BACKGROUND Among U.S. adults, over 4 million report a history of epilepsy, and more than 15 million report a history of chronic obstructive pulmonary disease (COPD); Chronic obstructive pulmonary disease, which includes chronic bronchitis and emphysema, is a common somatic comorbidity of epilepsy. This study assessed the relationship between self-reported physician-diagnosed epilepsy and COPD in a large representative sample of the U.S. adult population and explored possible mechanisms. METHODS Cross-sectional National Health Interview Surveys for 2013, 2015, and 2017 were aggregated to compare the prevalence of COPD between U.S. respondents aged ≥18 years with a history of physician-diagnosed epilepsy (n = 1783) and without epilepsy (n = 93,126). We calculated prevalence of COPD by age-standardized adjustment and prevalence ratios of COPD overall adjusted for sociodemographic and risk factors, by using multivariable logistic regression analyses. A Z-test was conducted to compare the prevalence between people with and without epilepsy at the statistical significance level of 0.05. Prevalence ratios whose 95% confidence intervals did not overlap 1.00 were considered statistically significant. RESULTS The overall age-standardized prevalence was 5.7% for COPD and 1.8% for epilepsy. Age-standardized prevalence of COPD among respondents with epilepsy (15.4%) exceeded that among those without epilepsy (5.5%). The association remained significantly different among all sociodemographic and risk factor subgroups (p < .05). In the adjusted analyses, epilepsy was also significantly associated with COPD, overall (adjusted prevalence ratio = 1.8, 95% confidence interval = 1.6-2.1) and in nearly all subgroups defined by selected characteristics. CONCLUSIONS Epilepsy is associated with a higher prevalence of COPD in U.S. adults. Public health interventions targeting modifiable behavioral and socioeconomic risk factors among people with epilepsy may help prevent COPD and related premature death.

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美国成年人的癫痫和慢性阻塞性肺疾病：2013、2015 和 2017 年全国健康访谈调查

背景 在美国成年人中，超过 400 万人报告有癫痫病史，超过 1500 万人报告有慢性阻塞性肺病 (COPD) 病史；慢性阻塞性肺疾病，包括慢性支气管炎和肺气肿，是癫痫的常见躯体合并症。本研究评估了美国成年人群的大型代表性样本中自我报告的医生诊断癫痫与 COPD 之间的关系，并探讨了可能的机制。方法 汇总了 2013、2015 和 2017 年的横断面全国健康访谈调查，以比较年龄≥18 岁、有医生诊断的癫痫病史 (n = 1783) 和无癫痫病史 (n = 93,126) 的美国受访者之间的 COPD 患病率）。我们使用多变量逻辑回归分析通过年龄标准化调整和针对社会人口统计学和危险因素调整后的 COPD 患病率计算了 COPD 的患病率。进行 Z 检验以在 0.05 的统计显着性水平上比较患有和未患有癫痫症的人群之间的患病率。95% 置信区间不与 1.00 重叠的患病率被认为具有统计学意义。结果 COPD 的总年龄标准化患病率为 5.7%，癫痫为 1.8%。患有癫痫症的受访者中 COPD 的年龄标准化患病率 (15.4%) 超过了没有癫痫症的受访者 (5.5%)。这种关联在所有社会人口统计学和风险因素亚组中仍然存在显着差异（p < .05）。在调整后的分析中，癫痫也与 COPD 显着相关，总体而言（调整后的患病率比 = 1.8，95% 置信区间 = 1.6-2.1）和几乎所有由选定特征定义的亚组。结论 癫痫与美国成年人中较高的 COPD 患病率相关。针对癫痫患者可改变的行为和社会经济风险因素的公共卫生干预措施可能有助于预防 COPD 和相关的过早死亡。