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.

Objective: Chronic 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. Methods: Data 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. Results: In 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). Conclusion: This 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.