흡연상태가 40세 이상 남성의 만성폐쇄성폐질환 유병가능성에 미치는 영향: 제5기 국민건강영양조사를 기반으로
Effects of Smoking Status on Chronic Obstructive Pulmonary Disease Prevalence in Males 40 years and Older: Findings from the Korean National Health and Nutrition Examination Survey
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연구배경: 국민건강영양조사 제5기 건강검진조사 자료를활용하여 COPD 유병률과, 흡연상태가 이 질병발생에 미치는 영향을 조사하였다. 방법: COPD 진단기준은 FEV1/FEV6<0.73, 흡연이 COPD유병률에 미치는 영향은 복합표본설계 로지스틱회귀분석을 하였다. 결과: 40세 이상 COPD 유병률은 11.6±0.5%였고, 남성은17.5±0.8%, 여성은 6.2±0.5%였다. 남성의 보정 전 COPD유병가능성은 현재흡연자는 OR 1.834 (95% CI 1.319-2.551),과거흡연자는 OR 2.112 (95% CI 1.551-2.875)였다. 연령과흡연지수를 보정한 현재흡연자의 유병가능성은 2.099(1.382-3.188)배 과거흡연자는 1.463 (1.012-2.115)배였으며각 군의 유의도는 0.001과 0.043으로 유의하였다(현재흡연의 회귀계수는 0.741±0.213, 과거흡연은 0.380±0.188). 연령 1세 증가시마다 유병가능성이 1.102 (1.090-1.115)배 증가하였고, 흡연지수가 1 pack*year 증가시마다 1.012 (1.007-1.018)배 증가하였다(P<0.001). 결론: 연령과 흡연량 보정 후, 흡연자의 COPD 유병가능성이 높았다. 또한 현재흡연자는 과거흡연자보다 승산비와 회귀계수가 더 높았다.
Abstract
Background: This is a study of the prevalence of chronic obstructive pulmonary disease (COPD), which showshigh mortality worldwide, and the effects of smoking on COPD by using data from the Korea National Healthand Nutrition Examination Survey V. Methods: FEV1/FEV6<0.73 was used as a diagnostic criterion of COPD. Frequency analysis for prevalence, descriptivestatistics for general characteristics and ventilation rate according to age-specifications, and complexsample logistic regression analysis for the effect of smoking on COPD prevalence were used. IBM SPSSStatistics 21 Standard, Complex Samples for Medical Science(Windows) was used for data analysis(α=0.05). Results: Prevalence of COPD was 11.6±0.5% of Koreans in their forties or over, and 17.5±0.8% in males, and6.2±0.5% in females. There was significant increase of COPD prevalence with age increment. Before adjustingfor age and smoking index(SI), the COPD possibilities of past and current-smokers compared with non-smokingmales were (odds ratio [OR] 2.112 [95% confidence interval [CI] 1.551-2.875]) and (OR 1.834 [95% CI1.319-2.551]) respectively. After adjustments with age and SI, the COPD possibility of current-smoking was2.099 (1.382-3.188) times higher and for past-smoking was 1.463 (1.012-2.115) times higher than non-smoking. The P-value of each group was significant. The regression coefficients (B) of current-smoking and past-smokingwere 0.741 and 0.380 respectively. The prevalence of COPD increased 1.102 (1.090-1.115) times for every1 year of age increase, and 1.012 (1.007-1.018) times for every 1 SI increase (P<0.001). Conclusions: After adjusting for age and SI, the prevalence of COPD in smokers was higher than non-smokers. And current-smoking had a higher OR and higher B than past-smoking.
