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Meta-Analysis
. 2024 Oct 30;24(1):3010.
doi: 10.1186/s12889-024-20170-z.

Prevalence of non-smoking chronic obstructive pulmonary disease and its risk factors in China: a systematic review and meta-analysis

Yue Zhang  1 , Xiaoyan Gai  1 , Hongling Chu  2 , Jingge Qu  1 , Liang Li  3 , Yongchang Sun  4
Affiliations
Meta-Analysis

Prevalence of non-smoking chronic obstructive pulmonary disease and its risk factors in China: a systematic review and meta-analysis

Yue Zhang et al. BMC Public Health. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disorder in China, impacting a significant proportion of individuals aged > 40 years. In China, the prevalence of and risk factors for COPD among non-smokers remain largely unexplored. In this study, we aimed to determine the prevalence of COPD in non-smokers within the Chinese population and identify potential risk factors associated with COPD in non-smokers.

Methods: Web of Science, PubMed, Embase, Chinese WanFang, Chinese China National Knowledge Infrastructure, and Weipu databases from inception to August 5, 2024, were searched. Studies reporting the percentage of never-smokers among those diagnosed with COPD and investigations exploring the risk factors associated with COPD in never-smokers in China were examined. Summary proportions and odds ratios (OR), along with their corresponding 95% confidence intervals (95% CI), were measured.

Results: In total, 112 investigations with 491,812 participants were included. The percentage of never-smokers in people with COPD was 41.1% (95% CI: 37.5-44.6%). The prevalence of never-smokers among males diagnosed with COPD was 22.3% (95% CI: 18.8-25.7%), which differed from that among women (81.3%, 95% CI: 75.3-87.2%). The results showed an association between the utilization of biomass fuel and the occurrence of COPD in never-smokers (OR: 1.25, 95% CI: 1.06-1.44). Among never-smokers, the data showed a close association between being underweight (OR: 1.89, 95% CI: 1.78-2.00), tuberculosis history (OR: 1.71, 95% CI: 1.53-1.88) and COPD. Never-smokers living in rural areas or those with low educational status were more susceptible to COPD.

Conclusion: This review confirmed the highly different proportions of never-smokers among male and female patients with COPD.

Trial registration: PROSPERO: CRD42023420786.

Keywords: Chronic obstructive pulmonary disease; Non-smoker; Proportion; Risk factor.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
The percentage of never-smokers in COPD patients
Fig. 3
Fig. 3
The percentage of never-smokers in male COPD patients
Fig. 4
Fig. 4
The percentage of never-smokers in female COPD patients
See this image and copyright information in PMC

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