The Association Between Stomach Disease and Chronic Obstructive Pulmonary Disease: A Cross–Sectional Analysis of the 2018 China Health and Retirement Longitudinal Study (CHARLS)

Hui Wang,1,* Yi-Zhao Sun,2,* Shu-Yi Li3 1Department of Urology, Lhasa People’s Hospital, Lhasa, Xizang Autonomous Region, People’s Republic of China; 2Department of Pharmacy, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of China; 3Department of General Practice, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shu-Yi Li, Department of General Practice, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of China, Email [email protected]: Chronic obstructive pulmonary disease (COPD) has become a global epidemic and is the third leading cause of death worldwide. However, its diagnostic rate is low. Based on the 2018 wave of China Health and Retirement Longitudinal Study (CHARLS) database, this cross–sectional study aimed to investigate the association between stomach disease and COPD using a nationally representative sample.Patients and Methods: A total of 9119 CHARLS subjects were divided into COPD and non–COPD groups using the DA007_5 questionnaire. Both COPD and stomach disease were identified based on participants’ self–reported physician diagnoses from the standardized CHARLS questionnaire. Baseline characteristics were compared between groups, and multivariate logistic regression analysis was used to analyze the association between stomach diseases and COPD. Receiver operating characteristic (ROC) curve assessment of Model 3’s predictive capacity for COPD and stratified analysis verified correlation stability.Results: In baseline comparisons, multiple covariates differed significantly between COPD and non–COPD groups (p< 0.05). However, the core regression analysis showed that stomach disease was significantly associated with COPD in Model 3 (OR = 1.95, 95% CI = 1.46– 2.57, p = 3.61E– 06), after full adjustment for potential confounders. Model 1 (odds ratio (OR) = 3.12, 95% confidence interval (CI) = 2.43– 3.98, p = 1.95E– 19), Model 2 (OR = 3.21, 95% CI = 2.49– 4.1, p = 3.65E– 20), and Model 3 (OR = 1.95, 95% CI = 1.46– 2.57, p =3.61E– 06) revealed that stomach disease was a risk factor for COPD. Furthermore, the ROC curve indicated a good prediction performance for Model 3. Stomach disease remained significantly associated with COPD in all three models (P < 0.05). In addition to stomach disease, sex (male), health status, dyslipidemia, liver disease, heart attack, kidney disease, and asthma were significantly associated with COPD.Conclusion: In this cross–sectional analysis of a nationally representative Chinese cohort, stomach disease was significantly associated with COPD, extending prior evidence and suggesting its role in risk assessment. Causality cannot be inferred; prospective spirometry–confirmed studies are needed.Keywords: chronic obstructive pulmonary disease, stomach disease, China health and retirement longitudinal study, cross–sectional study