The Prevalence of Chronic Obstructive Pulmonary Disease by the Global Lung Initiative Equations in North-Western Russia

Abstract

Background: The prevalence of chronic obstructive pulmonary disease (COPD) varies in different countries, while the cut-off for airflow obstruction (AO) is still contested. No COPD prevalence data based on the Global Lung Initiative (GLI) 2012 equations are available in Russia. Objectives: This study aims to assess AO prevalence by the GLI lower limit of normal (GLI-LLN) and the fixed cut-off, to identify AO risk factors and to assess the diagnostic value of respiratory symptoms in north-western Russia. Methods: In a north-western Russian population-based sample of 2,974 adults aged 35-70 years, data on socio-demographics, smoking, occupational exposures and respiratory symptoms were collected, and spirometry was performed before and after bronchodilator (BD) administration. Results: The AO prevalence was 6.8% (95% CI 5.8-7.9) based on the fixed and 4.8% (95% CI 3.9-5.7) based on the GLI-LLN cut-off. 22.5% of the participants with post-BD AO had a positive bronchodilator test, and 1% showed a paradoxical BD response. Of the environmental factors studied, only smoking was independently associated with AO (odds ratio 2.47, 95% CI 1.60-3.82). The positive predictive value of respiratory symptoms for AO was 11% based on the fixed and 8% based on the GLI-LLN cut-off. Conclusions: In a sample of adults in north-western Russia, the AO prevalence by the GLI-LLN cut-off was lower than that by the fixed cut-off. The predictive value of respiratory symptoms was low.

Characteristics of COPD patients according to GOLD classification and clinical phenotypes in the Russian Federation: the SUPPORT trial

“… 2 – 6 An epidemiological study conducted in 12 regions of the Russian Federation estimated a COPD prevalence of 15.3%, 7 while other studies have reported prevalence of between 6.8% and 21%. 8 , 9 Recent studies have also suggested that the prevalence could be even higher. 7 , 10 The smoking rate in the Russian Federation is also high, with 61% of men and 22.1% of women being active smokers.…”

“…Previous studies have provided data on the prevalence and demographics of COPD in the Russian Federation, 7 , 9 , 10 but there is still a lack of information related to disease severity, clinical phenotypes, and treatment approaches used in routine clinical practice. However, the results of the POPE study showed that the majority of COPD patients in Central and Eastern Europe belong to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) D group and have frequent exacerbations.…”

<p>Impacts of Different Spirometry Reference Equations and Diagnostic Criteria on the Frequency of Airway Obstruction in Adult People of North China</p>

“…Beside the reference equations, the criterion for airway obstruction definition also has a large impact on the diagnosis of airway obstruction. [20][21][22] The FEV1/FVC<LLN was the most widely used diagnostic criteria for airway obstruction. However, because the calculation of LLN was relatively complex, the usage of LLN in clinical practices was limited.…”

Diagnostic algorithm for detecting chronic obstructive pulmonary disease in primary care

“…Однако, как показали наши ис-следования, и в условиях реальной практики среди пациентов, обращающихся за медицин-ской помощью к семейным врачам, была выяв-лена высокая распространенность хронических респираторных жалоб, составившая 58,9 % [9]. Тем не менее одного выявления симптомов для диагностики ХОБЛ недостаточно ввиду их низ-кой прогностической значимости [10]. Решению этой проблемы может способствовать исполь-зование международных стандартизованных опросников, которые рекомендованы для при-менения в первичном звене здравоохране-ния [11].…”