Objective: To understand the incidence of chronic obstructive pulmonary disease (COPD) in the Suzhou cohort, and explore the risk factors for the development of COPD in Suzhou, and provide a scientific basis for COPD prevention. Methods: This study was based on the China Kadoorie Biobank project in Wuzhong District, Suzhou. After excluding individuals with airflow obstruction and self-reported chronic bronchitis, emphysema, or pulmonary heart disease at baseline, 45 484 individuals were finally included in the analysis. Cox proportional risk models were used to analyze risk factors of COPD and calculate hazard ratios and 95% confidence interval (CI) in the Suzhou cohort. The effect modifications of smoking on the association between other risk factors and COPD were evaluated. Results: Complete follow-up was available through December 31, 2017. Participants were followed up for a median of 11.12 years, and 524 individuals were diagnosed with COPD during the follow-up period; the incidence was 105.54 per 100 000 person-years. Multivariate Cox proportional risk regression models showed that age (HR=3.78, 95%CI:3.32-4.30), former smoking (HR=2.00, 95%CI:1.24-3.22), current smoking (<10 cigarettes/day, HR=2.14, 95%CI:1.36-3.35;≥10 cigarettes/day, HR=2.69, 95%CI:1.60-4.54), history of respiratory disease (HR=2.08, 95%CI:1.33-3.26), daily sleep duration ≥10 hours (HR=1.41, 95%CI:1.02-1.95) were associated with increased risk of COPD. However, education level of primary school and above (primary or junior high school, HR=0.65, 95%CI:0.52-0.81; high school and above, HR=0.54, 95%CI:0.33-0.87), consuming fresh fruit daily (HR=0.59, 95%CI:0.42-0.83) and consuming spicy food weekly (HR=0.71, 95%CI:0.53-0.94) were associated with reduced risk of COPD. Conclusions: The incidence of COPD is low in Suzhou. Older age, smoking, history of respiratory disease, and long sleep duration were risk factors for the development of COPD in the Suzhou cohort.
目的： 了解苏州队列人群慢性阻塞性肺疾病（COPD）的发病状况及人群分布特征，探索其发病的危险因素，为防控COPD提供科学依据。 方法： 基于中国慢性病前瞻性研究苏州市吴中区项目点数据，剔除基线气流受限及基线调查时自报患有慢性支气管炎/肺气肿/肺心病的个体后，最终纳入分析45 484人。采用Cox比例风险回归模型筛选影响队列人群COPD发病的危险因素并计算风险比（HR）及其95%可信区间（CI），同时分析吸烟在其他危险因素与COPD发病关联中是否存在效应修饰作用。 结果： 截至2017年12月31日，研究对象中位随访时间为11.12年，随访期间共诊断COPD 524人，COPD的发病密度为105.54/10万人年。多因素Cox比例风险回归分析显示，年龄（HR=3.78，95%CI：3.32~4.30）、曾经吸烟（HR=2.00，95%CI：1.24~3.22）、当前吸烟（<10支/d，HR=2.14，95%CI：1.36~3.35；≥10支/d，HR=2.69，95%CI：1.60~4.54）、有呼吸系统疾病史（HR=2.08，95%CI：1.33~3.26）、每日睡眠时间过长（HR=1.41，95%CI：1.02~1.95）与COPD发病风险增加相关；文化程度为小学及以上（小学/初中，HR=0.65，95%CI：0.52~0.81；高中及以上，HR=0.54，95%CI：0.33~0.87）、每日食用新鲜水果（HR=0.59，95%CI：0.42~0.83）、每周吃辣食（HR=0.71，95%CI：0.53~0.94）与COPD发病风险降低相关。 结论： 苏州队列人群COPD发病密度处于较低水平，高龄、吸烟、有呼吸系统疾病史、每日睡眠时间过长是苏州队列人群COPD发病的危险因素。.