Objective To report the global, regional, and national burden of chronic obstructive pulmonary disease (COPD) and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index. Design Systematic analysis. Data source Global Burden of Disease Study 2019. Main outcome measures Data on the prevalence, deaths, and disability adjusted life years (DALYs) of COPD, and its attributable risk factors, were retrieved from the Global Burden of Disease 2019 project for 204 countries and territories, between 1990 and 2019. The counts and rates per 100 000 population, along with 95% uncertainty intervals, were presented for each estimate. Results In 2019, 212.3 million prevalent cases of COPD were reported globally, with COPD accounting for 3.3 million deaths and 74.4 million DALYs. The global age standardised point prevalence, death, and DALY rates for COPD were 2638.2 (95% uncertainty intervals 2492.2 to 2796.1), 42.5 (37.6 to 46.3), and 926.1 (848.8 to 997.7) per 100 000 population, which were 8.7%, 41.7%, and 39.8% lower than in 1990, respectively. In 2019, Denmark (4299.5), Myanmar (3963.7), and Belgium (3927.7) had the highest age standardised point prevalence of COPD. Egypt (62.0%), Georgia (54.9%), and Nicaragua (51.6%) showed the largest increases in age standardised point prevalence across the study period. In 2019, Nepal (182.5) and Japan (7.4) had the highest and lowest age standardised death rates per 100 000, respectively, and Nepal (3318.4) and Barbados (177.7) had the highest and lowest age standardised DALY rates per 100 000, respectively. In men, the global DALY rate of COPD increased up to age 85-89 years and then decreased with advancing age, whereas for women the rate increased up to the oldest age group (≥95 years). Regionally, an overall reversed V shaped association was found between sociodemographic index and the age standardised DALY rate of COPD. Factors contributing most to the DALYs rates for COPD were smoking (46.0%), pollution from ambient particulate matter (20.7%), and occupational exposure to particulate matter, gases, and fumes (15.6%). Conclusions Despite the decreasing burden of COPD, this disease remains a major public health problem, especially in countries with a low sociodemographic index. Preventive programmes should focus on smoking cessation, improving air quality, and reducing occupational exposures to further reduce the burden of COPD. The data used for the analyses in the study are publicly available at .

中文翻译：

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1990-2019 年 204 个国家和地区的慢性阻塞性肺疾病负担及其归因危险因素：2019 年全球疾病负担研究结果

目的 按年龄、性别和社会人口学指数报告 1990 年至 2019 年间全球、区域和国家慢性阻塞性肺病 (COPD) 负担及其归因危险因素。设计系统分析。数据来源 2019 年全球疾病负担研究。主要结果测量 COPD 的患病率、死亡和残疾调整生命年 (DALYs) 及其归因风险因素的数据来自 2019 年全球疾病负担项目，针对 204 个国家和1990 年至 2019 年之间的领土。每 10 万人口的计数和比率，以及 95% 的不确定性区间，都针对每个估计值进行了介绍。结果 2019 年，全球报告了 2.123 亿例 COPD 流行病例，其中 COPD 死亡人数为 330 万，DALY 为 7440 万。全球年龄标准化点患病率，COPD 的死亡率和 DALY 率分别为每 10 万人口 2638.2（95% 不确定区间 2492.2 至 2796.1）、42.5（37.6 至 46.3）和 926.1（848.8 至 997.7），分别降低 8.7%、41.7% 和 39.8%分别比 1990 年。2019年，丹麦（4299.5）、缅甸（3963.7）和比利时（3927.7）的COPD年龄标准化点患病率最高。埃及（62.0%）、格鲁吉亚（54.9%）和尼加拉瓜（51.6%）在整个研究期间的年龄标准化点患病率增幅最大。2019 年，尼泊尔（182.5）和日本（7.4）的每 10 万人年龄标准化死亡率分别最高和最低，尼泊尔（3318.4）和巴巴多斯（177.7）每 10 万人的年龄标准化 DALY 率最高和最低，分别。在男性中，COPD 的全球 DALY 率在 85-89 岁之前增加，然后随着年龄的增长而下降，而对于女性来说，这一比例一直上升到最高年龄组（≥95 岁）。在区域上，社会人口学指数与 COPD 的年龄标准化 DALY 率之间存在整体反向 V 形关联。对 COPD DALYs 率影响最大的因素是吸烟 (46.0%)、环境颗粒物污染 (20.7%) 以及对颗粒物、气体和烟雾的职业暴露 (15.6%)。结论 尽管 COPD 的负担有所减轻，但这种疾病仍然是一个主要的公共卫生问题，尤其是在社会人口学指数较低的国家。预防计划应侧重于戒烟、改善空气质量和减少职业暴露，以进一步减轻 COPD 的负担。用于研究分析的数据可在以下网站公开获得.