Anne Lindberg, MD; Ann-Christin Jonsson, SRN; Eva Rönmark, PhD; Rune Lundgren, MD, PhD, FCCP; Lars-Gunnar Larsson, MD, PhD; and Bo Lundbäck, MD, PhD
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1 10 y Anne Lindberg, MD; Ann-Christin Jonsson, SRN; Eva Rönmark, PhD; Rune Lundgren, MD, PhD, FCCP; Lars-Gunnar Larsson, MD, PhD; and Bo Lundbäck, MD, PhD (BTS) (GOLD) (GOLD 0 ) 10 y % (PFT) 1506 (91%) % 1165 (86%) ( 534 ) PFTs 10 y 8.2% ( BTS ) 13.5% ( GOLD ) ( BTS GOLD ) 1 OR 3.49 (BTS ) 3.37 (GOLD ) 2 OR 4.50 (BTS ) 5.70 (GOLD ) OR 5.37 (BTS ) 4.56 (GOLD ) (OR % CI ) (OR % CI ) 10 y 8.2% ( BTS ) 13.5% ( GOLD ) ( ) GOLD O () (diagnosis) (epidemiology) (gender) (incidence) (prevalence) (respiratory symptoms) (risk factors) 562
2 [15, 16] [1~5] 4% 10% y [6,7] (British Thoracic Society BTS) GOLD [8, 9] [10~12] (Global Initiative for Chronic Obstructive Lung Disease GOLD) (GOLD 0 ) [13] Norrbotten 8 [12] 86% (5 698 ) (pulmonary function test PFT) (91%) PFT y % 2 PFT ( 86%) ( [8, 9, 13, 14] 74%) 2 PFTs ( ) ( 1) From the Obstructive Lung Disease in Northern Sweden Studies (Drs. Lindberg, Rönmark, and Larsson, and Ms. Jonsson), Sunderby Central Hospital of Norrbotten, Luleå; the Department of Respiratory Medicine and Allergy (Dr. Lundgren), Umeå University, Umeå; and Lung and Allergy Research (Dr. Lundbäck), National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Correspondence to: Anne Lindberg, MD, Senior Consultant, Division of Respiratory Medicine and Allergy, Department of Medicine, Sunderby Central Hospital of Norrbotten, SE Luleå, Sweden; anne.lindberg@nll.se % 93.7% (P < 0.001) (P = 0.040) 35.7% (obstructive lung disease OLD) ( CHEST
3 1 / FEV 1 % FEV 1 / FVC FEV 1 % FEV 1 / FVC (21.9) 252 (47.2) 378 (34.1) 198 (34.4) 94 (17.6) 292 (26.3) 80 (13.9) 55 (10.3) 135 (12.2) 9 (1.6) 13 (2.4) 22 (2.0) 151 (26.3) 116 (21.7) 267 (24.1) (59.5) 304 (56.9) 649 (58.5) 316 (55.0) 269 (50.4) 585 (52.8) 258 (44.9) 207 (38.8) 465 (41.9) 188 (33.0) 239 (44.8) 427 (38.5) 389 (67.7) 324 (60.7) 731 (65.9) x- ± s ( ) ) ( ) 21 (1.9%) OLD BTS FEV 1 /VC <0.70 FEV 1 < [9] 80% 2 GOLD FEV 1 /FVC <0.70 [13] [17~23] BTS GOLD (Vicatest 5; Mijnhardt; Bunnik, the Netherlands) [24] (vital capacity VC) FVC VC PFTs PFTs [25] [26] Umeå
4 ( 1 y) 2 (1986 / 1996 ) ( / ) ( / ) ( / ) ( / ) ( / ) ( ) (7.3) 51 (9.6) 93 (8.4) ( ) ( ) GOLD y 3 mo 10 y ( ) BTS 10 y (SPSS; SPSS; Chicago, IL) χ 2 BTS ( ) ( ) OLD (socioeconomic index SEI) [27] ( 2) (19.5) 71 (13.3) 183 (16.5) (13.2) 106 (19.9) 182 (16.4) (20.6) 22 (4.1) 250 (22.5) (13.9) 238 (44.6) 318 (28.7) (6.4) 15 (2.8) 52 (4.7) 6. 0 (0) 31 (5.8) 31 (2.8) ( ) BTS GOLD P (2) P (3) 79.5 (66) 55.0 (507) < (89) 54.1 (437) (60) 49.0 (453) < (80) 48.1 (390) (54) 37.6 (348) < (68) 36.6 (297) (49) 34.8 (316) < (60) 34.8 (277) (72) 62.1 (572) < (95) 60.8 (748) ( ) (2) (3) BTS GOLD CHEST
5 10 y SEI ( (SEI 1 2 SEI 3 7 ) 3) 1986 BTS 95%CI 65.1% GOLD 53.5% 8.2% 13.5% ( 4) 3 (BTS 16.7% % GOLD 24.5% 9.4%) ( ) 1/ (BTS ) 165 ( 13.7% ORs % P <0.001) ( % % % P <0.001) ( 8.0% 13.5% 11.3% P =0.025) 1986 ( GOLD 38.5% 15.9% BTS 28.8% 9.6% P <0.001) 1996 FEV 1 ( )% ( )% P < GOLD FEV 1 ( )% ( )% (P = 0.001) BTS FEV 1 ( )% ( )% (P < 0.001) BTS 127 GOLD BTS GOLD 10 y 3.99 OLD logistic 4 BTS GOLD 10 y BTS GOLD P P (2) < (2) P < (2) < (2) (2) % 566
