zheng, Carl Zou, James C. Hogg, Wan C. Tan

Medicine

Résultat de recherche: Article › examen par les pairs

24 Citations (Scopus)

Résumé

Purpose: To determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors. Patients and Methods: In this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥ 40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV₁/FVC < 0.70 (fixed ratio, FR) and as FEV₁/FVC < 5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I² and Tau² analyses were used to evaluate heterogeneity. Results: Out of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0– 57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5– 17.8) by FR and 11.2% (95% CI, 9.7– 12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33– 1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42– 4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17– 2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55– 4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau² analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease. Conclusion: This study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.

Langue d'origine	English
Pages (de-à)	305-320
Nombre de pages	16
Journal	International Journal of COPD
Volume	16
DOI	https://doi.org/10.2147/COPD.S285338
Statut de publication	Published - 2021

Note bibliographique

Funding Information:
The Canadian Cohort Obstructive Lung Disease (CanCOLD; NCT00920348) study is currently funded by the Canadian Respiratory Research Network and the industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, and Novartis. Researchers at RI-McGill University Health Centre Montreal and iCAPTURE Centre V ancouver lead the project. Previous funding partners were the Canadian Institutes of Health Research (CIHR; CIHR/Rx&D Collaborative Research Program Operating Grants – 93326), the Respiratory Health Network of the Fonds de la recherche en santé du Québec (FRQS), and industry partners: Almirall; Merck Nycomed; Pfizer Canada Ltd; and Theratechnologies. The funding sponsors had no role in the study design; in the collection, analysis, and interpretation of data, in the writing of this manuscript or in the decision to submit this manuscript for publication. The funders had no role in the study design, data collection and analysis, or preparation of the manuscript.

Funding Information:
Jean Bourbeau reports grants from CIHR, grants from Foundation of the MUHC, personal fees from Canadian Thoracic Society , personal fees from AstraZeneca, consultant/lecture for CHEST , advisor/lecture for Boehringer Ingelheim, Grifols, GlaxoSmithKline, and Novartis, lecture for T rudell, grants from Aerocrine, outside the submitted work.

Funding Information:
Darcy D Marciniuk reports grants from McGill University , during the conduct of the study; grants from AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Canadian Health Infowayfor Healthcare Improvement, Lung Association of Saskatchewan, and Canadian Institute of Health Research, Grifols, Novartis, Sanofi, Saskatchewan Health Research Foundation, Schering-Plough, and is an employee of the University of Saskatchewan, outside the submitted work.

Funding Information:
Paul Hernandez reports personal fees from AstraZeneca, grants from Boehringer Ingelheim, Grifols, and V ertex, fees for medical advisory board from Actelion, GlaxoSmithKline, and Novartis, outside the submitted work.

Funding Information:
W an C T an reports grants from Canadian Institute of Heath Research, rgrants from GlaxoSmithKline Canada Ltd, nothing from AstraZeneca Canada Ltd., nothing from Boehringer-Ingelheim Canada Ltd, nothing from Novartis, nothing from Merck, nothing from Pfizer , Canada, and nothing from Nycomed, Canada, during the conduct of the study; personal fees from GlaxoSmithKline, Canada and AstraZeneca, Canada, outside the submitted work.

Publisher Copyright:
© 2021 Leung et al.

ASJC Scopus Subject Areas

Pulmonary and Respiratory Medicine
Health Policy
Public Health, Environmental and Occupational Health

PubMed: MeSH publication types

Journal Article

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

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10.2147/COPD.S285338

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Leung, C., Bourbeau, J., Sin, D. D., Aaron, S. D., Fitzgerald, J. M., Maltais, F., Marciniuk, D. D., O’donnell, D., Hernandez, P., Chapman, K. R., Walker, B., Road, J. D., Zheng, L., Zou, C., Hogg, J. C., & Tan, W. C. (2021). The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population: Results from the Canadian obstructive lung disease (COLD) study. International Journal of COPD, 16, 305-320. https://doi.org/10.2147/COPD.S285338

