Objective To report the prevalence of lower airway dysfunction in athletes and highlight risk factors and susceptible groups. Design Systematic review and meta-analysis. Data sources PubMed, EBSCOhost and Web of Science (1 January 1990 to 31 July 2020). Eligibility criteria Original full-text studies, including male or female athletes/physically active individuals/military personnel (aged 15–65 years) who had a prior asthma diagnosis and/or underwent screening for lower airway dysfunction via self-report (ie, patient recall or questionnaires) or objective testing (ie, direct or indirect bronchial provocation challenge). Results In total, 1284 studies were identified. Of these, 64 studies (n=37 643 athletes) from over 21 countries (81.3% European and North America) were included. The prevalence of lower airway dysfunction was 21.8% (95% CI 18.8% to 25.0%) and has remained stable over the past 30 years. The highest prevalence was observed in elite endurance athletes at 25.1% (95% CI 20.0% to 30.5%) (Q=293, I2=91%), those participating in aquatic (39.9%) (95% CI 23.4% to 57.1%) and winter-based sports (29.5%) (95% CI 22.5% to 36.8%). In studies that employed objective testing, the highest prevalence was observed in studies using direct bronchial provocation (32.8%) (95% CI 19.3% to 47.2%). A high degree of heterogeneity was observed between studies (I2=98%). Conclusion Lower airway dysfunction affects approximately one in five athletes, with the highest prevalence observed in those participating in elite endurance, aquatic and winter-based sporting disciplines. Further longitudinal, multicentre studies addressing causality (ie, training status/dose–response relationship) and evaluating preventative strategies to mitigate against the development of lower airway dysfunction remain an important priority for future research.

中文翻译：

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运动员下气道功能障碍的患病率：国际奥委会“运动员急性呼吸道疾病”共识小组的一个亚组进行的系统评价和荟萃分析

目的 报告运动员下呼吸道功能障碍的患病率，并突出危险因素和易感人群。设计系统回顾和荟萃分析。数据来源 PubMed、EBSCOhost 和 Web of Science（1990 年 1 月 1 日至 2020 年 7 月 31 日）。资格标准 原始全文研究，包括男性或女性运动员/身体活跃的个人/军事人员（15-65 岁），他们有哮喘诊断和/或通过自我报告接受下气道功能障碍筛查（即患者回忆或问卷调查）或客观测试（即直接或间接支气管激发挑战）。结果 总共确定了 1284 项研究。其中，纳入了来自超过 21 个国家（81.3% 欧洲和北美）的 64 项研究（n=37 643 名运动员）。下气道功能障碍的患病率为 21.8% (95% CI 18. 8% 至 25.0%），并在过去 30 年保持稳定。精英耐力运动员的患病率最高，为 25.1%（95% CI 20.0% 至 30.5%）（Q=293，I2=91%），参加水上运动的运动员（39.9%）（95% CI 23.4% 至 57.1%） ) 和冬季运动 (29.5%) (95% CI 22.5% 至 36.8%)。在采用客观测试的研究中，使用直接支气管激发的研究中观察到的患病率最高（32.8%）（95% CI 19.3% 至 47.2%）。研究之间观察到高度异质性（I2=98%）。结论 下气道功能障碍影响大约五分之一的运动员，在参加精英耐力、水上运动和冬季运动项目的运动员中观察到的患病率最高。进一步针对因果关系的纵向、多中心研究（即，