| Title | Prevalence, risk factors, and management of asthma in China: a national cross-sectional study |
| Authors | Huang, Kewu Yang, Ting Xu, Jianying Yang, Lan Zhao, Jianping Zhang, Xiangyan Bai, Chunxue Kang, Jian Ran, Pixin Shen, Huahao Wen, Fuqiang Chen, Yahong Sun, Tieying Shan, Guangliang Lin, Yingxiang Xu, Guodong Wu, Sinan Wang, Chaolong Wang, Ruiying Shi, Zhihong Xu, Yongjian Ye, Xianwei Song, Yuanlin Wang, Qiuyue Zhou, Yumin Li, Wen Ding, Liren Wan, Chun Yao, Wanzhen Guo, Yanfei Xiao, Fei Lu, Yong Peng, Xiaoxia Zhang, Biao Xiao, Dan Wang, Zuomin Chen, Zhengming Bu, Xiaoning Zhang, Hong Zhang, Xiaolei An, Li Zhang, Shu Zhu, Jianguo Cao, Zhixin Zhan, Qingyuan Yang, Yuanhua Liang, Lirong Tong, Xunliang Dai, Huaping Cao, Bin Wu, Tangchun Chung, Kian Fan He, Jiang Wang, Chen |
| Affiliation | Capital Med Univ, Beijing Chao Yang Hosp, Beijing Key Lab Resp & Pulm Circulat Disorders, Dept Pulm & Crit Care Med, Beijing, Peoples R China Capital Med Univ, Beijing Chao Yang Hosp, Dept Stomatol, Beijing, Peoples R China Capital Med Univ, Beijing Chao Yang Hosp, Dept Epidemiol, Beijing, Peoples R China Beijing Inst Resp Med, Beijing, Peoples R China China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Ctr Resp Med, Beijing 100029, Peoples R China China Japan Friendship Hosp, Tobacco Med & Tobacco Cessat Ctr, Ctr Resp Med, Beijing, Peoples R China China Japan Friendship Hosp, Inst Clin Med Sci, Ctr Resp Med, Beijing, Peoples R China Chinese Acad Med Sci, Inst Resp Med, Beijing, Peoples R China Natl Clin Res Ctr Resp Dis, Beijing, Peoples R China WHO Collaborating Ctr Tobacco Cessat & Resp Dis P, Beijing, Peoples R China Capital Med Univ, Dept Resp Med, Beijing, Peoples R China Shanxi Dayi Hosp, Dept Pulm & Crit Care Med, Taiyuan, Shanxi, Peoples R China Xi An Jiao Tong Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Xian, Shaanxi, Peoples R China Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Pulm & Crit Care Med, Wuhan, Hubei, Peoples R China Guizhou Prov Peoples Hosp, Dept Pulm & Crit Care Med, Guiyang, Guizhou, Peoples R China Fudan Univ, Zhongshan Hosp, Dept Pulm & Crit Care Med, Shanghai, Peoples R China China Med Univ, Hosp 1, Dept Pulm & Crit Care Med, Shenyang, Liaoning, Peoples R China Guangzhou Med Univ, Affiliated Hosp 1, State Key Lab Resp Dis, Natl Clin Res Ctr Resp Dis,Guangzhou Inst Resp Di, Guangzhou, Guangdong, Peoples R China Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Resp & Crit Care Med, Hangzhou, Zhejiang, Peoples R China Sichuan Univ, West China Hosp, State Key Lab Biotherapy China, Chengdu, Sichuan, Peoples R China Sichuan Univ, West China Hosp, Dept Resp & Crit Care Med, Chengdu, Sichuan, Peoples R China Peking Univ, Hosp 3, Dept Resp & Crit Care Med, Beijing, Peoples R China Beijing Hosp, Dept Resp & Crit Care Med, Beijing, Peoples R China Beijing Hosp, Natl Ctr Gerontol, Beijing, Peoples R China Chinese Acad Med Sci, Inst Basic Med Sci, Sch Basic Med, Peking Union Med Coll, Beijing, Peoples R China Huazhong Univ Sci & Technol, Sch Publ Hlth, Tongji Med Coll, Wuhan, Hubei, Peoples R China Capital Med Univ, Beijing Childrens Hosp, Ctr Clin Epidemiol & Evidence Based Med, Natl Ctr Childrens Hlth, Beijing, Peoples R China Univ Oxford, Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Oxford, England Univ Oxford, Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Oxford, England Imperial Coll London, Natl Heart & Lung Inst, London, England Royal Brompton & Harefield NHS Trust, London, England Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA USA Chinese Acad Med Sci, Beijing, Peoples R China Peking Union Med Coll, Beijing, Peoples R China |
| Issue Date | 2019 |
| Publisher | LANCET |
| Abstract | Background Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population. Methods A representative sample of 57 779 adults aged 20 years or older was recruited for the national cross-sectional China Pulmonary Health (CPH) study using a multi-stage stratified sampling method with parameters derived from the 2010 census. Ten Chinese provinces, representative of all socioeconomic settings, from six geographical regions were selected, and all assessments were done in local health centres. Exclusion criteria were temporary residence, inability to take a spirometry test, hospital treatment of cardiovascular conditions or tuberculosis, and pregnancy and breastfeeding. Asthma was determined on the basis of a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. All participants were assessed with a standard asthma questionnaire and were classed as having or not having airflow limitation through pulmonary function tests before and after the use of a bronchodilator (400 mu g of salbutamol). Risk factors for asthma were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was assessed by the self-reported history of physician diagnosis, treatments, and hospital visits in people with asthma. Findings Between June 22, 2012, and May 25, 2015, 57 779 participants were recruited into the CPH study. 50 991 (21 446 men and 29 545 women) completed the questionnaire survey and had reliable post-bronchodilator pulmonary function test results and were thus included in the final analysis. The overall prevalence of asthma in our sample was 4.2% (95% CI 3.1-5.6), representing 45.7 million Chinese adults. The prevalence of asthma with airflow limitation was 1.1% (0.9-1.4), representing 13.1 million adults. Cigarette smoking (odds ratio [OR] 1.89, 95% CI 1.26-2.84; p=0.004), allergic rhinitis (3.06, 2.26-4.15; p<0.0001), childhood pneumonia or bronchitis (2.43, 1.44-4.10; p=0.002), parental history of respiratory disease (1.44, 1.02-2.04; p=0.040), and low education attainment (p=0.045) were associated with prevalent asthma. In 2032 people with asthma, only 28.8% (95% CI 19.7-40.0) reported ever being diagnosed by a physician, 23.4% (13.9-36.6) had a previous pulmonary function test, and 5.6% (3.1-9.9) had been treated with inhaled corticosteroids. Furthermore, 15.5% (11.4-20.8) people with asthma reported at least one emergency room visit and 7.2% (4.9-10.5) at least one hospital admission due to exacerbation of respiratory symptoms within the preceding year. Interpretation Asthma is prevalent but largely undiagnosed and undertreated in China. It is crucial to increase the awareness of asthma and disseminate standardised treatment in clinical settings to reduce the disease burden. Copyright (C) 2019 Elsevier Ltd. All rights reserved. |
| URI | http://hdl.handle.net/20.500.11897/546019 |
| ISSN | 0140-6736 |
| DOI | 10.1016/S0140-6736(19)31147-X |
| Indexed | SCI(E) |
| Appears in Collections: | 第三医院 |