Leung, C, Bourbeau, J, Sin, DD, Aaron, SD, Fitzgerald, JM, Maltais, F, Marciniuk, DD, O’donnell, D, Hernandez, P, Chapman, KR, Walker, B, Road, JD, Zheng, L, Zou, C, Hogg, JC & Tan, WC 2021, 'The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population: Results from the Canadian obstructive lung disease (COLD) study', International Journal of COPD, vol. 16, pp. 305-320. https://doi.org/10.2147/COPD.S285338

@article{40213eb3059e4b69a61c56039a6aa63b,

title = "The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population: Results from the Canadian obstructive lung disease (COLD) study",

abstract = "Purpose: To determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors. Patients and Methods: In this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥ 40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV1/FVC < 0.70 (fixed ratio, FR) and as FEV1/FVC < 5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I2 and Tau2 analyses were used to evaluate heterogeneity. Results: Out of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0– 57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5– 17.8) by FR and 11.2% (95% CI, 9.7– 12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33– 1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42– 4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17– 2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55– 4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau2 analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease. Conclusion: This study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.",

author = "Clarus Leung and Jean Bourbeau and Sin, {Don D.} and Aaron, {Shawn D.} and Fitzgerald, {J. Mark} and Fran{\c c}ois Maltais and Marciniuk, {Darcy D.} and Denis O{\textquoteright}donnell and Paul Hernandez and Chapman, {Kenneth R.} and Brandie Walker and Road, {Jeremy D.} and Liyun Zheng and Carl Zou and Hogg, {James C.} and Tan, {Wan C.}",

note = "Funding Information: The Canadian Cohort Obstructive Lung Disease (CanCOLD; NCT00920348) study is currently funded by the Canadian Respiratory Research Network and the industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, and Novartis. Researchers at RI-McGill University Health Centre Montreal and iCAPTURE Centre V ancouver lead the project. Previous funding partners were the Canadian Institutes of Health Research (CIHR; CIHR/Rx&D Collaborative Research Program Operating Grants – 93326), the Respiratory Health Network of the Fonds de la recherche en sant{\'e} du Qu{\'e}bec (FRQS), and industry partners: Almirall; Merck Nycomed; Pfizer Canada Ltd; and Theratechnologies. The funding sponsors had no role in the study design; in the collection, analysis, and interpretation of data, in the writing of this manuscript or in the decision to submit this manuscript for publication. The funders had no role in the study design, data collection and analysis, or preparation of the manuscript. Funding Information: Jean Bourbeau reports grants from CIHR, grants from Foundation of the MUHC, personal fees from Canadian Thoracic Society , personal fees from AstraZeneca, consultant/lecture for CHEST , advisor/lecture for Boehringer Ingelheim, Grifols, GlaxoSmithKline, and Novartis, lecture for T rudell, grants from Aerocrine, outside the submitted work. Funding Information: Darcy D Marciniuk reports grants from McGill University , during the conduct of the study; grants from AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Canadian Health Infowayfor Healthcare Improvement, Lung Association of Saskatchewan, and Canadian Institute of Health Research, Grifols, Novartis, Sanofi, Saskatchewan Health Research Foundation, Schering-Plough, and is an employee of the University of Saskatchewan, outside the submitted work. Funding Information: Paul Hernandez reports personal fees from AstraZeneca, grants from Boehringer Ingelheim, Grifols, and V ertex, fees for medical advisory board from Actelion, GlaxoSmithKline, and Novartis, outside the submitted work. Funding Information: W an C T an reports grants from Canadian Institute of Heath Research, rgrants from GlaxoSmithKline Canada Ltd, nothing from AstraZeneca Canada Ltd., nothing from Boehringer-Ingelheim Canada Ltd, nothing from Novartis, nothing from Merck, nothing from Pfizer , Canada, and nothing from Nycomed, Canada, during the conduct of the study; personal fees from GlaxoSmithKline, Canada and AstraZeneca, Canada, outside the submitted work. Publisher Copyright: {\textcopyright} 2021 Leung et al.",

year = "2021",

doi = "10.2147/COPD.S285338",

language = "English",

volume = "16",

pages = "305--320",

journal = "International Journal of COPD",

issn = "1176-9106",

publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - The prevalence of chronic obstructive pulmonary disease (COPD) and the heterogeneity of risk factors in the Canadian population

T2 - Results from the Canadian obstructive lung disease (COLD) study

AU - Leung, Clarus

AU - Bourbeau, Jean

AU - Sin, Don D.