6 ( logistic ) OR %CI ( 5) BTS OR %CI OR %CI OR %CI OR ( 95%CI OR %CI logistic 10 y ( 1) OR %CI ORs ( < 1.5) OLD OR %CI logistic BTS GOLD OR 95% CI OR 95%CI ~ ~1.96 OLD ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~7.79 OLD ( BTS GOLD ) ( 4) 10 y ) 10 y BTS (OR % CI OR % CI ) OR 95%CI OR % CI OR %CI OR % CI OR 95%CI OR % CI OR %CI OR % CI OR %CI OR %CI OR %CI OR %CI CHEST
7 y BTS (BTS GOLD) 3 1 (GOLD FEV 1 [18, 26] [5] 85% 80% ) GOLD BTS [28] GOLD (GOLD 0 ) 1 GOLD % (BTS ) 24.5% (GOLD ) 4.8% (BTS ) 9.4% (GOLD ) [29] FEV 1 [12] GOLD 0 [12] GOLD 0 10 y 8.2% (BTS ) [2 5] 13.5% (GOLD ) [10~12] [10, 11] FEV 1 /FVC 10 y <0.6 <
8 [12] 0.2% 0.5% GOLD OLD y OLD 13.2% 20.5% [12] 20 α 1 [35] [2, 30] 10 y ( ) [12] ( ) ( ) ( [12] GOLD 0 ) ( ) BTS GOLD ( FEV 1 /FVC < ORs 0.70 FEV 1 <80% ) BTS 10 y [16] [36~38] [30~34] FEV 1 (GOLD 0 ) PFTs [39] ( ) [5, 18, 35, 36] OLD 10 y 8.2% (BTS ) 13.5% (GOLD ) CHEST
9 GOLD 0 ( ) 1 Lange P, et al. Eur Respir J 1989;2: Bakke PS, et al. Thorax 1991;46: Sobradillo V, et al. Arch Bronconeumol 1999;35: Mannino DM, et al. Arch Intern Med 2000;160: Lundbäck B, et al. Respir Med 2003;97: Murray CJL, et al. Alternative visions of the future:projecting mortality and disability, In: Murray CJL, et al, eds. The global burden of disease. Cambridge MA: Harvard University Press, 1996; Gulsvik A. Monaldi Arch Chest Dis 2001;56: Siafkas NM, et al. Eur Respir J 1995;8: British Thoracic Society. Thorax 1997;52(Suppl): 1S 28S 10 Huhti E, et al. Eur J Respir Dis 1980;61: Krzyzanowski M, et al. Am Rev Respir Dis 1986;134: Vestbo J, et al. AJR Am J Roentgenol 2002;166: Pauwels RA, et al. Am J Respir Crit Care Med 2001;46: American Thoracic Society. Am J Respir Crit Care Med 1995; 152(Suppl):77S 120S 15 Viegi G, et al. Chest 2000;117(Suppl):339S 345S 16 Celli BR, et al. Eur Respir J 2003;22: Lundbäck B, et al. Eur Respir J 1991;4: Lindström M, et al. Chest 2001;119: Larsson LG, et al. Chest 2003;124: Pallasaho P, et al. Respir Med 1999;93: Medical Research Council Committee on Aetiology of Chronic Bronchitis. BMJ 1960; ii: Lebowitz MD, et al. Am J Epidemiol 1975;102: Burney PG, et al. Eur Respir J 1989;2: American Thoracic Society. Am Rev Respir Dis 1987;136: Berglund E, et al. Acta Med Scand 1963;173: Lundbäck B, et al. Tuber Lung Dis 1994;75: Statistics Sweden The Socioeconomic classification of occupations. Stockholm, Sweden: Statistics Sweden, Jansson SA, et al. Chest 2002;122: Hansen EF, et al. Am J Respir Crit Care Med 1999;159: Heederik D, et al. Int J Epidemiol 1990;19: Annesi I, et al. Am Rev Respir Dis 1986;134: Krzyzanowski M, et al. Chest 1990;98: Sherman CB, et al. Am Rev Dis 1992;146: Vestbo J, et al. AJR Am J Roentgenol 1996;153: Sandford AJ, et al. Eur Respir J 1997;10: Viegi G, et al. Eur Respir Rev 2001;11:80, Xu X, et al. Eur Respir J 1994;7: Prescott E, et al. Eur Respir J 1997;10: Langhammer A, et al. Eur Respir J 2003;21: CHEST 2005;127:
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