Repositorio
Institucional

Duong, MyLinh

Islam, Shofiqul

Rangarajan, Sumathy

Teo, Koon

O'Byrne, Paul M.

Schuenemann, Holger J.

Igumbor, Ehimario

Chifamba, Jephat

Liu, Lisheng

Li, Wei

Ismail, Tengku

Shankar, Kiruba

Shahid, Muhammad

Vijayakumar, Krishnapillai

Yusuf, Rita

Zatonska, Katarzyna

Oguz, Aytekin

Rosengren, Annika

Heidari, Hossain

Almahmeed, Wael

Diaz, Rafael

Oliveira, Gustavo

Lopez-Jaramillo, Patricio

Seron, Pamela

Killian, Kieran

Yusuf, Salim

Global differences in lung function by region (PURE): an international, community-based prospective study

ELSEVIER SCI LTD

LANCET RESPIRATORY MEDICINE

en

Background Despite the rising burden of chronic respiratory diseases, global data for lung function are not available. We investigated global variation in lung function in healthy populations by region to establish whether regional factors contribute to lung function. Methods In an international, community-based prospective study, we enrolled individuals from communities in 17 countries between Jan 1, 2005, and Dec 31, 2009 (except for in Karnataka, India, where enrolment began on Jan 1, 2003). Trained local staff obtained data from participants with interview-based questionnaires, measured weight and height, and recorded forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). We analysed data from participants 130-190 cm tall and aged 34-80 years who had a 5 pack-year smoking history or less, who were not affected by specified disorders and were not pregnant, and for whom we had at least two FEV1 and FVC measurements that did not vary by more than 200 mL. We divided the countries into seven socioeconomic and geographical regions: south Asia (India, Bangladesh, and Pakistan), east Asia (China), southeast Asia (Malaysia), sub-Saharan Africa (South Africa and Zimbabwe), South America (Argentina, Brazil, Colombia, and Chile), the Middle East (Iran, United Arab Emirates, and Turkey), and North America or Europe (Canada, Sweden, and Poland). Data were analysed with nonlinear regression to model height, age, sex, and region. Findings 153 996 individuals were enrolled from 628 communities. Data from 38 517 asymptomatic, healthy nonsmokers (25 614 women; 12 903 men) were analysed. For all regions, lung function increased with height nonlinearly, decreased with age, and was proportionately higher in men than women. The quantitative effect of height, age, and sex on lung function differed by region. Compared with North America or Europe, FEV1 adjusted for height, age, and sex was 31.3% (95% CI 30.8-31.8%) lower in south Asia, 24.2% (23.5-24.9%) lower in southeast Asia, 12.8% (12.4-13.4%) lower in east Asia, 20.9% (19.9-22.0%) lower in sub-Saharan Africa, 5.7% (5.1-6.4%) lower in South America, and 11.2% (10.6-11.8%) lower in the Middle East. We recorded similar but larger differences in FVC. The differences were not accounted for by variation in weight, urban versus rural location, and education level between regions. Interpretation Lung function differs substantially between regions of the world. These large differences are not explained by factors investigated in this study; the contribution of socioeconomic, genetic, and environmental factors and their interactions with lung function and lung health need further clarification.

Artículo original

The main PURE study and its components are funded by the Population Health Research Institute, the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, through unrestricted grants from several pharmaceutical companies (AstraZeneca [Canada], Sanofi-Aventis [France and Canada], Boehringer Ingelheim [Germany and Canada], Servier, and GlaxoSmithKline), and additional contributions from Novartis and King Pharma. Various national or local organisations in participating countries also contributed: Independent University, Bangladesh, and Mitra and Associates (Bangladesh)

Unilever Health Institute (Brazil)

Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network (Canada)

Universidad de la Frontera (Chile)

National Center for Cardiovascular Diseases (China)

Colciencias (grant 6566-04-18062

Colombia)

Indian Council of Medical Research (India)

Ministry of Science, Technology and Innovation of Malaysia (grant 07-05-IFN-MEB010), Universiti Teknologi MARA, and Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010

Malaysia)

Polish Ministry of Science and Higher Education (grant 290/W-PURE/2008/0) and Wroclaw Medical University (Poland)

North-West University, the South Africa Netherlands research Programme on Alternatives in Development, National Research Foundation, Medical Research Council of South Africa, South African Sugar Association, and Faculty of Community and Health Sciences (University of the Western Cape

South Africa)

AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, Swedish Heart and Lung Foundation, Swedish Research Council, the Swedish State under LakarUtbildnings Avtalet, and the Vastra Gataland Region (Forskning och Undervisning/Utveckling

Sweden)

Metabolic Syndrome Society, AstraZeneca, and Sanofi-Aventis (Turkey)

and Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority (United Arab Emirates).

