Table 1_The burden and risk factors of chronic obstructive pulmonary disease in Asia and its countries from 1990 to 2021: a systematic analysis based on the 2021 global burden of disease study.xlsx

ObjectiveChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by airflow limitation that is not fully reversible. In Asia, risk exposures such as smoking and ambient PM₂.₅ are prevalent, and regional differences are significant. This has led to the COPD disease burden in this region being at a relatively high level globally. Based on this, this study conducts a systematic assessment of the COPD disease burden in Asia.
MethodsData on incidence, mortality, and disability-adjusted life years (DALYs) were obtained from the Global Burden of Disease (GBD) 2021 study. The analysis incorporated the Sociodemographic Index (SDI) and included stratification by sex and age to reveal the distribution and disparities in the burden of COPD across populations. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC) to estimate temporal trends. In addition, major attributable risk factors for COPD were analyzed to identify key drivers of disease burden across regions and populations.
ResultsIn 2021, the number of COPD cases in Asia reached 10,512,843 (95% UI: 9,610,006–11,432,970), with an age-standardized incidence rate of 210.79 per 100,000 persons (95% UI: 193.52–227.94). COPD accounted for 2,885,059 deaths (95% UI: 2,571,267–3,218,689), corresponding to an age-standardized mortality rate of 64.10 per 100,000 persons (95% UI: 56.74–71.66). The total DALYs were 60,507,100 (95% UI: 55,319,463–66,518,282), with an age-standardized rate of 1,253.15 per 100,000 persons (95% UI: 1,148.26–1,376.29). Among Asian subregions, South Asia bore the heaviest burden of COPD. Major risk factors included particulate matter (PM) pollution, smoking, secondhand smoke, and occupational exposure to particulate matter, gases, and fumes (OP-MGF).
ConclusionThis study highlights the substantial COPD burden in Asia, with air pollution, smoking, and occupational exposures being the predominant risk factors. Targeted public health interventions are urgently needed to mitigate the COPD burden and improve overall health outcomes in the region.

研究目的：慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）是一类以不完全可逆气流受限为特征的慢性呼吸系统疾病。亚洲地区吸烟、环境细颗粒物（PM₂.₅）等风险暴露因素流行广泛，且区域差异显著，导致该区域COPD疾病负担位居全球较高水平。基于此，本研究对亚洲地区的COPD疾病负担开展系统性评估。
研究方法：本研究从2021年全球疾病负担（Global Burden of Disease, GBD）研究中获取发病率、死亡率与残疾调整生命年（Disability-Adjusted Life Years, DALYs）相关数据。分析纳入社会人口学指数（Sociodemographic Index, SDI），并按性别与年龄进行分层，以揭示不同人群中COPD疾病负担的分布特征与差异。采用连接点回归模型（Joinpoint Regression Models）计算年度百分比变化（Annual Percent Change, APC）与平均年度百分比变化（Average Annual Percent Change, AAPC），以估算时间变化趋势。此外，本研究还分析了COPD的主要归因风险因素，以明确各区域及人群中疾病负担的关键驱动因子。
研究结果：2021年，亚洲地区COPD患病人数达10,512,843例（95%不确定区间：9,610,006–11,432,970），年龄标化发病率为每10万人210.79例（95%不确定区间：193.52–227.94）。COPD相关死亡人数为2,885,059例（95%不确定区间：2,571,267–3,218,689），对应年龄标化死亡率为每10万人64.10例（95%不确定区间：56.74–71.66）。总残疾调整生命年为60,507,100人年（95%不确定区间：55,319,463–66,518,282），年龄标化率为每10万人1,253.15人年（95%不确定区间：1,148.26–1,376.29）。亚洲各次区域中，南亚地区的COPD疾病负担最为沉重。主要风险因素包括颗粒物（Particulate Matter, PM）污染、吸烟、二手烟暴露以及职业性颗粒物、气体和烟雾暴露（Occupational exposure to particulate matter, gases, and fumes, OP-MGF）。
研究结论：本研究凸显了亚洲地区沉重的COPD疾病负担，其中空气污染、吸烟与职业暴露为主要风险因素。亟需制定针对性公共卫生干预措施，以减轻该地区的COPD疾病负担，改善整体健康结局。