Tuberc Respir Dis.  2011 Nov;71(5):328-334.

Prevalence of Chronic Obstructive Pulmonary Disease in Korea: The Result of Forth Korean National Health and Nutrition Examination Survey

• Hwang YI
• Yoo KH
• Sheen SS
• Park JH
• Kim SH
• Yoon HI
• Lim SC
• Lee SY
• Park JY
• Park SJ
• Seo KH
• Kim KU
• Lee SY
• Park IW
• Lee SD
• Kim SK
• Kim YK
• Lee SM
• Han SK
• Kim Y
• Cho YM
• Park HJ
• Oh KW
• Kim YS
• Oh YM

Abstract

BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged > or =45 years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009.
METHODS
Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged > or =40 years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed.
RESULTS
The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged > or =40 years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender.
CONCLUSION
The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.

Keyword

Pulmonary Disease, Chronic Obstructive; Korea; Prevalence; Spirometry; survey

MeSH Terms

Aged
Censuses
Female
Forced Expiratory Volume
Humans
Hypogonadism
Korea
Male
Mitochondrial Diseases
Nutrition Surveys
Ophthalmoplegia
Prevalence
Pulmonary Disease, Chronic Obstructive
Surveys and Questionnaires
Risk Factors
Smoke
Smoking
Spirometry
Vital Capacity
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia
Smoke

Figure

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  Figure 1 Prevalence of airflow obstruction stratified by age group.

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  Figure 2 Distribution of COPD severity stratified by the GOLD classification. COPD: chronic obstructive pulmonary disease; GOLD: global initiative for chronic obstructive lung disease.

Reference

1. Renwick DS, Connolly MJ. Prevalence and treatment of chronic airways obstruction in adults over the age of 45. Thorax. 1996. 51:164–168.

2. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997. 349:1498–1504.

3. World Health Organization (WHO). The Global Burden of Disease: 2004 Update. 2008. Geneva, Switzerland: WHO.

4. Celli BR, MacNee W. ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004. 23:932–946.

5. World Health Organization (WHO). Chronic obstructive pulmonary disease (COPD). Fact sheet No. 315. 2011. Geneva, Switzerland: WHO.

6. The cause of death statistics [Internet]. Korean Statistical Information Service (KSIS). c2010. cited 2010 Jun 1. Daejeon: KSIS;Available from:http://kosis.kr/abroad/abroad_01List.jsp?parentId=D.

7. Information for chronic diseases 2009. Health Insurance Review & Assessment Service (HIRA). c2010. cited 2011 Jun 1. Seoul: HIRA;Available from:http://www.hira.or.kr.

8. Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006. 28:523–532.

9. Kim DS, Kim YS, Jung KS, Chang JH, Lim CM, Lee JH, et al. Prevalence of chronic obstructive pulmonary disease in Korea: a population-based spirometry survey. Am J Respir Crit Care Med. 2005. 172:842–847.

10. Korean national health and nutrition examination survey. Korea Centers for Disease Control and Prevention (KCDC). c2011. cited 2011 Jul 1. Cheongwon: KCDC;Available from:http://knhanes.cdc.go.kr/intro/intro01.jsp.

11. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005. 26:319–338.

12. Choi JK, Paek DM, Lee JO. Normal predictive values of spirometry in Korean population. Tuberc Respir Dis. 2005. 58:230–242.

13. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2009. [place unknown]: GOLD.

14. Yoo KH, Kim YS, Sheen SS, Park JH, Hwang YI, Kim SH, et al. Prevalence of chronic obstructive pulmonary disease in Korea: the fourth Korean National Health and Nutrition Examination Survey, 2008. Respirology. 2011. 16:659–665.

15. Soriano JB, Zielinski J, Price D. Screening for and early detection of chronic obstructive pulmonary disease. Lancet. 2009. 374:721–732.

16. Hwang YI, Kwon OJ, Kim YW, Kim YS, Park YB, Lee MG, et al. Awareness and impact of COPD in Korea: an epidemiologic insight survey. Tuberc Respir Dis. 2011. (accepted).

17. Jenkins CR, Jones PW, Calverley PM, Celli B, Anderson JA, Ferguson GT, et al. Efficacy of salmeterol/fluticasone propionate by GOLD stage of chronic obstructive pulmonary disease: analysis from the randomised, placebo-controlled TORCH study. Respir Res. 2009. 10:59.

18. Decramer M, Celli B, Kesten S, Lystig T, Mehra S, Tashkin DP, et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet. 2009. 374:1171–1178.

19. Celli BR, Thomas NE, Anderson JA, Ferguson GT, Jenkins CR, Jones PW, et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study. Am J Respir Crit Care Med. 2008. 178:332–338.

20. Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB. U.S. Preventive Services Task Force. Screening for chronic obstructive pulmonary disease using spirometry: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2008. 148:535–543.

21. Lee SW, Yoo JH, Park MJ, Kim EK, Yoon HI, Kim DK, et al. Early diagnosis and management of chronic obstructive pulmonary disease. Tuberc Respir Dis. 2011. 70:293–300.

22. Hwang YI, Kim CH, Kang HR, Shin T, Park SM, Jang SH, et al. Comparison of the prevalence of chronic obstructive pulmonary disease diagnosed by lower limit of normal and fixed ratio criteria. J Korean Med Sci. 2009. 24:621–626.