regional variations in the prevalence and misdiagnosis of air flow obstruction in china baseline results from a prospective cohort of the china kadoorie biobank ckb

Respiratory epidemiology Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB) Om P Kurmi,1 Liming Li,2,3 Margaret Smith,1 Mareli Augustyn,1 Junshi Chen,4 Rory Collins,1 Yu Guo,2 Yabin Han,5 Jingxin Qin,6 Guanqun Xu,7 Jian Wang,8 Zheng Bian,2 Gang Zhou,9 Kourtney Davis,10 Richard Peto,1 Zhenming Chen,1 on behalf of the China Kadoorie Biobank Collaborative Group To cite: Kurmi OP, Li L, Smith M, et al Regional variations in the prevalence and misdiagnosis of air flow obstruction in China: baseline results from a prospective cohort of the China Kadoorie Biobank (CKB) BMJ Open Resp Res 2014;1:e000025 doi:10.1136/bmjresp-2014000025 ▸ Additional data are published online only To view this file please visit the journal online (http://dx.doi org/10.1136/bmjresp-2014000025) Received February 2014 Revised 14 April 2014 Accepted 16 April 2014 ABSTRACT Background: Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors Methods: We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004–2008 Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-measured lung function The prevalence of AFO was analysed by region, age, socioeconomic status, body mass index (BMI) and smoking history and compared with the prevalence of self-reported physician-diagnosed chronic bronchitis or emphysema (CB/E) and its symptoms Findings: The prevalence of AFO was 7.3% in men (range 2.5–18.2%) and 6.4% in women (1.5–18.5%) Higher prevalence of AFO was associated with older age ( p