Evidence map›Paper›PMID 40791891›Full record

ArticleEClinicalMedicine2025

Factors influencing the prevalence and death rate of COPD: a pan-database ecological study covering 201 countries and regions from 1990 to 2021.

Zihui Wang, Wenhan Cao, Zhixuan You, Shaoqiang Li, Mingshan Xue, Haiyang Li, Junfeng Lin, Guannan Cai, Yuqi Chen, Zhiman Liang and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Zihui WangState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Wenhan CaoState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Zhixuan YouState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Shaoqiang LiState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Mingshan XueState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Haiyang LiState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Junfeng LinState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Guannan CaiState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Yuqi ChenState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Zhiman LiangState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Chengtao ZhouState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Xiaofang WuFirst People's Hospital of Chun'an County, China.
Guanghui DongGuangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, China.
Nanshan ZhongState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Baoqing SunState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.
Zhangkai J ChengState Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou Laboratory, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common, heterogeneous disease and may be influenced by diverse factors. However, gaps remain in previous studies regarding the exploration of potential influencing factors. This study aims to investigate the wide range of potential factors influencing COPD based on a pan-database ecological analysis. Methods: We integrated data from 17 global databases (e.g., the Global Burden of Disease Study) which encompass social, environmental, and health data across various regions. Generalized linear regression was used to analyze the association of cumulative and instant exposures of factors with COPD and to rank their importance. Spearman analysis was used to assess the correlation of various factors with COPD. Heatmaps, scatter plots, and nonclassical multidimensional scaling (i.e., network graph) were employed to visualize the correlations. Findings: The study aggregated 77 social and environmental factors, 85 lifestyle and dietary factors, 25 physiological indicators, and 28 diseases. In the cumulative exposure analysis, tobacco consumption, atmospheric pollutants (e.g., ozone, CO, and organic matter aerosol), biomass cooking, and climatic conditions (e.g., vapor pressure, solar radiation, and temperature) were found to be associated with COPD prevalence. Additionally, tobacco consumption, social factors (e.g., hunger index, gender inequality index, and education year), and climatic conditions significantly impacted death rates. The results for cumulative exposures were consistent with those for instant exposures. Network graph analysis indicated a positive correlation between COPD and chronic kidney disease, other chronic respiratory diseases, gout, and stroke. Interpretation: Various factors (e.g., tobacco consumption, atmospheric pollution, biomass cooking, temperature, social factors, and comorbidities) significantly influence COPD. Comprehensive interventions are needed to reduce the disease burden of COPD. Funding: The Foundation of Guangzhou National Laboratory (SRPG22-018, SRPG22-016), State Key Laboratory of Respiratory Disease (SKLRD-OP-202402), Zhejiang medical health science and technology project (2025KY1245), Multi-Center Clinical Research Project of Guangzhou Medical University (GMUCR2025-02009), and Guangzhou Municipal Science and Technology Bureau (SL2024A04J00706).

Indexed as

COPDDeath rateInfluencing factorsPan-database ecological studyPrevalence

Identifiers

PMID40791891
PMCPMC12337789

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.