El estudio principal PURE y sus componentes son financiados por el Population Health Research Institute, los Canadian Institutes of Health Research, la Heart and Stroke Foundation of Ontario, a través de subvenciones sin restricciones de varias compañías farmacéuticas (AstraZeneca [Canadá], Sanofi-Aventis [Francia y Canadá], Boehringer Ingelheim [Alemania y Canadá], Servier y GlaxoSmithKline), y contribuciones adicionales de Novartis y King Pharma. Varias organizaciones nacionales o locales en los países participantes también contribuyeron: Independent University, Bangladesh, y Mitra and Associates (Bangladesh)

Unilever Health Institute (Brasil)

Public Health Agency of Canada y Champlain Cardiovascular Disease Prevention Network (Canadá)

Universidad de la Frontera (Chile)

National Center for Cardiovascular Diseases (China)

Colciencias (subvención 6566-04-18062

Colombia)

Indian Council of Medical Research (India)

Ministerio de Ciencia, Tecnología e Innovación de Malasia (subvención 07-05-IFN-MEB010), Universiti Teknologi MARA y Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010

Malasia)

Ministerio de Ciencia y Educación Superior de Polonia (subvención 290/W-PURE/2008/0) y Universidad Médica de Breslavia (Polonia)

Universidad del Noroeste, Programa de investigación Sudáfrica-Países Bajos sobre alternativas en el desarrollo, Fundación Nacional de Investigación, Consejo de Investigación Médica de Sudáfrica, Asociación Sudafricana del Azúcar y Facultad de Ciencias Comunitarias y de la Salud (Universidad del Cabo Occidental

Sudáfrica)

AFA Insurance, Consejo Sueco para la Vida Laboral y la Investigación Social, Consejo Sueco de Investigación para el Medio Ambiente, las Ciencias Agrícolas y la Planificación Espacial, Fundación Sueca del Corazón y los Pulmones, Consejo Sueco de Investigación, el Estado sueco bajo LakarUtbildnings Avtalet y la Región de Vastra Gataland (Forskning och Undervisning/Utveckling

Suecia)

Sociedad del Síndrome Metabólico, AstraZeneca y Sanofi-Aventis (Turquía)

y el Premio Sheikh Hamdan Bin Rashid Al Maktoum de Ciencias Médicas y la Autoridad Sanitaria de Dubái (Emiratos Árabes Unidos).

10.1016/S2213-2600(13)70164-4

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REFERENCE VALUES

PULMONARY-FUNCTION

RISK-FACTORS

RESPIRATORY SYMPTOMS

SOCIOECONOMIC-STATUS

ETHNIC-DIFFERENCES

SECULAR TRENDS

FUNCTION TESTS

POPULATION

COUNTRIES

VALORES DE REFERENCIA

FUNCIÓN PULMONAR

FACTORES DE RIESGO

SÍNTOMAS RESPIRATORIOS

NIVEL SOCIOECONÓMICO

DIFERENCIAS ÉTNICAS

TENDENCIAS SECULARES

PRUEBAS DE FUNCIÓN

POBLACIÓN

PAÍSES

REFERENCE VALUES

PULMONARY-FUNCTION

RISK-FACTORS

RESPIRATORY SYMPTOMS

SOCIOECONOMIC-STATUS

ETHNIC-DIFFERENCES

SECULAR TRENDS

FUNCTION TESTS

POPULATION

COUNTRIES

VALORES DE REFERENCIA

FUNCIÓN PULMONAR

FACTORES DE RIESGO

SÍNTOMAS RESPIRATORIOS

NIVEL SOCIOECONÓMICO

DIFERENCIAS ÉTNICAS

TENDENCIAS SECULARES

PRUEBAS DE FUNCIÓN

POBLACIÓN

PAÍSES

Sistema Respiratorio

Epidemiología

Salud Pública y Ambiental

Global differences in lung function by region (PURE): an international, community-based prospective study