참고문헌 (25)
- "Burden of COPD" (2014)[URL]
- Burney P, "Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty―a BOLD analysis", Thorax, 69(5), pp.465~473 (2014)
- Yoo KH, "Prevalence of chronic obstructive pulmonary disease in Korea:the fourth Korean National Health and Nutrition Examination Survey, 2008", Respirology, 16(4), pp.659~665 (2011)
- "Guideline of COPD" (2012)[URL]
- "Education and Quality Control of Pulmonary Function Test and Chest X-ray in the National Health and Nutrition Examination Survey" (2012)[URL]
- Patel JG, "Indirect costs in chronic obstructive pulmonary disease: a review of the economic burden on employers and individuals in the United States", Int J Chron Obstruct Pulmon Dis, 9, pp.289~300 (2014)
- 이정오, "과거 무기분진에 노출된 이직근로자들의 연간 폐기능 변화", Tuberculosis and Respiratory Diseases, 71(5), pp.341~348 (2011), 대한결핵및호흡기학회
- Ministry of Health and Welfare, "Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1)", Korea Centers for Disease Control and Prevention, ~ (2011)
- Ministry of Health and Welfare, "Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2)", Korea Centers for Disease Control and Prevention, ~ (2012)
- Ministry of Health and Welfare, "Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3)", Korea Centers for Disease Control and Prevention, ~ (2013)
- Rosa FW, "Efficacy of the FEV1", FEV6 ratio compared to the FEV1, Braz J Med Biol Res, pp.2007, 40(12)[DOI]
- 황용일, "Prevalence of Chronic Obstructive Pulmonary Disease in Korea: The Result of Forth Korean National Health and Nutrition Examination Survey", Tuberculosis and Respiratory Diseases, 71(5), pp.328~334 (2011), 대한결핵및호흡기학회
- 황용일, "Comparison of the Prevalence of Chronic Obstructive Pulmonary Disease Diagnosed by Lower Limit of Normal and Fixed Ratio Criteria", Journal of Korean Medical Science, 24(4), pp.621~626 (2009), 대한의학회
- Tilert T, "Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES)2007-2010", Respir Res, 14, pp.103~ (2013)
- Chan-Yeung M, "The burden and impact of COPD in Asia and Africa", Int J Tuberc Lung Dis, 8(1), pp.2~14 (2004)
- 정영미, "한국성인의 만성 폐쇄성 폐질환 유병률, 위험요인 및 삶의 질", Journal of Korean Academy of Nursing, 41(2), pp.149~156 (2011), 한국간호과학회
- Kim HW, "The effect of aging on the pulmonary function of the healthy adults", Korean J Anesthesiol, 23(6), pp.1021~1026 (1990)
- 홍성철, "천식환자 및 만성 폐쇄성 폐질환환자군에서 연간 최대 호기유속의 변화량", Tuberculosis and Respiratory Diseases, 72(1), pp.24~29 (2012), 대한결핵및호흡기학회
- Burney P, "Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty-a BOLD analysis", Thorax, 69(5), pp.465~473 (2014)
- Yoonki Hong, "Contributors of the Severity of Airflow Limitation in COPD Patients", Tuberculosis and Respiratory Diseases, 72(1), pp.8~14 (2012), 대한결핵및호흡기학회
- 이경주, "만성폐쇄성폐질환의 조기 진단과 조기 치료", 대한내과학회지, 77(4), pp.415~421 (2009), 대한내과학회
- Gershon AS, "Asthma and chronic obstructive pulmonary disease (COPD) prevalence and health services use in Ontario Métis: a population-based cohort study", PLoS One, 23(9(4)), pp.e95899~ (2014)
- 박춘식, "Effects of Smoking Cessation on Airflow Obstruction and Quality of Life in Asthmatic Smokers", Allergy, Asthma & Immunology Research, 2(4), pp.254~259 (2010), 대한천식알레르기학회
- Evans J, "Estimating the prevalence of COPD in Canada: Reported diagnosis versus measured airflow obstruction", Health Rep, 19(25(3)), pp.3~11 (2014)
- Masuko H, "Lower FEV1 in non-COPD, nonasthmatic subjects: association with smoking, annual decline in FEV1, total IgE levels, and TSLP genotypes", Int J Chron Obstruct Pulmon Dis, 6, pp.181~189 (2011)