AU - Aaron, Shawn D.

AU - Fitzgerald, J. Mark

AU - Maltais, François

AU - Marciniuk, Darcy D.

AU - O’donnell, Denis

AU - Hernandez, Paul

AU - Chapman, Kenneth R.

AU - Walker, Brandie

AU - Road, Jeremy D.

AU - Zheng, Liyun

AU - Zou, Carl

AU - Hogg, James C.

AU - Tan, Wan C.

N1 - Funding Information: The Canadian Cohort Obstructive Lung Disease (CanCOLD; NCT00920348) study is currently funded by the Canadian Respiratory Research Network and the industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, and Novartis. Researchers at RI-McGill University Health Centre Montreal and iCAPTURE Centre V ancouver lead the project. Previous funding partners were the Canadian Institutes of Health Research (CIHR; CIHR/Rx&D Collaborative Research Program Operating Grants – 93326), the Respiratory Health Network of the Fonds de la recherche en santé du Québec (FRQS), and industry partners: Almirall; Merck Nycomed; Pfizer Canada Ltd; and Theratechnologies. The funding sponsors had no role in the study design; in the collection, analysis, and interpretation of data, in the writing of this manuscript or in the decision to submit this manuscript for publication. The funders had no role in the study design, data collection and analysis, or preparation of the manuscript. Funding Information: Jean Bourbeau reports grants from CIHR, grants from Foundation of the MUHC, personal fees from Canadian Thoracic Society , personal fees from AstraZeneca, consultant/lecture for CHEST , advisor/lecture for Boehringer Ingelheim, Grifols, GlaxoSmithKline, and Novartis, lecture for T rudell, grants from Aerocrine, outside the submitted work. Funding Information: Darcy D Marciniuk reports grants from McGill University , during the conduct of the study; grants from AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Canadian Health Infowayfor Healthcare Improvement, Lung Association of Saskatchewan, and Canadian Institute of Health Research, Grifols, Novartis, Sanofi, Saskatchewan Health Research Foundation, Schering-Plough, and is an employee of the University of Saskatchewan, outside the submitted work. Funding Information: Paul Hernandez reports personal fees from AstraZeneca, grants from Boehringer Ingelheim, Grifols, and V ertex, fees for medical advisory board from Actelion, GlaxoSmithKline, and Novartis, outside the submitted work. Funding Information: W an C T an reports grants from Canadian Institute of Heath Research, rgrants from GlaxoSmithKline Canada Ltd, nothing from AstraZeneca Canada Ltd., nothing from Boehringer-Ingelheim Canada Ltd, nothing from Novartis, nothing from Merck, nothing from Pfizer , Canada, and nothing from Nycomed, Canada, during the conduct of the study; personal fees from GlaxoSmithKline, Canada and AstraZeneca, Canada, outside the submitted work. Publisher Copyright: © 2021 Leung et al.

PY - 2021

Y1 - 2021

N2 - Purpose: To determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors. Patients and Methods: In this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥ 40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV1/FVC < 0.70 (fixed ratio, FR) and as FEV1/FVC < 5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I2 and Tau2 analyses were used to evaluate heterogeneity. Results: Out of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0– 57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5– 17.8) by FR and 11.2% (95% CI, 9.7– 12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33– 1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42– 4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17– 2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55– 4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau2 analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease. Conclusion: This study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.

AB - Purpose: To determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors. Patients and Methods: In this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥ 40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV1/FVC < 0.70 (fixed ratio, FR) and as FEV1/FVC < 5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I2 and Tau2 analyses were used to evaluate heterogeneity. Results: Out of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0– 57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5– 17.8) by FR and 11.2% (95% CI, 9.7– 12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33– 1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42– 4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17– 2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55– 4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau2 analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease. Conclusion: This study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.

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U2 - 10.2147/COPD.S285338

DO - 10.2147/COPD.S285338

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AN - SCOPUS:85101734127

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VL - 16

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EP - 320

JO - International Journal of COPD

JF - International Journal of COPD

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