LANCET RESPIRATORY MEDICINE

hibrida

verde

metadata

metadata

PMID 24461663

en

Artículo original

versión publicada

Population Health Research Institute#Canadian Institutes of Health Research#Heart and Stroke Foundation of Ontario#AstraZeneca Canada#Sanofi-Aventis France#Sanofi-Aventis Canada#Boehringer Ingelheim Germany#Boehringer Ingelheim Canada#Servier#GlaxoSmithKline#Novartis#King Pharma#Independent University, Bangladesh#Mitra and Associates (Bangladesh)#Unilever Health Institute (Brazil)#Public Health Agency of Canada (Canada)#Champlain Cardiovascular Disease Prevention Network (Canada)#Universidad de la Frontera (Chile)#National Center for Cardiovascular Diseases (China)#Colciencias (Colombia) 6566-04-18062#Indian Council of Medical Research (India)#Ministry of Science, Technology and Innovation of Malaysia 07-05-IFN-MEB010#Universiti Teknologi MARA#Universiti Kebangsaan Malaysia (Malaysia) UKM-Hejim-Komuniti-15-2010#Polish Ministry of Science and Higher Education 290/W-PURE/2008/0#Wroclaw Medical University (Poland)#North-West University#South Africa Netherlands research Programme on Alternatives in Development#National Research Foundation#Medical Research Council of South Africa#South African Sugar Association#Faculty of Community and Health Sciences (University of the Western Cape#South Africa)#AFA Insurance, Swedish Council for Working Life and Social Research#Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning#Swedish Heart and Lung Foundation#Swedish Research Council#Swedish State under LakarUtbildnings Avtalet#Vastra Gataland Region (Forskning och Undervisning/Utveckling#Sweden)#Metabolic Syndrome Society (Turkey)#AstraZeneca (Turkey)#Sanofi-Aventis (Turkey)#Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences (United Arab Emirates)#Dubai Health Authority (United Arab Emirates)

Population Health Research Institute

Canadian Institutes of Health Research

Heart and Stroke Foundation of Ontario

AstraZeneca Canada

Sanofi-Aventis France

Sanofi-Aventis Canada

Boehringer Ingelheim Germany

Boehringer Ingelheim Canada

Servier

GlaxoSmithKline

Novartis

King Pharma

Independent University, Bangladesh

Mitra and Associates (Bangladesh)

Unilever Health Institute (Brazil)

Public Health Agency of Canada (Canada)

Champlain Cardiovascular Disease Prevention Network (Canada)

Universidad de la Frontera (Chile)

National Center for Cardiovascular Diseases (China)

Colciencias (Colombia) 6566-04-18062

Indian Council of Medical Research (India)

Ministry of Science, Technology and Innovation of Malaysia 07-05-IFN-MEB010

Universiti Teknologi MARA

Universiti Kebangsaan Malaysia (Malaysia) UKM-Hejim-Komuniti-15-2010

Polish Ministry of Science and Higher Education 290/W-PURE/2008/0

Wroclaw Medical University (Poland)

North-West University

South Africa Netherlands research Programme on Alternatives in Development

National Research Foundation

Medical Research Council of South Africa

South African Sugar Association

Faculty of Community and Health Sciences (University of the Western Cape

South Africa)

AFA Insurance, Swedish Council for Working Life and Social Research

Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning

Swedish Heart and Lung Foundation

Swedish Research Council

Swedish State under LakarUtbildnings Avtalet

Vastra Gataland Region (Forskning och Undervisning/Utveckling

Sweden)

Metabolic Syndrome Society (Turkey)

AstraZeneca (Turkey)

Sanofi-Aventis (Turkey)

Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences (United Arab Emirates)

Dubai Health Authority (United Arab Emirates)

ELSEVIER SCI LTD

2213-2600

599

609

Medicina de cuidados intensivos

Sistema respiratorio

Critical Care Medicine

Respiratory System

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WOS:000342690300014